Sexual Health and Rehabilitation (SHARE): An Online Educational Intervention for Young Adult Female Cancer Survivors

Project Summary
Sexual dysfunction is one of the most common and distressing consequences of cancer therapy for young
female (YF) cancer survivors, with more than 50% of YF survivors reporting chronic sexual problems,2,3,4
including pain with sexual activity, vulvo-vaginal atrophy, and low desire. Severe sexual dysfunction sharply
diminishes psychological well-being and quality-of-life7,8 for YF survivors. For young women who are
developing or trying to maintain intimate relationships, the consequences can be devastating5. However,
sexual health rehabilitation is not available for most young women suffering from treatment-related sexual
dysfunction.36,37 To address this gap in survivorship care, the PI previously developed and piloted a brief (3-
hour), group-delivered, skills-based intervention called SHARE (Sexual Health And Rehabilitation). SHARE is
a self-management intervention that integrates state-of-the-art sexual rehabilitation with body awareness
training, elements of mindfulness-based cognitive therapy and individual action planning. In two previous
single-arm, pilot trials, SHARE significantly reduced cancer-related female sexual dysfunction15 as well as
psychological distress. However, in its existing form, SHARE requires in-person attendance, which limits
access only to those with the time, means and ability to attend. To overcome this barrier, while building on our
previous success, we adapted the intervention for online delivery via videoconference format (SHAREonline)
and subsequently conducted informal pretesting of materials and format. Synchronous videoconferencing is a
format that has been shown to be as effective as in-person group61 but never before used to deliver sexual
rehabilitation to young cancer survivors. We now propose a Phase II “proof-of-concept” RCT to examine
preliminary effects of SHAREonline to reduce sexual dysfunction and psychological distress in a sample of 84
YF survivors. We will randomize 84 young female cancer survivors with sexual health concerns to either the
SHAREonline intervention or to an Enhanced Usual Care attention control condition (2:1) consisting of
education only. Sexual function will be assessed at baseline and at 8- and 16-weeks post-intervention.
Feasibility, acceptability, and credibility, including credibility of the control condition, will be examined to
prepare for a definitive efficacy trial. Women also receive take-home educational materials and a single
booster telephone call 4 weeks post-group session. SHAREonline was developed to meet the needs for
accessible and efficient intervention for young survivors. Whereas most YF survivors currently have no access
to evidence-based sexual health rehabilitation, SHAREonline has the potential to help close a major gap in
survivorship care. Evaluating preliminary effects of SHAREonline is a critical next step for planning a future
efficacy trial, and ultimately ensuring SHAREonline is an effective and widely available intervention to improve
the health and quality-of-life of young female cancer suffering from pronounced sexual dysfunction.

Grant Number: 5R21CA279278-02
NIH Institute/Center: NIH
Principal Investigator: Sharon Bober