Rebecca Shelby

Overview:

Rebecca Shelby, Ph.D. is an Associate Professor with Tenure 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

Mammography Pain in Breast Cancer Survivors

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
PI-Fellow
Start Date
End Date

Best Quality of Care from a Distance (BQal-D): Maintaining High Quality Care for Hormone Receptor Positive Metastatic Breast Cancer during the COVID Pandemic

Administered By
Medicine, Medical Oncology
Awarded By
Pfizer, Inc.
Role
Co Investigator
Start Date
End Date

Publications:

Behavioral cancer pain intervention using videoconferencing and a mobile application for medically underserved patients: Rationale, design, and methods of a prospective multisite randomized controlled trial.

BACKGROUND: Women with breast cancer in medically underserved areas are particularly vulnerable to persistent pain and disability. Behavioral pain interventions reduce pain and improve outcomes. Cancer patients in medically underserved areas receive limited adjunctive cancer care, as many lack access to pain therapists trained in behavioral interventions, face travel barriers to regional medical centers, and may have low literacy and limited resources. mHealth technologies have the potential to decrease barriers but must be carefully adapted for, and efficacy-tested with, medically underserved patients. We developed an mHealth behavioral pain coping skills training intervention (mPCST-Community). We now utilize a multisite randomized controlled trial to: 1) test the extent mPCST-Community reduces breast cancer patients' pain severity (primary outcome), pain interference, fatigue, physical disability, and psychological distress; 2) examine potential mediators of intervention effects; and 3) evaluate the intervention's cost and cost-effectiveness. METHODS/DESIGN: Breast cancer patients (N = 180) will be randomized to mPCST-Community or an attention control. mPCST-Community's four-session protocol will be delivered via videoconferencing at an underserved community clinic by a remote pain therapist at a major medical center. Videoconference sessions will be supplemented with a mobile application. Participants will complete self-report measures at baseline, post-intervention, and 3- and 6-month follow-ups. CONCLUSIONS: mPCST-Community has the potential to reduce pain and disability, and decrease barriers for cancer patients in medically underserved areas. This is one of the first trials to test an mHealth behavioral cancer pain intervention developed specifically for medically underserved communities. If successful, it could lead to widespread implementation and decreased health disparities.
Authors
Kelleher, SA; Winger, JG; Fisher, HM; Miller, SN; Reed, SD; Thorn, BE; Spring, B; Samsa, GP; Majestic, CM; Shelby, RA; Sutton, LM; Keefe, FJ; Somers, TJ
MLA Citation
URI
https://scholars.duke.edu/individual/pub1472509
PMID
33497833
Source
pubmed
Published In
Contemp Clin Trials
Volume
102
Published Date
Start Page
106287
DOI
10.1016/j.cct.2021.106287

An mHealth Pain Coping Skills Training Intervention for Hematopoietic Stem Cell Transplantation Patients: Development and Pilot Randomized Controlled Trial (Preprint)

<sec> <title>BACKGROUND</title> <p>Pain is a challenge for patients following hematopoietic stem cell transplantation (HCT).</p> </sec> <sec> <title>OBJECTIVE</title> <p>This study aimed to develop and test the feasibility, acceptability, and initial efficacy of a Web-based mobile pain coping skills training (mPCST) protocol designed to address the needs of HCT patients.</p> </sec> <sec> <title>METHODS</title> <p>Participants had undergone HCT and reported pain following transplant (N=68). To guide intervention development, qualitative data were collected from focus group participants (n=25) and participants who completed user testing (n=7). After their input was integrated into the mPCST intervention, a pilot randomized controlled trial (RCT, n=36) was conducted to examine the feasibility, acceptability, and initial efficacy of the intervention. Measures of acceptability, pain severity, pain disability, pain self-efficacy, fatigue, and physical disability (self-report and 2-min walk test [2MWT]) were collected.</p> </sec> <sec> <title>RESULTS</title> <p>Participants in the focus groups and user testing provided qualitative data that were used to iteratively refine the mPCST protocol. Focus group qualitative data included participants’ experiences with pain following transplant, perspectives on ways to cope with pain, and suggestions for pain management for other HCT patients. User testing participants provided feedback on the HCT protocol and information on the use of videoconferencing. The final version of the mPCST intervention was designed to bridge the intensive outpatient (1 in-person session) and home settings (5 videoconferencing sessions). A key component of the intervention was a website that provided personalized messages based on daily assessments of pain and activity. The website also provided intervention materials (ie, electronic handouts, short videos, and audio files). The intervention content included pain coping advice from other transplant patients and instructions on how to apply pain coping skills while engaging in meaningful and leisure activities. In the RCT phase of this research, HCT patients (n=36) were randomized to receive the mPCST intervention or to proceed with the treatment as usual. Results revealed that the mPCST participants completed an average of 5 out of 6 sessions. The participants reported that the intervention was highly acceptable (mean 3/4), and they found the sessions to be helpful (mean 8/10) and easy to understand (mean 7/7). The mPCST participants demonstrated significant improvements in pre- to post-treatment pain, self-efficacy (P=.03, d=0.61), and on the 2MWT (P=.03, d=0.66), whereas the patients in the treatment-as-usual group did not report any such improvements. Significant changes in pain disability and fatigue were found in both groups (multiple P&lt;.02); the magnitudes of the effect sizes were larger for the mPCST group than for the control group (pain disability: d=0.79 vs 0.69; fatigue: d=0.94 vs 0.81). There were no significant changes in pain severity in either group.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>Using focus groups and user testing, we developed an mPCST protocol that was feasible, acceptable, and beneficial for HCT patients with pain.</p> </sec> <sec> <title>CLINICALTRIAL</title> <p>ClinicalTrials.gov NCT01984671; https://clinicaltrials.gov/ct2/show/NCT01984671 (Archived by WebCite at http://www.webcitation.org/6xbpx3clZ)</p> </sec>
URI
https://scholars.duke.edu/individual/pub1466266
Source
crossref
DOI
10.2196/preprints.8565

