Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 15, 2020
Date Accepted: Mar 21, 2020
Date Submitted to PubMed: Mar 26, 2020
Development and Evaluation of a Digital Self-Management Programme: iHOPE for Cancer Survivors
ABSTRACT
Background:
People living with cancer face numerous psychosocial challenges, including cancer-related fatigue, fear of recurrence and depression. There is a lack of digital interventions which are tailored to the needs of people living with all types of cancer. We developed a six week, digital, peer delivered, self-management programme: iHOPE. The programme is underpinned by positive psychology and cognitive behavioural therapy to meet these psychosocial challenges.
Objective:
To assess the feasibility of the iHOPE Programme among people living with cancer using a mixed methods design. Programme adherence, and satisfaction along with changes in psychological distress and positive wellbeing were measured.
Methods:
A pre-post, acceptability and feasibility design was used. People living with cancer were recruited via a national cancer charity in the United Kingdom and were given access to the iHOPE programme. Demographic and other participant characteristics were recorded. Participants completed digital measures at baseline and the end of the six-week programme for depression, anxiety, cancer-related fatigue, cancer “worry” or fear of cancer recurrence, positive mental wellbeing, hope, gratitude and health status. The website’s system recorded data on the usage of the programme. Satisfaction with the programme was also measured.
Results:
One hundred and fourteen participants completed baseline questionnaires. Seventy people participated in all six sessions. The mean number of sessions undertaken was 5.0 (SD = 1.5). Fifty-one participants completed at least three sessions and the end-of-programme outcome measures. Fifty-nine participants completed the satisfaction questionnaire with ≥ 90% of participants finding the programme easy to navigate, well managed by the peer coaches and the social networking tools useful. Preliminary efficacy testing among the 51 participants who completed baseline and post-programme outcome measures showed that post-programme scores decreased for depression, anxiety, cancer related fatigue and fear of recurrence (all P<.001) and increased for positive mental wellbeing, hope (both P<.001) and gratitude (P=0.015).
Conclusions:
The feasibility evidence is promising, showing that the peer-delivered, digital iHOPE programme is acceptable and practical. Implementation of the iHOPE programme on a wider scale will incorporate further research and development to maximise completion rates of the measures. Initial effectiveness data suggest positive impacts on important cancer-related quality of life and mental wellbeing outcomes. A randomised controlled trial design with longer follow up is needed to confirm the potential of the iHOPE programme for improving mental and physical health outcomes for cancer survivors.
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