Rebecca Shelby

Overview:

Rebecca Shelby, Ph.D. is an Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Duke University and the Director of Education and Training for the Duke Cancer Patient Support Program.  Dr. Shelby is a member of the Duke Pain Prevention and Treatment Research Program and the Duke Cancer Control and Population Sciences Program. Dr. Shelby completed her graduate training in clinical psychology at the Ohio State University and her clinical internship and postdoctoral fellowship at Duke University Medical Center.  Her research focuses on developing and evaluating behavioral interventions for cancer patients, management of cancer pain and treatment side effects, and improving adherence to recommended care. Dr. Shelby serves on the Duke clinical psychology internship faculty and supervises clinical psychology fellows, interns, and clinical psychology graduate practicum students completing clinical rotations as part of the Duke Cancer Patient Support Program.   

Positions:

Associate Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Associate Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2006

Ohio State University

Grants:

Improving Adherence to Recommended Surveillance in Breast Cancer Survivors

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Publications:

A feasible and acceptable multicultural psychosocial intervention targeting symptom management in the context of advanced breast cancer.

OBJECTIVE: Advanced breast cancer patients around the world experience high symptom burden (ie, distress, pain, and fatigue) and are in need of psychosocial interventions that target symptom management. This study examined the feasibility, acceptability, and engagement of a psychosocial intervention that uses cognitive-behavioral strategies along with mindfulness and values-based activity to enhance patients' ability to manage symptoms of advanced disease in a cross-cultural setting (United States and Singapore). Pre-treatment to post-treatment outcomes for distress, pain, and fatigue were compared between intervention recipients and waitlisted controls. METHODS: A pilot randomized controlled trial included women with advanced breast cancer (N = 85) that were recruited in the United States and Singapore. Participants either received the four session intervention or were put on a waitlist. Descriptive statistics and effect size of symptom change were calculated. RESULTS: The psychosocial intervention was found to be feasible as indicated through successful trial accrual, low study attrition (15% ), and high intervention adherence (77% completed all sessions). Acceptability (ie, program satisfaction and cultural sensitivity) and engagement to the study intervention (ie, practice of skills taught) were also high. Anxiety, depression, and fatigue scores remained stable or improved among intervention participants while the same symptoms worsened in the control group. In general, effect sizes are larger in the US sample compared with the Singapore sample. CONCLUSIONS: The cognitive-behavioral, mindfulness, and values-based intervention is feasible, acceptable, and engaging for advanced breast cancer patients in a cross-cultural setting and has potential for efficacy. Further larger-scaled study of intervention efficacy is warranted.
Authors
Teo, I; Vilardaga, JP; Tan, YP; Winger, J; Cheung, YB; Yang, GM; Finkelstein, EA; Shelby, RA; Kamal, AH; Kimmick, G; Somers, TJ
MLA Citation
URI
https://scholars.duke.edu/individual/pub1421436
PMID
31703146
Source
pubmed
Published In
Psychooncology
Published Date
DOI
10.1002/pon.5275

WEIGHT-RELATED BEHAVIORS OF CANCER SURVIVORS & PARTNERS: INTERVENTION DEVELOPMENT AND RESULTS OF A PILOT DYADIC INTERVENTION

Authors
Dorfman, CS; Winger, JG; Somers, T; Shelby, RA; Kimmick, G; Craighead, L; Patel, ML; Keefe, FJ
MLA Citation
Dorfman, Caroline S., et al. “WEIGHT-RELATED BEHAVIORS OF CANCER SURVIVORS & PARTNERS: INTERVENTION DEVELOPMENT AND RESULTS OF A PILOT DYADIC INTERVENTION.” Annals of Behavioral Medicine, vol. 53, OXFORD UNIV PRESS INC, 2019, pp. S709–S709.
URI
https://scholars.duke.edu/individual/pub1398066
Source
wos
Published In
Annals of Behavioral Medicine
Volume
53
Published Date
Start Page
S709
End Page
S709

Higher symptom burden is associated with lower function in women taking adjuvant endocrine therapy for breast cancer.

