Feasibility Testing of Remotely-Delivered Metacognitive Strategy Training in Cancer-Related Cognitive Impairment.

Boone, Anna; Kiselica, Andrew; Earwood, Juliana; Golzy, Mojgan; Reid-Arndt, Stephanie; Wolf, Timothy J · Arch Phys Med Rehabil · 2025

rct · Level II

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Abstract

To evaluate the feasibility and preliminary effects of remotely delivered metacognitive strategy training (MCST) to address CRCI in breast cancer survivors. Single-blind, pilot randomized controlled trial SETTING: University research laboratory and community PARTICIPANTS: Women with self-reported CRCI, aged 40-80 years, who completed chemotherapy for breast cancer between six months and three years prior were recruited from a local cancer center and community support groups. Outcome data were gathered pre- and post-intervention. Participants (n=42) were randomized to either a 10-session Cognitive Orientation to daily Occupational Performance (CO-OP; i.e., a type of MCST) group or an attention control + education group. All study procedures were conducted via secure videoconferencing. 10, 45-minute weekly sessions of remotely-delivered metacognitive strategy training or an attention + education control group MAIN OUTCOME MEASURES: The primary aim of this study was to evaluate feasibility RESULTS: The study demonstrated strong feasibility with a 41% recruitment rate and a 91.3% retention rate. Participants rated the CO-OP intervention and its remote delivery as highly feasible, appropriate, and acceptable. The intervention group showed small to medium positive effects on trained activity performance goals, cognition in daily life, and executive function measures compared to the control group. The control group showed a small positive effect on quality-of-life outcomes compared to the intervention group. Breast cancer survivors found the remotely-delivered CO-OP intervention to be suitable and practical. The positive effects of CO-OP on activity performance and cognitive outcomes support the need for further research on efficacy.