{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T05:38:45Z","timestamp":1768282725396,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["AD\u20101511\u201033395"],"award-info":[{"award-number":["AD\u20101511\u201033395"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The comparative effectiveness study (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>, NCT03016403) assessed the effects of a <jats:italic>stepped\u2010care intervention<\/jats:italic> versus usual care on mental health outcomes, including anxiety, depression, coping self\u2010efficacy, emotional distress (anxiety and depression combined), health\u2010related quality of life (HRQoL), and perceived stress among underserved patients (i.e., low\u2010income, uninsured, underinsured) with lung cancer (LC) and head\u2010and\u2010neck cancer (HNC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a randomized controlled trial, we investigated if 147 patients who received the <jats:italic>stepped\u2010care intervention<\/jats:italic> had better mental health outcomes compared to 139 patients who received usual care. Using an intent\u2010to\u2010treat approach, we analyzed outcomes with linear mixed models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For the primary outcomes estimated mean differences (denoted by \u201c\u0394\u201d), depression (\u0394\u00a0=\u00a01.75, 95% CI\u00a0=\u00a00.52, 2.98, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01) and coping self\u2010efficacy (\u0394\u00a0=\u00a0\u221215.24, 95% CI\u00a0=\u00a0\u221226.12, \u22124.36, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01) were better for patients who received the intervention compared to patients who received usual care, but anxiety outcomes were not different. For secondary outcomes, emotional distress (\u0394\u00a0=\u00a01.97, 95% CI: 0.68, 3.54, <jats:italic>p<\/jats:italic> =&lt; 0.01) and HRQoL (\u0394\u00a0=\u00a0\u22124.16 95% CI: \u22127.45, \u22120.87, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01) were better for patients who received the intervention compared to usual care patients, while perceived stress was not different across groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The <jats:italic>stepped\u2010care intervention<\/jats:italic> influenced depression and coping self\u2010efficacy, important outcomes for patients with acute illnesses like LC and HNC. Although differences in emotional distress met the minimally important differences (MID) previously reported, depression and HRQoL were not above the MID threshold. Our study is among a few to report differences in mental health outcomes for underserved LC and HNC patients after receiving a psychological intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>ClinicalTrials.gov identifier<\/jats:title><jats:p>NCT03016403.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.6223","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T13:58:46Z","timestamp":1695995926000},"page":"1718-1726","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Stepped\u2010care to improve mental health outcomes among underserved patients with lung and head and neck cancer"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6874-030X","authenticated-orcid":false,"given":"Evelinn A.","family":"Borrayo","sequence":"first","affiliation":[{"name":"Department of Community &amp; Behavioral Health Colorado School of Public Health  Aurora Colorado USA"},{"name":"Latino Research and Policy Center Colorado School of Public Health  Denver Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Juarez\u2010Colunga","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; Informatics Colorado School of Public Health  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Kilbourn","sequence":"additional","affiliation":[{"name":"Department of Psychology College of Liberal Arts and Sciences  Denver Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanette","family":"Waxmonsky","sequence":"additional","affiliation":[{"name":"Department of Family Medicine School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marty","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Veterans Administration Medical Center  Grand Junction Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Okuyama","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology Denver Health and Hospital Authority  Denver Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Swaney","sequence":"additional","affiliation":[{"name":"Medical Oncology Ascension St. Vincent Evansville Cancer Center  Newburgh IN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick S.","family":"Wamboldt","sequence":"additional","affiliation":[{"name":"Department of Medicine National Jewish Health  Denver Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana","family":"Karam","sequence":"additional","affiliation":[{"name":"Radiation Oncology School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Lopez Alvarez","sequence":"additional","affiliation":[{"name":"Latino Research and Policy Center Colorado School of Public Health  Denver Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; 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