{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:49:59Z","timestamp":1788929399241,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The Lee\u2010Jones model posits that antecedent individual and interpersonal factors predicate the development of fear of cancer recurrence (FCR) through cognitive and emotional processing, which further to behavioral, emotional, and\/or physiological responses. We analyzed data from <jats:italic>FoRtitude<\/jats:italic>, a FCR intervention grounded in the Lee\u2010Jones FCR model, to evaluate associations between FCR antecedents, resources (e.g., breast cancer self\u2010efficacy, BCSE) and psychological and behavioral consequences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women with breast cancer who completed treatment and reported clinically elevated levels of FCR were randomized into a 4\u2010week online psychosocial intervention or contact control group. We assessed BCSE, FCR, and physical activity, anxiety and depression, or symptoms at baseline, 4 and 8\u00a0weeks. Separate structural equation models were constructed with both baseline data and change scores (baseline\u20108\u00a0weeks) to examine the pathways linking BCSE, FCR and: (1) physical activity; (2) anxiety and depression; and (3) symptoms (fatigue, sleep disturbance, cognitive concerns).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, higher levels of BCSE were associated with lower levels of FCR. Higher FCR was associated with worse psychological effects and symptoms but not behavioral response. Change models revealed that an increase in BCSE was associated with a decrease in FCR at 8\u2010week assessment, which was associated with reductions in psychological effects. A change in BCSE was also directly associated with reductions in psychological effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Results support the Lee\u2010Jones model as a foundation for FCR interventions among breast cancer survivors. Replicability among varied populations is needed to examine effects on behavioral outcomes of FCR such as health care utilization.<\/jats:p><jats:p><jats:italic>Clinical Trials Registration<\/jats:italic>: NCT03384992.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.6076","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T09:33:45Z","timestamp":1670232825000},"page":"256-265","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Validation of the Lee\u2010Jones theoretical model of fear of cancer recurrence among breast cancer survivors using a structural equation modeling approach"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7318-3387","authenticated-orcid":false,"given":"Alexander R.","family":"Lucas","sequence":"first","affiliation":[{"name":"Department of Health Behavior and Policy, Internal Medicine \u2010 Cardiology Virginia Commonwealth 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