Cancer survivors with ostomies, most commonly rectal and bladder cancers, face complex adjustment issues.
Typically, post-operative care does not adequately prepare cancer survivors for ostomy self-management,
behavior change, psychological support or healthy living, which is requisite to assure optimal Health-Related
Quality of Life (HRQOL). We developed an ostomy nurse and peer ostomate-led post-treatment chronic care-
based Ostomy Self-Management Telehealth program (OSMT). This program is an education and support
curriculum delivered in the group setting for both cancer survivors and their caregiver/support person. We
received positive pilot feasibility results, but encountered major access barriers in patients getting to a
centralized location to participate in the program. Therefore, we are utilizing telehealth as a delivery method to
improve cancer survivor ability to participate. For this study, we will target patients living in rural and other
The proposal is a randomized controlled study of our self-management program delivered by telehealth
intervention compared to an Attention Control Condition (ACC) group. We expect OSMT subjects will improve
patient activation, self-efficacy, HRQOL and knowledge via: 1) techniques for self-management to handle
frustration, fatigue, pain, isolation, equipment, social situations; 2) overcoming barriers to appropriate exercise;
3) communication skills; 4) nutrition, menu planning, meal timing. In addition, we hope to show a cost benefit to
the program, and evidence of reimbursement in the community.
Aim 1: Using our enhanced telehealth techniques, determine if patient activation (PA), self-efficacy, ostomy-
related knowledge, and HRQOL are improved and sustained over time, comparing OSMT and attention control
condition (ACC) groups in rural populations.
Aim 2: Determine whether third-party reimbursement for telehealth care encounters are comparable to those
for in-person visits and adequate for supporting our OSMT intervention in rural areas.