Meagan Whisenant, PhD, RN, is applying her two decades of symptom science experience to two new grant-funded research projects. One aims to support patients experiencing brain tumors and their caregivers, and the other focuses on chemoprevention of breast cancer. Whisenant is an associate professor in the Department of Research at the Cizik School of Nursing at UTHealth Houston.

Creating helpful interventions for caregivers of patients with brain tumors

While assisting with a COVID-19 vaccination drive in 2021, Whisenant noticed a woman helping her husband get out of the car.

“It was evident to me that she was struggling, so I went over to her to give a helping hand and learned that her husband was a brain tumor patient and struggled with mobility,” said Whisenant. “My exchange with the couple got my wheels turning, and I began to think about the challenges caregivers of patients with brain tumors have and what could be done to help them.”

The interaction led Whisenant to collaborate as co-principal investigators with Kathrin Milbury, PhD, and Shiao-Pei Weathers, MD, of The University of Texas MD Anderson Cancer Center, to apply for an R21 grant through the National Institutes of Health/National Cancer Institute for a research project titled “Simulation-Based Caregiving Skills Training for Family Members of High-Grade Glioma Patients.” Cizik School of Nursing Associate Professor Kristin Ownby, PhD, RN, is consulting on the project as well.  The team will use the $275,000 grant to pilot-test methods that may help family members better manage the care of a loved one with a brain tumor.

“A cancer diagnosis impacts the entire family. Family caregivers shoulder tremendous responsibility for managing patient symptoms and treatment,” said Whisenant. “Caregivers of those with brain tumors face unique challenges, given the rapid decline and poor prognosis. Distress among these caregivers is particularly high, reducing the quality of care they can provide to their loved one.”

The needs of families caring for a loved one with a brain tumor can quickly change, especially when the patient is symptomatic. These patients may also experience mood or personality shifts, which can be emotionally trying for a caregiver. 

“It stands to reason that a behavioral intervention addressing both tangible caregiving skills and emotional coping skills might be beneficial to this population,” she said.

The pilot study will deliver content in three ways: educational materials, including a workbook and brief instructional videos; two simulation-based caregiving skill sessions led by registered nurses in the Smart Apartment at the Cizik School of Nursing; and two psychoeducation sessions that offer ways to cope emotionally and manage changing roles. 

“To date, in the neuro-oncological setting, interventions for family caregivers that integrate hands-on training with emotional coping strategies are lacking,” said Whisenant.

The study will be one of the first to target caregiving skills using simulation-based instruction tailored specifically for a family’s particular needs. To date, most interventions for caregivers of patients with brain tumors don’t offer personalized training or the flexibility often required for these families.

“As it stands now, it is largely unknown how a simulation-based caregiver intervention may improve patient outcomes. However, given that distress and quality of life are interdependent in families coping with cancer, there is reason to believe the patient’s symptoms and quality of life may improve as well,” said Whisenant. “The data gleaned through this research will be looked at in additional ways to help caregivers and patients navigate other challenging chronic conditions.”

Preventing breast cancer in high-risk populations

Another of Whisenant’s research proposals, “Adherence to chemoprevention among women at high risk for breast cancer,” was recently selected for a $2,000 Elizabeth W. Quinn Oncology Research Award.

“Breast cancer is the most commonly diagnosed cancer in women, with one in eight diagnosed with invasive breast cancer during their lifetime. There is evidence that for the 10 million women in the U.S. who are considered high risk, certain interventions, including chemoprevention, may help reduce the likelihood of developing it," said Whisenant.

Whisenant added that despite the benefits and effectiveness of chemoprevention in reducing the risk of breast cancer by as much as 50%, research has shown that nearly half of the women recommended for chemoprevention don’t follow through with it for a variety of reasons.

Through her collaborative research with Jessica Jones, MD, a breast medical oncologist at McGovern Medical School at UTHealth Houston, Whisenant has identified specific barriers that may hinder women from adhering to a chemoprevention regime, including a lack of understanding of breast cancer risk, ineffective patient-provider communication, and bothersome symptoms.

"We also have found that social determinants of health, including race, ethnicity, socioeconomic status, insurance status, education, and employment, play a role," said Whisenant.

She and her team will use the funds to conduct a pilot study to increase breast cancer preventive behaviors among women prone to developing the disease. At the same time, the study will explore women's experience when it's suggested they begin chemoprevention.

To carry out the study, Whisenant and her team will enroll 20 women whose providers have recommended they receive chemoprevention, representing clinics with high concentrations of Black and Hispanic women predisposed to developing breast cancer. 

The team will follow the participants for eight weeks to capture their chemoprevention adherence to help inform future studies and intervention development.

“If we move the needle just a little bit on cancer prevention, we are moving in the right direction,” said Whisenant. “Learning about adherence to chemoprevention, in combination with educating women on how certain lifestyle behaviors can impact a diagnosis, holds promise for decreasing the prevalence of breast cancer among certain high-risk populations in the future,” she said.

Laura Frnka Davis