Dyadic yoga Program for Patients with Lung Cancer Undergoing Radiotherapy and their Family Caregivers

Patients with lung cancer, on the most prevalent cancer diagnoses in the United States, tend to experience debilitating physical and psychological sequelae. Common symptoms include reduced lung function, dyspnea, fatigue, sleep disturbances, and depression compromising their physical function and quality of life (QOL). Consequently, patients have a high need for care and support. Patients’ family members are their most important and valued source of support and care; yet, caregiving is physically and emotionally taxing. In fact, family caregivers report high rates of psychological distress, fatigue, and sleep disturbances, which may undermine the quality of care they are able and willing to provide to the patient. Including caregivers in supportive care interventions may not only reduce caregiver burden but may potentially improve patient outcomes beyond the typical patient-oriented programs. Thus, there is a need to establish evidence-based dyadic interventions targeting both patient and caregiver outcomes. To this end, we have systematically built a program of research testing a patient-caregiver dyadic yoga program to address the needs of this vulnerable population. The parent R37 project seeks to examine the efficacy of an instructor-led dyadic yoga program regarding improved objective physical function and QOL outcomes in both patients and caregivers while patients are undergoing standard thoracic radiotherapy. With the goal to facilitate the large-scale implementation of this promising intervention with a flexible, cost-effective delivery strategy, we now propose to deliver the intervention on-demand via a mobile application. Under the proposed R37 extension project, we seek to field test a mobile app prototype and assess the feasibility, usability, and acceptability of the app-based yoga program in 20 patient-caregiver dyads. We will examine social determinants of health variables as correlates of these study outcomes to ensure that the app is acceptable to families from diverse backgrounds. We will use a mixed-methods approach to understand the experience of participants with the intervention and its delivery using qualitative accounts. Participant feedback will inform the need to refine and enhance the yoga app. The proposed innovative work will provide rich pilot data that will inform a subsequent, larger trial seeking to test the effectiveness of the app-based program in the community setting. Thus, this study represents a compelling next step of this program of research to support this vulnerable patient-caregiver population. Together, the results of the parent project—a rigorous, single-blind randomized controlled trial with a stringent comparison group—beautifully dovetail with the knowledge gained from the proposed pilot trial to inform future implementation research and ultimately, the clinical care of this high need population.