Adapting a self-guided eHealth intervention into a tailored therapist-guided eHealth intervention for colorectal cancer survivors
ABSTRACT
Background:
Therapist-guided eHealth interventions targeting psychological symptoms have demonstrated greater engagement and efficacy compared to self-guided interventions.
Objective:
This study aimed to adapt a self-guided eHealth intervention for fear of cancer recurrence (iConquerFear) into a therapist-guided intervention (TG-iConquerFear) for colorectal cancer survivors (CRCS) to optimize patient outcomes and minimize resource investment.
Methods:
The Information System Research Framework facilitated the systematic integration of: 1) knowledge from iConquerFear development, feedback from end-users, oncologists, and therapists (Knowledge Base), and 2) adaptation of the intervention through rigorous design cycles and testing in the Environment.
Results:
After the first Design Cycle based on insights from the Knowledge Base, internal field-testing revealed the need for adjustments. No changes were made to the iConquerFear intervention concept, but noteworthy changes were made to enable access (adjustment to mobile devices), increase adherence (elaboration on exercises), and provide therapists with relevant information (reflective questions and a therapist monitored control panel). Subsequent external field testing in five CRCS revealed a high degree of user acceptability which led to the launch of a randomized controlled trial, and some minor changes to consider incorporating in future versions.
Conclusions:
It is possible to successfully adapt a self-guided eHealth intervention for people with fear of cancer recurrence into a therapist-guided eHealth intervention tailored for CRCS. The described procedure can be used in similar settings incorporating therapist guidance into an existing self-guided intervention. Clinical Trial: ClinicalTrials.gov #NCT04287218
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