Using SMART Design to Improve Symptom Management Strategies Among Cancer Patients

First, dyads were randomized to receive caregiver-delivered reflexology or meditative

practice. Fatigue severity was assesses weekly via phone calls to the cancer patients

during weeks 1-4 of the intervention. For patients who did not respond to the

intervention during the first 4 weeks, those dyads were referred to as non-responder and

re-randomized. A non-responder was determined if the level of reported fatigue remained

the same or increased from the first week of the intervention.

The re-randomization placed the non-responders in either a group that received a higher

dose (more time) with the first intervention or to the alternate practice (meditative

practice to those randomized to reflexology and vice versa) for weeks 5-8. Those who did

respond during weeks 1-4 continued the same therapy they began with.