JMIR Publications

ABSTRACT

Background:

Cancer is the leading cause of death in Canada, and living with cancer generates psychological demands, including depression and anxiety among cancer survivors and caregivers. Text4Hope-Cancer Care text-based service was provided to people with cancer and caregivers during the COVID-19 pandemic to support their mental health.

Objective:

To examine the clinical effectiveness of and satisfaction with Text4Hope-Cancer Care in addressing mental health conditions among people living with cancer and caregivers.

Methods:

The study was run in Alberta, Canada, and patients diagnosed or receiving cancer treatment and caregivers self-subscribed to receive 3-months daily supportive Cognitive Behavioral Therapy-based text messages. Self-reported questionnaires assessing the demographic and clinical characteristics of study subscribers were used. The Hospital Anxiety and Depression scale was used to examine changes in anxiety and depression symptoms before and after receiving the service. Satisfaction with the service was assessed using a survey with Likert scale. Descriptive and inferential statistics were used, and test significance was considered with P ≤ 0.05.

Results:

Overall, 107 individuals subscribed to the service, and 93 completed the program (completion rate 86.9%). A significant improvement in the anxiety symptoms (HADS-A subscale) among people living with cancer and caregivers after three months of Text4Hope-Cancer Care (t(11) = 2.62, p = .02), with medium effect size (Hedges’ g = 0.7), but not depression symptoms. Subscribers expressed high satisfaction and agreed that the service has helped them to cope with mental health symptoms and improve their quality of life. Most subscribers read the texts more than once (90%); took time to reflect or took a beneficial action after reading the messages (90%); and highly agreed with the value of the received supportive texts as being relevant, succinct, affirmative, and positive (>80%). All subscribers recommended text messaging for stress, anxiety, and depression and for cancer care support (100%).

Conclusions:

Text4Hope-Cancer Care was well-perceived and effectively addressed anxiety symptoms among people living with cancer and caregivers during the peak of COVID-19 pandemic. This study provides evidence-based support and insight for policy and stakeholders to implement convenient, economic and accessible mental health services that support vulnerable populations during crises. Clinical Trial: Ethics approval has been granted by the University of Alberta Health Research Ethics Board (Pro00086163).