POEM (Practice Of Embracing Each Moment) STUDY
POEM (Practice Of Embracing Each Moment) STUDY
A cancer diagnosis is extremely stressful, emotionally challenging, and often life-altering
 for both patients and their loved ones. Although more than one-third of patients experience
 distress, doctors are typically at a loss as to how to help patients and their families
 manage these emotional challenges. Mindfulness-based programs, including meditation, are
 offered at major medical centers in the US and have been found to help reduce stress and
 improve quality of life among cancer patients. However, these classes often require 30+ hours
 of in-person instruction over 8 weeks, which is neither practical nor feasible for patients
 undergoing chemotherapy due to side effects and scheduling conflicts.

 This study will test whether an 8-week mobile app-based mindfulness program is accepted and
 useful for patients who have recently received chemotherapy and their loved ones. It will
 also test whether it is feasible to randomize participants into three groups: intervention,
 active control (receiving progressive muscle relaxation through the same app) and a wait list
 control group (will receive the meditation intervention 8 weeks later), so that a future
 study can test whether mindfulness intervention can help reduce stress and improve quality of
 life. Because many Americans own smartphone or tablet, an app that can teach stress reduction
 techniques at home or at infusion clinics has great potential to address emotional needs that
 providers often cannot.

 The study will also include caregivers of patients who have recently received chemotherapy as
 research has shown that caregivers tend to show high levels of stress and depression and
 worse physical health compared to non-caregivers. The negative effects of caregiving are most
 pronounced in caregivers of patients with cancer. However, little support is directed to
 caregivers as most medical attention goes toward the patients. The patient-caregiver
 relationship may serve as a source of mutual support and a surrogate for community, which is
 traditionally considered to be an essential ingredient for sustaining mindfulness practices.

 If this study is successful, it will justify a larger trial to determine if use of a
 mindfulness app is effective in reducing stress and improving quality of life for cancer
 patients and caregivers. If effective, this low-cost stress reduction strategy could be
 distributed and used for all types and stages of cancer patients and their caregivers,
 anywhere, any time, helping to improve the quality of life of the many individuals affected
 by cancer.
Inclusion Criteria:

 -  active member of Kaiser Permanente Northern California

 -  a diagnosis of cancer, and currently undergoing chemotherapy or completed chemotherapy
 in the past 6 months at time of recruitment

 -  English literacy/fluency, access to a smartphone, a tablet (e.g., iPad) or a computer
 with internet

 -  Caregivers: a partner, other family member, or a close friend who identify him/herself
 as the patient's primary unpaid caregiver. English literacy/fluency, access to a
 smartphone, a tablet (e.g., iPad) or a computer with internet access

 Exclusion Criteria:

 -  Deafness

 -  severe mental illness

 -  Hospital Anxiety and Depression Scale score <8 or >14 on either anxiety or depression
 scale (patient only)

 -  current stress reduction practice