JMIR Publications

ABSTRACT

Background:

Despite the efficacy of psychosocial interventions in minimizing psychosocial morbidity in Breast Cancer Survivors (BCS), intervention delivery across survivorship is limited by physical, organizational, and attitudinal barriers, which contribute to a mental healthcare treatment gap in cancer settings.

Objective:

To develop iNNOV Breast Cancer (iNNOVBC), a guided internet-delivered individually-tailored Acceptance and Commitment Therapy-influenced Cognitive Behavioural intervention program aiming to treat mild to moderate anxiety and depression in BCS, as well as improving fatigue, insomnia, sexual dysfunction and HRQoL in this group. To evaluate the usefulness, usability, and preliminary feasibility of INNOVBC.

Methods:

iNNOVBC was developed using a User-centred design approach, involving its primary and secondary end-users, i.e., BCS (n=11) and Mental Health Professionals (MHP; n=13). We used mixed methods, namely in-depth semi-structured interviews, lab-based usability tests, short-term field trials, and surveys to assess iNNOVBC’s usefulness, usability, and preliminary feasibility among these target users. Descriptive statistics were used to characterize the study sample, evaluate performance data, and assess surveys responses. Qualitative data were recorded, transcribed verbatim and thematically analysed.

Results:

Overall, participants considered iNNOVBC highly useful, with most participants reporting on the pertinence of its scope, the digital format, the relevant content, and the appropriate features. However, various usability issues were identified, and participants suggested that the program should be refined by simplifying navigation paths, using a more dynamic colour scheme, including more icons and images, displaying information in different formats and versions, and developing smartphone and tablet versions. In addition, participants suggested that tables should be converted into plain text boxes and the inclusion of data visualization dashboards to facilitate the tracking of progress. The possibility of using iNNOVBC in a flexible manner, tailoring it according to BCS changing needs and along the cancer care continuum was another suggestion identified.

Conclusions:

The study results suggest that iNNOVBC is considered useful by both BCS and MHP, configuring a promising point-of-need solution to bridge the psychological supportive care gap experienced by BCS across the survivorship trajectory. We believe that our results may be applicable to other similar programs. However, to fulfil its full supportive role, such programs should be comprehensive, highly usable, tailorable, and adopt a flexible yet integrated structure capable of evolving in accordance with survivors changing needs and the cancer continuum.