Tamara Somers

Overview:

Tamara J. Somers, PhD, is a Clinical Psychologist and Faculty Member in the Department of Psychiatry and Behavioral Sciences. Dr. Somers conducts research developing, testing, and implementing behavioral interventions for pain and other symptoms in patients with chronic disease (e.g., cancer, arthritis). She is particularly interested in developing behavioral interventions that are personalized to the needs of individual patients and using innovative delivery methods (mobile health) to deliver the interventions. Grant awards from the NIH, American Cancer Society, and other funding agencies support her research. Dr. Somers also co-directs a clinical psychology training program at the Duke Cancer Institute (DCI) that trains graduate students, clinical psychology interns, and post-doctoral fellows in psychosocial and behavioral symptom management interventions. She is the Director of Research for the Duke Cancer Patient Support Program at DCI. Dr. Somers maintains a small clinical practice at the Duke Faculty Practice at Erwin Square. 

Positions:

Associate Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2007

University of Pittsburgh

Grants:

Coping Skills for Colorectal Cancer Survivors with Pain and Distress

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences
Awarded By
American Cancer Society, Inc.
Role
Co-Sponsor
Start Date
End Date

Behavioral Weight and Symptom Management for Breast Cancer Survivors and Partners

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences
Awarded By
National Institutes of Health
Role
Co-Sponsor
Start Date
End Date

Optimizing Delivery of a Behavioral Cancer Pain Intervention Using a SMART

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

Palliative Care Research Cooperative Group (PCRC) Refinement and Expansion

Administered By
Duke Cancer Institute
Role
Co Investigator
Start Date
End Date

Pain Coping Skills Training for African Americans with Osteoarthritis

Administered By
Medicine, General Internal Medicine
Awarded By
University of North Carolina - Chapel Hill
Role
Co Investigator
Start Date
End Date

Publications:

Trajectories of fatigue in a population-based sample of older adult breast, prostate, and colorectal cancer survivors: an analysis using the SEER-MHOS data resource.

<h4>Purpose</h4>Fatigue is one of the most common and distressing symptoms experienced by cancer survivors. Understanding fatigue trajectories from pre- to post-diagnosis could inform fatigue prevention and management strategies.<h4>Methods</h4>We used the Surveillance, Epidemiology and End Results Medicare Health Outcomes Survey (SEER-MHOS) linked data resource to characterize fatigue trajectories and their predictors 1214 older adult survivors of breast, colorectal, or prostate cancer. Fatigue was measured prior to the cancer diagnosis (T0) and at two timepoints after diagnosis (T1: mean = 20 months and T2: mean = 39 months post-diagnosis). Latent growth curve modeling and mixed effects models for repeated measurements were used to investigate fatigue experiences before and after a cancer diagnosis.<h4>Results</h4>Overall, mean fatigue T-scores declined (T0 = 50, T1 = 46, and T2 = 45) indicating worsening fatigue over time. Four latent trajectory subgroups were identified: severe fatigue worsening over time (8.2% of sample), severe fatigue persisting over time (14.4%), no fatigue pre-diagnosis and mild fatigue post-diagnosis (44.4%), and not fatigued (33%). Age, cancer stage, comorbidities, and depressed mood predicted membership in the two trajectory groups experiencing severe fatigue that persisted or that worsened post-diagnosis. Older age, advanced cancer stage at diagnosis, and depressed mood were significantly associated with worsening fatigue from T1 to T2 (all p < 0.0001).<h4>Conclusions</h4>Evaluating cancer patients for depressive symptoms and considering prior fatigue levels, age, comorbid conditions, and cancer stage may help providers anticipate fatigue trajectories and implement pre-emptive strategies to lessen fatigue impact.
Authors
Byrne, M; Leiser, J; Mitchell, SA; Kent, EE; Siembida, EJ; Somers, T; Arem, H
MLA Citation
Byrne, Morgan, et al. “Trajectories of fatigue in a population-based sample of older adult breast, prostate, and colorectal cancer survivors: an analysis using the SEER-MHOS data resource.Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, May 2021. Epmc, doi:10.1007/s00520-021-06267-w.
URI
https://scholars.duke.edu/individual/pub1484805
PMID
34052930
Source
epmc
Published In
Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Published Date
DOI
10.1007/s00520-021-06267-w

A SMART approach to optimizing delivery of an mHealth intervention among cancer survivors with posttraumatic stress symptoms.

