Individuals with cancer face an array of psychosocial needs, and it has been estimated that up to 35% of cancer survivors experience clinically-significant levels of distress. Psychosocial interventions may be effective for improving quality of life and reducing levels of mood disturbance in these patients. Unfortunately, barriers to accessing psychosocial intervention are common, and many are unable to access those services. Internet- based psychosocial interventions improve accessibility of care and offer additional methodological advantages, including the ability to easily collect self-report data, track exposure to the intervention, and evaluate effects of specific intervention components. A study conducted by the PI is one of only three randomized trials of the effects of internet-based psychosocial intervention on adjustment to cancer, and all three of these trials were limited to now-outdated Internet interventions provided exclusively to women with breast cancer. There is a clear and pressing need to evaluate an internet-based intervention that: a) has modern features that will increase the amount of time spent interacting with intervention components (i.e., social-networking features), b) is inclusive of other cancers (i.e., not just breast cancer), and c) employs a system for carefully tracking levels of behavioral engagement with the intervention.
The specific aims of the proposed study are 1) to evaluate the feasibility of a randomized, controlled trial of an online social-networking intervention and to identify key strengths and weaknesses of the intervention materials and 2) to estimate effect sizes necessary for adequately powering a larger controlled trial comparing face-to-face and online interventions. To accomplish these aims, a registry-based recruitment procedure will be used to identify recently diagnosed individuals with cancer who are currently experiencing significant cancer-related distress. Individuals interested in participating in the study will be randomized to receive access to a 12-week internet-based treatment group or to a 12-week waiting list control group. Subjects assigned to the treatment group will have access to a group discussion board, a structured 12-week coping-skills training course, professional facilitation of the group, a real-time chat board, and personal profiles established by other group members. Subjects will be asked to complete online self-report measures of distress, mood disturbance, and quality of life at baseline and again after participation in the 12-week group. Wait-list control subjects will be able to join a group after they complete the 12-week assessment and will be asked to complete a 24-week assessment in order to measure change over time. It is hypothesized that the treatment group will show greater improvements in quality of life and mood disturbance compared to the control group and that greater levels of engagement with the intervention materials will be associated with greater improvements in mood and quality of life. Long-term goals of the research team are to continually improve effect sizes and accessibility of psychosocial interventions for cancer survivors and to evaluate the effects of internet-based and face-to-face interventions in a head-to-head trial.
Only a handful of studies have evaluated the effects of internet-based psychological treatments for distress in those living with cancer. The proposed study will evaluate whether a website developed specifically for providing psychological treatment and enhancing communication between cancer survivors can improve distress among cancer survivors who indicate that they have high levels of distress. If successful, the study will also provide valuable information needed to improve the treatment and to adequately conduct a larger trial comparing internet-based and face-to-face treatments.
