JMIR Publications

ABSTRACT

Background:

The internet-based stepped care intervention (iCAN-DO) used in the multicentre randomized controlled trial AdultCan was developed for adult patients undergoing treatment for cancer and concurrently experiencing anxiety or depressive symptoms. iCAN-DO aimed to decrease symptoms of anxiety or depression. Step 1 comprises access to a library with psychoeducational material and a peer-support section, and the possibility to pose questions to a nurse. Step 2 of the intervention offers treatment consisting of internet-based cognitive behaviour therapy (iCBT) to participants still experiencing anxiety or depression at 1, 4, or 7 months after inclusion.

Objective:

The study aimed to explore user experiences of delivery, design, and structure of iCAN-DO from the perspective of people with cancer.

Methods:

We studied user experiences by interviewing 15 participants individually (10 women (breast cancer), 5 men (colorectal cancer, n = 1; prostate cancer, n = 4); mean age 58.9 (SD 8.9) years) regarding their perceptions of ease of use and of system design and structure. Participants had been included in iCAN-DO for at least seven months. They were purposefully selected based on activity in step 1, participation in iCBT (step 2), gender, and diagnosis.

Results:

Of the 15 participants, six had been offered iCBT. All informants used the internet on a daily basis, but two described themselves as very inexperienced computer users. The interviews revealed three subthemes concerning how user experiences were affected by disease-specific factors and side effects (User experience in the context of cancer), technical problems (Technical struggles require patience and troubleshooting), and the structure and design of iCAN-DO (Appealing and usable, but rather simple).

Conclusions:

The results indicate that user experiences were affected by participants’ life situation, the technical aspects and design of iCAN-DO itself, and participants’ preferences. The results have generated some developments feasible to launch during the ongoing study, but if iCAN-DO is to be used beyond research interest, a greater level of tailoring of information, features, and design may be needed to improve user experiences. The use of recurrent questionnaires during the treatment period may highlight an individual’s health, but also function as a motivator showing improvements over time.