BACKGROUND/AIMS: Many cancer survivors who received intensive treatment such as hematopoietic stem cell transplantation (HCT) experience posttraumatic stress disorder (PTSD) symptoms. PTSD is associated with lower quality of life and other symptoms that require clinical treatment. The iterative treatment decisions that happen in clinical practice are not adequately represented in traditional randomized controlled trials (RCT) of PTSD treatments. The proposed stepped-care SMART design allows for evaluation of initial response to the Cancer Distress Coach mobile app; adaptive stepped-care interventions; and precision treatment strategies that tailor treatment selection to patient characteristics. METHODS/DESIGN: HCT survivors (N = 400) reporting PTSD symptoms are being recruited at two cancer centers and randomly assigned to: 1) Cancer Distress Coach app or 2) Usual Care. The app includes educational and cognitive behavioral therapy (CBT)-based activities. Four weeks post-randomization, participants re-rate their PTSD symptoms and, based on intervention response, non-responders are re-randomized to receive video-conferenced sessions with a therapist: 3) coaching sessions in using the mobile app; or 4) CBT specific to HCT survivors. Participants complete outcome measures of PTSD, depression, and anxiety after Months 1, 3, and 6. Participant characteristics moderating intervention responses will be examined. CONCLUSIONS: This novel adaptive trial design will afford evidence that furthers knowledge about optimizing PTSD interventions for HCT survivors. To our knowledge, this study is the first SMART design evaluating PTSD symptom management in cancer survivors. If successful, it could be used to optimize treatment among a range of cancer and other trauma survivors.
Authors
Smith, SK; Somers, TJ; Kuhn, E; Laber, E; Sung, AD; Syrjala, KL; Feger, B; Kelleher, SA; Majestic, C; Gebert, R; LeBlanc, M; Owen, JE; Applebaum, AJ
MLA Citation
Smith, Sophia K., et al. “A SMART approach to optimizing delivery of an mHealth intervention among cancer survivors with posttraumatic stress symptoms.Contemp Clin Trials, vol. 110, Sept. 2021, p. 106569. Pubmed, doi:10.1016/j.cct.2021.106569.
URI
https://scholars.duke.edu/individual/pub1497125
PMID
34536584
Source
pubmed
Published In
Contemp Clin Trials
Volume
110
Published Date
Start Page
106569
DOI
10.1016/j.cct.2021.106569

Meaning-Centered Pain Coping Skills Training: A Pilot Feasibility Trial of a Psychosocial Pain Management Intervention for Patients with Advanced Cancer.

Background: Pain from advanced cancer can greatly reduce patients' physical, emotional, and spiritual well-being. Objective: To examine the feasibility and acceptability of a behavioral pain management intervention, Meaning-Centered Pain Coping Skills Training (MCPC). Design: This trial used a single-arm feasibility design. Setting/Subjects: Thirty participants with stage IV solid tumor cancer, moderate-to-severe pain, and clinically elevated distress were enrolled from a tertiary cancer center in the United States. The manualized protocol was delivered across four 45- to 60-minute videoconference sessions. Measurements: Feasibility and acceptability were assessed through accrual, session/assessment completion, intervention satisfaction, and coping skills usage. Participants completed validated measures of primary outcomes (i.e., pain severity, pain interference, and spiritual well-being) and secondary outcomes at baseline, post-intervention, and four-week follow-up. Results: Eighty-eight percent (38/43) of patients who completed screening met inclusion criteria, and 79% (30/38) consented and completed baseline assessment. Sixty-seven percent (20/30) of participants were female (mean age = 57). Most participants were White/Caucasian (77%; 23/30) or Black/African American (17%; 5/30) with at least some college education (90%; 27/30). Completion rates for intervention sessions and both post-intervention assessments were 90% (27/30), 87% (26/30), and 77% (23/30), respectively. At the post-intervention assessment, participants reported a high degree of intervention satisfaction (mean = 3.53/4.00; SD = 0.46), and 81% (21/26) reported weekly use of coping skills that they learned. Participants also showed improvement from baseline on all primary outcomes and nearly all secondary outcomes at both post-intervention assessments. Conclusions: MCPC demonstrated strong feasibility and acceptability. Findings warrant further evaluation of MCPC in a randomized controlled trial. ClinicalTrials.gov Identifier: NCT03207360.
Authors
MLA Citation
URI
https://scholars.duke.edu/individual/pub1494121
PMID
34388037
Source
pubmed
Published In
Journal of Palliative Medicine
Published Date
DOI
10.1089/jpm.2021.0081

Changes in Identification of Possible Pain Coping Strategies by People with Osteoarthritis who Complete Web-based Pain Coping Skills Training.

