Abstract
BackgroundPeople living with cancer face numerous psychosocial challenges, including cancer-related fatigue, fear of recurrence, and depression. There is a lack of digital interventions tailored to the needs of people living with all types of cancer. We developed a 6-week, digital, peer-delivered, self-management program: iHOPE (Help to Overcome Problems Effectively; where ‘i’ indicates the digital version of the program). The program is underpinned by positive psychology and cognitive behavioral therapy to meet these psychosocial challenges.ObjectiveThis study aimed to assess the feasibility of the iHOPE program among people living with cancer. Program adherence and satisfaction along with changes in psychological distress and positive well-being were measured.MethodsA pre-post, acceptability, and feasibility design was used. People living with cancer (N=114) were recruited via a national cancer charity in the United Kingdom and were given access to the iHOPE program. Demographic and other participant characteristics were recorded. Participants completed digital measures at baseline and the end of the 6-week program for depression, anxiety, cancer-related fatigue, cancer worry or fear of cancer recurrence, positive mental well-being, hope, gratitude, and health status. The website’s system recorded data on the usage of the program. Satisfaction with the program was also measured.ResultsA total of 114 participants completed the baseline questionnaires. Of these, 70 people (61.4%) participated in all 6 sessions. The mean number of sessions undertaken was 5.0 (SD 1.5). Moreover, 44.7% (51/114) of participants completed at least three sessions and end-of-program outcome measures. A total of 59 participants completed the satisfaction questionnaire, where ≥90% (54/58) of participants reported that the program was easy to navigate and was well managed by the peer facilitators, and that they found the social networking tools useful. Preliminary efficacy testing among the 51 participants who completed baseline and postprogram outcome measures showed that postprogram scores decreased for depression, anxiety, cancer-related fatigue, and fear of recurrence (all P<.001) and increased for positive mental well-being (P<.001), hope (both P<.001), and gratitude (P=.02).ConclusionsThe feasibility evidence is promising, showing that the peer-delivered digital iHOPE program is acceptable and practical. Implementation of the iHOPE program on a wider scale will incorporate further research and development to maximize the completion rates of the measures. Initial effectiveness data suggest positive impacts on important cancer-related quality of life and mental well-being outcomes. A randomized controlled trial design with a longer follow-up is needed to confirm the potential of the iHOPE program for improving mental and physical health outcomes for cancer survivors.
Highlights
BackgroundGlobally, there were an estimated 18.1 million new cases of cancer in 2018 [1]
People living with cancer (N=114) were recruited via a national cancer charity in the United Kingdom and were given access to the iHOPE program
Anxiety, well-being, quality of life, cancer-related fatigue and worry, hope, and gratitude scores between those who did and did not complete postprogram questionnaires revealed no significant differences
Summary
BackgroundGlobally, there were an estimated 18.1 million new cases of cancer in 2018 [1]. The worldwide incidence of cancer is predicted to rise by 75% over the two decades [2], leading to a world cancer burden of around 25 million cases by 2030 [3]. There are around 43.8 million people living 5 years beyond their diagnosis [1]. On the basis of the most recently collected national datasets in the United Kingdom, 4.7 million new cases of cancer were detected in 2018, with 13.5 million people living 5 years beyond their diagnosis [4]. This leads to a growing population of cancer survivors, many with unmet needs, and experiencing psychosocial and physical difficulties. People living with cancer face numerous psychosocial challenges, including cancer-related fatigue, fear of recurrence, and depression. The program is underpinned by positive psychology and cognitive behavioral therapy to meet these psychosocial challenges
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