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Feasibility Testing of Remotely Delivered Metacognitive Strategy Training in Cancer-Related Cognitive Impairment
Anna Boone1, Andrew Kiselica2, Juliana Earwood1
1Department of Occupational Therapy, University of Missouri, Columbia, MO.
Archives of Physical Medicine and Rehabilitation
|December 8, 2025
Summary
Remote metacognitive strategy training (MCST) is feasible for breast cancer survivors with cognitive impairment. The Cognitive Orientation to daily Occupational Performance (CO-OP) intervention showed positive effects on daily functioning and cognition.
Area of Science:
- Oncology
- Neuroscience
- Rehabilitation
Background:
- Cancer-related cognitive impairment (CRCI) affects breast cancer survivors.
- Metacognitive strategy training (MCST) may address CRCI.
- Remote delivery of interventions offers accessibility.
Purpose of the Study:
- Evaluate the feasibility of remotely delivered MCST for CRCI in breast cancer survivors.
- Assess preliminary effects of MCST on cognitive function and daily performance.
- Determine the acceptability and practicality of remote interventions.
Main Methods:
- Pilot randomized controlled trial with 42 breast cancer survivors reporting CRCI.
- Intervention: 10-session remote Cognitive Orientation to daily Occupational Performance (CO-OP; a type of MCST).
- Control: Attention + education group, all via secure videoconferencing.
Main Results:
- High feasibility demonstrated by 41% recruitment and 91.3% retention rates.
- Participants found remote CO-OP highly feasible, appropriate, and acceptable.
- Intervention group showed positive effects on activity performance, daily cognition, and executive function.
Conclusions:
- Remotely delivered CO-OP is a suitable and practical intervention for breast cancer survivors with CRCI.
- Positive effects on performance and cognition warrant further efficacy research.
- Remote MCST is a promising approach for managing CRCI.
