Coping strategies and changes in depressive symptoms: Insights from a collaborative care intervention for individuals facing cancer in underserved communities.

Coping trajectories are important predictors of depressive symptoms among individuals with cancer. However, less is understood about the relationship between coping and depression within the context of psychosocial interventions, especially among minoritized (i.e. "underserved") populations. The current study addresses this gap by investigating the relationship between coping strategies and changes in depression severity among underserved cancer patients participating in the Collaborative Oncology Project to Enhance Depression Care (COPE-D), a 12-week collaborative care depression management intervention for patients with cancer. The sample comprised 137 participants who completed both baseline and 12-week follow-up measures. Coping strategies were measured using a shortened version of the adapted Coping Orientation to Problems Experienced (COPE) Inventory, and depression severity was assessed using the Patient Health Questionnaire-9 (PHQ-9). Pre-intervention coping strategies were investigated as predictors of change in depression severity over the intervention, and changes in coping were investigated as moderators of the association between pre- and post-intervention depression severity. Participants reported significant increases in approach-oriented coping over the course of the intervention (t = 6.57, df = 140, p < 0.001). Conversely, participants exhibited a statistically significant decrease in avoidance-oriented coping (t = -2.76, df = 192, p = 0.006). Neither the degree of approach nor avoidant baseline coping strategies significantly predicted changes in depression severity over the course of the intervention. Changes in avoidance-oriented coping were associated with changes in depression severity (β = 0.2662, p = 0.0304) such that those who maintained or increased avoidant coping over time were less likely to report decreases in depressive symptoms. Baseline coping did not predict changes in depression severity during the intervention. However, increases in avoidance-oriented coping were associated with greater increases in depression severity over time. These findings underscore the importance of considering coping strategies in depression management interventions for cancer patients.