Factors associated with falls in older women with breast cancer: the use of a brief geriatric screening tool in clinic.

PURPOSE: Unintentional falls and breast cancer are common among older women, but the associations between them are understudied. We aimed to identify factors associated with falls in older women with breast cancer. METHODS: We retrospectively reviewed clinical records of older women with breast cancer at Duke Medical Center who had completed the Senior Adult Oncology Program geriatric assessment. Characteristics were compared between women had had at least one fall in the past year and those who did not. Pearson's Chi-square tests and t tests were used for comparison of groups' characteristics. Logistic regression determined factors associated with falling. RESULTS: We identified 425 women, age 76.2 years (range 65-89 years), at the time of the assessment. 118 (27.8%) women reported a fall in the prior year. Age, race, ethnicity, and time since diagnosis (all p > 0.05) were similar between groups. In univariate analyses, metastatic disease (p = 0.023) and history of endocrine therapy (p = 0.042) were more common among women who fell. Women who fell had lower systolic (p = 0.001), diastolic (p < 0.001) blood pressures, and SpO2 (p = 0.018). Women who had fallen had a higher Charlson Comorbidity Index (CCI: p = 0.033), and were more likely to report using a walking aide (p < 0.001), nutritional issues (p = 0.006), and depression symptoms (p = 0.038). In multivariate analysis, falling was associated with low DBP (OR 0.93; p = 0.0017), low SpO2 (OR 0.79; p = 0.0169), a higher CCI (OR 1.23; p = 0.0076), and depression symptoms (OR 1.61; p = 0.039). CONCLUSIONS: Among older women with breast cancer, depressive symptoms, higher comorbidity level, and vital sign measurements were associated with having fallen.
Authors
Bartlett, DB; Broadwater, G; White, HK; Shelby, R; Zullig, LL; Robertson, J; Kanesvaran, R; Cohen, HJ; Kimmick, G
MLA Citation
Bartlett, David B., et al. “Factors associated with falls in older women with breast cancer: the use of a brief geriatric screening tool in clinic.Breast Cancer Res Treat, vol. 184, no. 2, Nov. 2020, pp. 445–57. Pubmed, doi:10.1007/s10549-020-05862-5.
URI
https://scholars.duke.edu/individual/pub1456216
PMID
32794062
Source
pubmed
Published In
Breast Cancer Res Treat
Volume
184
Published Date
Start Page
445
End Page
457
DOI
10.1007/s10549-020-05862-5

ASSOCIATION BETWEEN PERCEIVED DISCRIMINATION IN MEDICAL CARE AND SELF-EFFICACY FOR PURSUING BREAST CANCER FOLLOW-UP CARE

Authors
Pita, MG; Coleman, JN; Kimmick, G; Keefe, FJ; Bosworth, HB; Sutton, LM; Owen, L; Gandhi, V; Shelby, RA
MLA Citation
Pita, Maria G., et al. “ASSOCIATION BETWEEN PERCEIVED DISCRIMINATION IN MEDICAL CARE AND SELF-EFFICACY FOR PURSUING BREAST CANCER FOLLOW-UP CARE.” Annals of Behavioral Medicine, vol. 54, 2020, pp. S702–S702.
URI
https://scholars.duke.edu/individual/pub1452110
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
54
Published Date
Start Page
S702
End Page
S702

PERCEPTIONS OF FOLLOW-UP CARE AMONG BREAST CANCER SURVIVORS: ASSOCIATIONS WITH COMMUNICATION AND TRUST IN MEDICAL CARE

Authors
Coleman, JN; Kimmick, G; Keefe, FJ; Bosworth, HB; Sutton, LM; Owen, L; Gandhi, V; Shelby, RA
MLA Citation
Coleman, Jessica N., et al. “PERCEPTIONS OF FOLLOW-UP CARE AMONG BREAST CANCER SURVIVORS: ASSOCIATIONS WITH COMMUNICATION AND TRUST IN MEDICAL CARE.” Annals of Behavioral Medicine, vol. 54, 2020, pp. S279–S279.
URI
https://scholars.duke.edu/individual/pub1452111
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
54
Published Date
Start Page
S279
End Page
S279