<h4>Background</h4>We previously demonstrated that automated, Web-based pain coping skills training (PCST) can reduce osteoarthritis pain. The present secondary analyses examined whether this program also changed coping strategies participants identified for use in hypothetical pain-related situations.<h4>Method</h4>People with hip/knee osteoarthritis (n = 107) were randomized to Web-based PCST or standard care control. At baseline and post-intervention, they reported their pain severity and impairment, then completed a task in which they described how they would cope with pain in four hypothetical pain-related situations, also reporting their perceived risk for pain and self-efficacy for managing it. We coded the generated coping strategies into counts of adaptive behavioral, maladaptive behavioral, adaptive cognitive, and discrete adaptive coping strategies (coping repertoire).<h4>Results</h4>Compared to the control arm, Web-based PCST decreased the number of maladaptive behavioral strategies generated (p = 0.002) while increasing the number of adaptive behavioral strategies generated (p = 0.006), likelihood of generating at least one adaptive cognitive strategy (p = 0.01), and the size of participants' coping repertoire (p = 0.009). Several of these changes were associated with changes in pain outcomes (ps = 0.01 to 0.65). Web-based PCST also reduced perceived risk for pain in the situations (p = 0.03) and increased self-efficacy for avoiding pain in similar situations (p < 0.001).<h4>Conclusion</h4>Salutary changes found in this study appear to reflect intervention-concordant learning.
Authors
Rini, C; Katz, AWK; Nwadugbo, A; Porter, LS; Somers, TJ; Keefe, FJ
MLA Citation
Rini, Christine, et al. “Changes in Identification of Possible Pain Coping Strategies by People with Osteoarthritis who Complete Web-based Pain Coping Skills Training.International Journal of Behavioral Medicine, vol. 28, no. 4, Aug. 2021, pp. 488–98. Epmc, doi:10.1007/s12529-020-09938-w.
URI
https://scholars.duke.edu/individual/pub1464315
PMID
33174614
Source
epmc
Published In
International Journal of Behavioral Medicine
Volume
28
Published Date
Start Page
488
End Page
498
DOI
10.1007/s12529-020-09938-w

Predictors of Response to an Evidence-Based Behavioral Cancer Pain Management Intervention: An Exploratory Analysis From a Clinical Trial.

CONTEXT: Interventions that teach patients cognitive and behavioral strategies for managing cancer pain have demonstrated effectiveness. Systematic reviews of such interventions call for research to inform their implementation in practice, including investigations into which patients are most likely to benefit. OBJECTIVES: We aimed to identify predictors of response to an evidence-based behavioral intervention for cancer pain, pain coping skills training (PCST). METHODS: We conducted an exploratory secondary analysis of a randomized noninferiority trial comparing in-person to videoconference-based PCST. Using modified Poisson regression, we estimated the adjusted associations of patient characteristics with clinically meaningful reductions (≥30%) in pain severity and pain interference. RESULTS: Of the 178 patients who were randomized, 135 completed at least one follow-up assessment and were included in this analysis. Proportions of patients experiencing reductions in pain severity and pain interference were 34% and 46%, respectively. In multivariable analysis, education level was associated with a reduction in pain severity (adjusted relative risk, some college or technical school vs. college or higher: 0.49, 95% CI: 0.26-0.93). Patients with colorectal cancer were 61% more likely to experience a reduction in pain interference than patients with breast cancer (95% CI:1.21-2.34). Marital status was also statistically significantly associated with pain interference reduction, with married patients less likely to experience a reduction in pain interference (adjusted relative risk, married vs. not: 0.69, 95% CI: 0.49-0.98). CONCLUSION: Our findings elucidate several subgroups of patients who may be especially likely to benefit from PCST, informing both targeted implementation efforts and opportunities to improve delivery for diverse patients.
Authors
Check, DK; Winger, JG; Jones, KA; Somers, TJ
MLA Citation
Check, Devon K., et al. “Predictors of Response to an Evidence-Based Behavioral Cancer Pain Management Intervention: An Exploratory Analysis From a Clinical Trial.J Pain Symptom Manage, vol. 62, no. 2, Aug. 2021, pp. 391–99. Pubmed, doi:10.1016/j.jpainsymman.2020.12.020.
URI
https://scholars.duke.edu/individual/pub1471096
PMID
33387606
Source
pubmed
Published In
J Pain Symptom Manage
Volume
62
Published Date
Start Page
391
End Page
399
DOI
10.1016/j.jpainsymman.2020.12.020