# A Pilot Clinical Trial of a Group Coping Intervention for English and Spanish Speakers with Chronic Graft-Versus-Host Disease

## TL;DR

A group-based coping program called Horizons was tested for chronic graft-versus-host disease patients in English and Spanish, showing high feasibility and acceptability.

## Contribution

The study introduces a culturally accessible group intervention for cGVHD patients, delivered in two languages, to address a gap in survivorship research.

## Key findings

- The Horizons program achieved 52.5% enrollment and 90.5% session attendance, meeting feasibility benchmarks.
- Participants reported increased support, self-efficacy, and comfort in discussing their experiences through peer validation.
- High treatment fidelity (96.7%) and 95.2% follow-up completion indicate strong program adherence and retention.

## Abstract

Chronic graft-versus-host disease (cGVHD) affects up to 40% of allogeneic hematopoietic cell transplant (HCT) survivors, producing lasting physical and psychosocial sequelae. Despite their high symptom burden, survivors with cGVHD are rarely included in survivorship intervention research. This pilot study evaluated the feasibility and acceptability of a group-based coping intervention for patients with cGVHD (Horizons program), delivered in English and Spanish to patients in South Florida, USA to inform larger-scale testing.

We conducted a single-arm trial of the Horizons program, enrolling adults with moderate or severe cGVHD from an academic medical center. Enrollment and group assignment were stratified by language. Participants engaged in eight weekly 90-minute videoconference sessions co-led by a transplant clinician and behavioral health expert (5–6 participants per group). Feasibility benchmarks included ≥50% enrollment, ≥80% attendance, and ≥80% retention. Exit interviews were analyzed using content analysis to assess acceptability.

From December 2023 to August 2024, 21 of 40 approached patients enrolled (52.5%). The sample (median age 60) was 71% male and 71% Hispanic/Latino; 11 participated in English and 10 in Spanish. Nineteen participants (90.5%) attended ≥4 sessions, and 95.2% completed follow-up. Treatment fidelity averaged 96.7%. Qualitative feedback underscored increased support, self-efficacy, and connection. Participants emphasized peer validation, the development of coping skills, and comfort in discussing their experiences.

Horizons demonstrated high feasibility, excellent fidelity, and acceptability among diverse, English- and Spanish-speaking cGVHD survivors, supporting further evaluation in larger, multisite trials.