Promoting resilience in stress management (PRISM) for patients with early stage breast cancer: a pilot feasibility study.
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PURPOSE: Women with breast cancer often experience persistent psychological distress. Promoting resilience in stress management (PRISM) is a manualized, skills-based, psychosocial intervention shown to promote resilience and alleviate psychological distress among adolescents and young adults with cancer. METHODS: This pilot, convergent mixed methods study examined PRISM's feasibility and in-sample preliminary impact (single-group) on psychosocial outcomes of women with early stage breast cancer (EBC). Women receiving chemotherapy for stage I-III breast cancer completed six standard PRISM sessions focused on rapport building, stress management, goal setting, cognitive reframing, meaning-making, and family integration. Feasibility, the primary outcome, was defined as 70% of participants completing all intervention sessions and pre-post survey. Secondary outcomes included intervention acceptability, appropriateness, and 8 psychosocial outcomes. Patient perspectives on PRISM were elucidated via qualitative interviews and deductively analyze. Pre- and post-intervention changes in survey scores were analyzed using paired t-tests and Cohen's d effect size. RESULTS: Of 57 patients approached, 30 (53%) participated in PRISM; participants were 57% Black with median age of 51 years (IQR 47-59). PRISM sessions were feasible based on the 83% completion rate. Additional secondary implementation outcomes also demonstrated feasibility, acceptability, and appropriateness using validated survey measured. The largest effects were observed in participants' resilience (d = 0.6), growth (d = 0.5), and self-improvement (d = 0.5). Interviews supported both feasibility and impact of PRISM. CONCLUSION: The PRISM-EBC intervention was feasible, and pre-post changes suggest potential benefit, warranting further investigation in a future randomized controlled trial.