Pilot Feasibility of DESCANSO: Cognitive Behavioral Therapy for Latino Cancer Patients to Treat the Symptom Cluster Depression, Insomnia and Fatigue

PROJECT SUMMARY Symptoms of depressed mood, insomnia, and fatigue (DIF) frequently co-occur in cancer patients and Latinos report higher symptom burden than non-Latino white cancer patients. When cancer patients experience these symptoms as a cluster, they lead to more severe burden and poorer quality of life, than do the symptoms individually. Notably, the onset of one symptom can trigger others in this cluster,6 underscoring the importance of treating initial symptoms (e.g., insomnia/fatigue) to prevent the onset of others (e.g., depressed mood). This proposal aims develop and pilot a CBT intervention, DESCANSO (Depresión/Depression, Cansancio/Fatigue, and Sueño/Sleep; Rest in English) to treat the DIF cluster in Spanish speaking Latino cancer patients. This study will be supported by a strong collaboration of clinics in New York (NY), and Puerto Rico addressing local and national disparities in availability of symptom management interventions. Our overall goal is to adapt, refine and pilot the DESCANSO intervention using the ORBIT model for developing behavioral treatments, and the Ecological Validity Framework for cultural adaptation of interventions. Our specific aims are: 1) Refine (culturally adapting) the intervention (DESCANSO) with CBT strategies to treat insomnia, depression, and fatigue (DESCANSO) in Latino patients; and 2) Determine the feasibility of DESCANSO via telehealth and further refine the intervention. We will conduct an open pilot followed by a randomized feasibility pilot with 100 Latino cancer patients (50 from New York and 50 from Puerto Rico) randomized to two arms: 1) DESCANSO or 2) Enhanced usual care. DESCANSO will be the first culturally adapted symptom management intervention to treat cancer-related depression, insomnia, and fatigue in Spanish speaking Latino patients.