OBJECTIVE: To explore the impact of symptoms on physical function in women on adjuvant endocrine therapy for breast cancer. METHODS: Eligible women were postmenopausal, had hormone receptor positive, stage I-IIIA breast cancer, completed surgery, chemotherapy, radiation, and on adjuvant endocrine therapy. At a routine follow-up visit, women (N = 107) completed standardized symptom measures: Brief Fatigue Inventory, Brief Pain Inventory, Menopause Specific Quality of Life Questionnaire, Functional Assessment of Cancer Therapy Neurotoxicity scales. Two performance measures assessed function: grip strength (Jamar dynamometer; n = 71) and timed get-up-and-go (TUG; n = 103). Analyses were performed with an overall symptom composite score. Correlations and multiple linear regression analyses were performed to test adverse effects on physical function. RESULTS: The mean age was 64 years (range 45-84), 81% white, 84% on an aromatase inhibitor, and on endocrine therapy for mean 35 months (range 1-130 months). Dominant hand grip strength was inversely correlated with symptom composite scores (r = -0.29, p = .02). Slower TUG was positively correlated with higher Charlson comorbidity level (r = 0.36, p < .001) and higher symptom composite scores (r = 0.24, p = .01). In multivariate analyses, weaker dominant and non-dominant hand grip strength were significantly associated with greater symptom composite scores (β = -0.27, t = 2.43, p = .02 and β = -0.36, t = 3.15, p = .003, respectively) and slower TUG was associated with higher symptom composite scores (β = 0.18, t = 1.97, p = .05). CONCLUSIONS: Higher symptom burden is associated with worse physical function, as measured by hand grip strength and TUG. Further study to determine the impact of endocrine therapy and its side effects on function is warranted.
MLA Citation
Sitlinger, Andrea, et al. “Higher symptom burden is associated with lower function in women taking adjuvant endocrine therapy for breast cancer..” J Geriatr Oncol, vol. 10, no. 2, Mar. 2019, pp. 317–21. Pubmed, doi:10.1016/j.jgo.2018.11.008.
URI
https://scholars.duke.edu/individual/pub1362777
PMID
30553719
Source
pubmed
Published In
J Geriatr Oncol
Volume
10
Published Date
Start Page
317
End Page
321
DOI
10.1016/j.jgo.2018.11.008

Anxiety prior to breast biopsy: Relationships with length of time from breast biopsy recommendation to biopsy procedure and psychosocial factors.

This study investigated how time from breast biopsy recommendation to biopsy procedure affected pre-biopsy anxiety ( N = 140 women), and whether the relationship between wait time and anxiety was affected by psychosocial factors (chronic life stress, traumatic events, social support). Analyses showed a significant interaction between wait time and chronic life stress. Increased time from biopsy recommendation was associated with greater anxiety in women with low levels of life stress. Women with high levels of life stress experienced increased anxiety regardless of wait time. These results suggest that women may benefit from shorter wait times and receiving strategies for managing anxiety.
Authors
Hayes Balmadrid, MA; Shelby, RA; Wren, AA; Miller, LS; Yoon, SC; Baker, JA; Wildermann, LA; Soo, MS
MLA Citation
Hayes Balmadrid, Melissa A., et al. “Anxiety prior to breast biopsy: Relationships with length of time from breast biopsy recommendation to biopsy procedure and psychosocial factors..” J Health Psychol, vol. 22, no. 5, Apr. 2017, pp. 561–71. Pubmed, doi:10.1177/1359105315607828.
URI
https://scholars.duke.edu/individual/pub1091621
PMID
26424811
Source
pubmed
Published In
J Health Psychol
Volume
22
Published Date
Start Page
561
End Page
571
DOI
10.1177/1359105315607828

Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation.

CONTEXT: Holding back, or withholding discussion of disease-related thoughts and emotions, is associated with negative outcomes including lower quality of life, diminished well-being, and relational distress. For patients undergoing hematopoietic stem cell transplantation (HSCT), the degree to which one holds back from discussing illness-related concerns may be an important determinant of social well-being and health; however, this has not been systematically assessed in this population. OBJECTIVES: The purpose of the present study was to assess the moderating effects of holding back discussion of disease-related concerns on the relationship between health-related symptoms and social well-being in adult patients undergoing HSCT. METHODS: Seventy autologous (n = 55) and allogeneic (n = 15) HSCT patients completed measures of holding back, social well-being, and health symptoms (i.e., pain, fatigue, sleep problems, cognitive problems) both before and after transplantation (i.e., three months after transplantation and six months after transplantation). RESULTS: In patients with average to high levels of holding back, health symptoms were significantly related to lower levels of social well-being; however, for patients with low levels of holding back, the relationship between health symptoms and social well-being was not significant. CONCLUSION: The results of the present study suggest that the level of holding back may be important in understanding how health-related symptoms relate to social well-being in patients undergoing HSCT. These findings underscore the importance of addressing how patients undergoing HSCT communicate about their disease with others as this may be related to their adjustment to illness and treatment.
Authors
Bartley, EJ; Edmond, SN; Wren, AA; Somers, TJ; Teo, I; Zhou, S; Rowe, KA; Abernethy, AP; Keefe, FJ; Shelby, RA
MLA Citation
Bartley, Emily J., et al. “Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation..” J Pain Symptom Manage, vol. 48, no. 3, Sept. 2014, pp. 374–84. Pubmed, doi:10.1016/j.jpainsymman.2013.09.019.
URI
https://scholars.duke.edu/individual/pub1015972
PMID
24529631
Source
pubmed
Published In
J Pain Symptom Manage
Volume
48
Published Date
Start Page
374
End Page
384
DOI
10.1016/j.jpainsymman.2013.09.019