Abstract
BackgroundIn‐person cognitive‐behavioral stress‐management interventions are consistently associated with reduced cancer distress. However, face‐to‐face delivery is an access barrier for many patients, and there is a need to develop remote‐delivered interventions. The current study evaluated the preliminary efficacy of an application (app)‐based cancer stress‐management intervention, StressProffen, in a randomized controlled trial.MethodsCancer survivors, maximum 1‐year posttreatment (N = 172), were randomized to StressProffen (n = 84) or a usual care control group (n = 88). Participants received a blended delivery care model: (a) one face‐to‐face introduction session, (b) 10 app‐based cognitive‐behavioral stress‐management modules, and (c) follow‐up phone calls at weeks 2‐3 and 6‐7. Outcome measures included stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety Depression Scale), and health‐related quality of life (HRQoL; Short‐Form Health Surveys [SF‐36]) at 3‐months post‐intervention, analyzed with change scores as dependent variables in linear regression models.ResultsParticipants were primarily women (82%), aged 20‐78 years (mean 52, SD 11.2), with mixed cancer types (majority breast cancer; 48%). Analysis of 149 participants completing questionnaires at baseline and 3 months revealed significant intervention effects: decreased stress (mean difference [MD] −2.8; 95% confidence interval [CI], [−5.2 to −0.4]; P = .022) and improved HRQoL (Role Physical MD = 17.7, [CI 3.7‐31.3], P = .013; Social Functioning MD = 8.5, [CI 0.7‐16.2], P = .034; Role Emotional MD = 19.5, [CI 3.7‐35.2], P = .016; Mental Health MD = 6.7, [CI 1.7‐11.6], P = .009). No significant changes were observed for anxiety or depression. ConclusionsDigital‐based cancer stress‐management interventions, such as StressProffen, have the potential to provide easily accessible, effective psychosocial support for cancer survivors.
Highlights
More than 30 years of research demonstrate the efficacy of cognitive-behavioral cancer distress- and stress-management interventions to reduce stress, anxiety, depression, and improve quality of life (QoL) and social support.[1,3,8,9,10,11,12,13,14]
Many access barriers exist for such interventions, including (a) interventions typically being limited to large, urban medical centers, (b) limited insurance coverage, and (c) cancer survivors not feeling physically or emotionally well enough to attend in-person sessions.[12]
The current study suggests that an app-based cognitive-behavioral stress-management intervention can provide effective, beneficial, and useful support for cancer survivors when delivered within a blended health-care delivery model
Summary
More than 30 years of research demonstrate the efficacy of cognitive-behavioral cancer distress- and stress-management interventions to reduce stress, anxiety, depression, and improve quality of life (QoL) and social support.[1,3,8,9,10,11,12,13,14] Positive long-term effects of such psychological interventions for cancer survivors have been observed.[15] many access barriers exist for such interventions, including (a) interventions typically being limited to large, urban medical centers, (b) limited insurance coverage, and (c) cancer survivors not feeling physically or emotionally well enough to attend in-person sessions.[12] These barriers, together with high rates of unmet needs with regard to rehabilitation and psychosocial support,[16] identify a critical need to expand health-care delivery options for cancer survivors. Conclusions: Digital-based cancer stress-management interventions, such as StressProffen, have the potential to provide accessible, effective psychosocial support for cancer survivors
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