Journal of Cancer Survivorship

, Volume 7, Issue 1, pp 63–73 | Cite as

Evaluation of the efficacy and usability of NCI’s Facing Forward booklet in the cancer community setting

  • Joanne S. Buzaglo
  • Suzanne M. Miller
  • Jeffery Kendall
  • Annette L. Stanton
  • Kuang-Yi Wen
  • John Scarpato
  • Fang Zhu
  • Jennifer Lyle
  • Julia Rowland



The NCI developed the print-based educational brochure, Facing Forward, to fill a gap in helping cancer patients meet the challenges of transitioning from active treatment to survivorship; however, little research has been conducted on its efficacy.


The aims of this study were to evaluate the efficacy of Facing Forward in promoting the uptake of recommended behaviors (e.g., ways to manage physical changes) and to explore its usability.


At the last treatment appointment, early-stage breast, prostate, colorectal, and thoracic cancer patients (N = 340) recruited from community clinical oncology practices and an academic medical center completed a baseline assessment and were randomized to receive either Facing Forward (n = 175) or an attention control booklet about the NCI’s Cancer Information Service (n = 165). Patients completed follow-up assessments at 8 weeks and 6 months post-baseline.


The reported uptake of recommended stress management behaviors was greater among intervention than control participants at both 8 weeks post-baseline (p = 0.016) and 6 months post-baseline (p = 0.017). At 8 weeks post-baseline, the intervention control group difference was greater among African-American than Caucasian participants (p < 0.03) and significant only among the former (p < 0.003); attendance at a cancer support group was also greater among the intervention than control group participants (p < 0.02). There were no significant intervention control group differences in the reported uptake of recommended behaviors in three other categories (p > 0.025). Intervention participants rated Facing Forward as understandable and helpful and indicated a high level of intention to try the behaviors recommended.


Facing Forward can enhance early-stage survivors’ reported ability to manage stress and increase support group use during the reentry period.

Implications for Cancer Survivors

Facing Forward can help survivors meet the challenges of the reentry period.


Survivorship Cancer control Psychosocial interventions Facing Forward 



This work was supported in part by National Institute of Health grants R01 CA104979, 5P01 CA057586, and the Fox Chase Cancer Center Behavioral Research Core Facility P30 CA06927, as well as Department of Defense grants DAMD 17-01-01-1-0238 and DAMD 17-02-1-0382 and the LAF PT07-07020 grant. We are indebted to Mary Anne Ryan for her technical assistance.


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Joanne S. Buzaglo
    • 1
  • Suzanne M. Miller
    • 2
  • Jeffery Kendall
    • 3
  • Annette L. Stanton
    • 4
  • Kuang-Yi Wen
    • 5
  • John Scarpato
    • 5
  • Fang Zhu
    • 6
  • Jennifer Lyle
    • 7
  • Julia Rowland
    • 8
  1. 1.Research & Training InstituteCancer Support CommunityPhiladelphiaUSA
  2. 2.Psychosocial and Biobehavioral Medicine DepartmentFox Chase Cancer CenterPhiladelphiaUSA
  3. 3.Psychosocial Oncology ProgramUT Southwestern Simmons Cancer CenterDallasUSA
  4. 4.Departments of Psychology and Psychiatry/Biobehavioral Sciences, Division of Cancer Prevention and Control ResearchUniversity of California Los AngelesLos AngelesUSA
  5. 5.Psychosocial and Biobehavioral Medicine Department, Fox Chase Cancer Center, Robert C. Young PavilionPhiladelphiaUSA
  6. 6.Biostatistics and Bioinformatics FacilityFox Chase Cancer CenterPhiladelphiaUSA
  7. 7.National Comprehensive Cancer NetworkFort WashingtonUSA
  8. 8.Office of Cancer Survivorship, National Cancer InstituteNational Institutes of Health, NIH/DHHSBethesdaUSA

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