Overcoming Psychological Distress Through Hymns

African Americans have a strong cultural history of relying on hymns to overcome oppression
and mental suffering encountered in their lived experience. This study will evaluate the
feasibility and acceptability of an intervention using hymns in reducing psychological
distress among African Americans during treatment for cancer. Study participants will take
part in 4 data collection sessions and also asked to view and provide feedback on audio- or
video recorded vignettes of African Americans use of hymns to reduce psychological distress
during the diagnosis and treatment for cancer. The findings from this preliminary study will
contribute to the body of research about incorporating spirituality in cancer care to
achieving optimal patient outcomes.

This feasibility study uses a randomized control design and qualitative methods to: 1)
determine feasibility and acceptability, and 2) estimate effect sizes for outcomes of
psychological distress, spiritual well-being, patient-physician communication, supportive
family relationships, and quality of life. African American patients with late stage cancer
and their FCGs will be randomized to receive the Overcoming Psychological Distress through
Hymns Intervention or usual care for 3 weeks. At the end of the intervention period, the
usual care study arm usual will receive the 3 week intervention. Participants will have 4
study visits where they will complete questionnaires and take part in open-ended,
semi-structured interviews and structured interviews. Questions asked will focus on
demographic characteristics of the sample such as age, education, whether residence is urban
or rural, religious affiliation, marital status, proximity to family, type cancer, date of
diagnosis, date of treatment. Structured interview questions will include measures of
psychological distress, spiritual well-being, relationship well-being, patient-physician
communication, and quality of life. Open ended interviews will focus on usefulness and
satisfaction with the video and audio recordings. Open ended interviews will be
audio-recorded. Participants will be in the study for 12 weeks to complete all follow up
visits.

Inclusion Criteria for Patients:

- Age 50-89 years

- Newly diagnosed with a stage 3 or 4 cancer

- Treatment plans to include weekly outpatient chemotherapy

- Previously screened and with any level of psychological distress

- Willingness to participate in all study activities including data collection

- Willing to identify a family caregiver (FCG) (immediate or extended family member) to
also participate

Exclusion Criteria for Patients:

- Have completed surgery with no plans for chemotherapy

- Find conversations around religion or spirituality emotionally upsetting

- Have completed more than half of prescribed chemotherapy treatments

- In hospice care

- Not able to provide informed consent

Inclusion Criteria for Family Caregiver:

- Immediate or extended family member of the patient

- 18 years of age or older

- Able to provide informed consent

- Willing to participate in study activities, including data collection

Exclusion Criteria for Family Caregiver:

- Find conversations around religion or spirituality emotionally upsetting