Sexual Health and Rehabilitation (SHARE): An Online Educational Intervention for Young Adult Female Cancer Survivors - Project Summary Sexual dysfunction is one of the most common and distressing consequences of cancer therapy for young female (YF) cancer survivors, with more than 50% of YF survivors reporting chronic sexual problems,2,3,4 including pain with sexual activity, vulvo-vaginal atrophy, and low desire. Severe sexual dysfunction sharply diminishes psychological well-being and quality-of-life7,8 for YF survivors. For young women who are developing or trying to maintain intimate relationships, the consequences can be devastating5. However, sexual health rehabilitation is not available for most young women suffering from treatment-related sexual dysfunction.36,37 To address this gap in survivorship care, the PI previously developed and piloted a brief (3- hour), group-delivered, skills-based intervention called SHARE (Sexual Health And Rehabilitation). SHARE is a self-management intervention that integrates state-of-the-art sexual rehabilitation with body awareness training, elements of mindfulness-based cognitive therapy and individual action planning. In two previous single-arm, pilot trials, SHARE significantly reduced cancer-related female sexual dysfunction15 as well as psychological distress. However, in its existing form, SHARE requires in-person attendance, which limits access only to those with the time, means and ability to attend. To overcome this barrier, while building on our previous success, we adapted the intervention for online delivery via videoconference format (SHAREonline) and subsequently conducted informal pretesting of materials and format. Synchronous videoconferencing is a format that has been shown to be as effective as in-person group61 but never before used to deliver sexual rehabilitation to young cancer survivors. We now propose a Phase II “proof-of-concept” RCT to examine preliminary effects of SHAREonline to reduce sexual dysfunction and psychological distress in a sample of 84 YF survivors. We will randomize 84 young female cancer survivors with sexual health concerns to either the SHAREonline intervention or to an Enhanced Usual Care attention control condition (2:1) consisting of education only. Sexual function will be assessed at baseline and at 8- and 16-weeks post-intervention. Feasibility, acceptability, and credibility, including credibility of the control condition, will be examined to prepare for a definitive efficacy trial. Women also receive take-home educational materials and a single booster telephone call 4 weeks post-group session. SHAREonline was developed to meet the needs for accessible and efficient intervention for young survivors. Whereas most YF survivors currently have no access to evidence-based sexual health rehabilitation, SHAREonline has the potential to help close a major gap in survivorship care. Evaluating preliminary effects of SHAREonline is a critical next step for planning a future efficacy trial, and ultimately ensuring SHAREonline is an effective and widely available intervention to improve the health and quality-of-life of young female cancer suffering from pronounced sexual dysfunction.
