“Pathways”: A hope-enhancing intervention for patients undergoing treatment for advanced lung cancer

Laurie E. McLouth, Brent J. Shelton, Vilma Bursac, Jessica L. Burris, Jennifer S. Cheavens, Kaitlyn Weyman, Amy H. Peterman, Lauren Corum, Jamie L. Studts, Susanne M. Arnold

Research output: Contribution to journalArticlepeer-review


Objective: Observational data suggest hope is associated with the quality of life and survival of people with cancer. This trial examined the feasibility, acceptability, and preliminary outcomes of “Pathways,” a hope intervention for people in treatment for advanced lung cancer. Methods: Between 2020 and 2022, we conducted a single-arm trial of Pathways among participants who were 3–12 weeks into systemic treatment. Pathways consisted of two individual sessions delivered during infusions and three phone calls in which participants discussed their values, goals, and goal strategies with a nurse or occupational therapist. Participants completed standardized measures of hope and goal interference pre- and post-intervention. Feasibility was defined as ≥60% of eligible patients enrolling, ≥70% of participants completing three or more sessions, ≥70% of participants completing post-assessments, and mean acceptability ratings ≥7 out of 10 on intervention relevance, helpfulness, and convenience. Linear regression fixed effects models with covariates modeled pre–post changes in complete case analysis and multiple imputation models. Results: Fifty two participants enrolled: female (59.6%), non-Hispanic White (84.6%), rural (75.0%), and with low educational attainment (51.9% high school degree or less). Except for enrollment (54%), feasibility and acceptability markers were surpassed (77% adherence, 77% retention, acceptability ratings ≥8/10). There was moderate improvement in hope and goal interference from pre-to post-intervention (d = 0.51, p < 0.05 for hope; d = −0.70, p < 0.005 for goal interference). Conclusions: Strong feasibility, acceptability, and patient-reported outcome data suggest Pathways is a promising intervention to increase hope and reduce cancer-related goal interference during advanced lung cancer treatment.

Original languageEnglish
Article numbere6316
Issue number3
StatePublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2024 John Wiley & Sons Ltd.


  • cancer
  • goal setting
  • goals
  • hope
  • lung neoplasms
  • oncology
  • psychosocial intervention

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Oncology
  • Psychiatry and Mental health


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