Uptake and adherence to an online intervention for cancer-related distress: older age is not a barrier to adherence but may be a barrier to uptake
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While online interventions are increasingly explored as an alternative to therapist-based interventions for cancer-related distress, limitations to efficacy potentially include low uptake and adherence. Few predictors of uptake or adherence to online interventions have been consistently identified, particularly in individuals with cancer. This study examined rates and predictors of uptake and adherence to Finding My Way, a RCT of an online intervention versus an information-only online control for cancer-related distress.
Participants were adults with cancer treated with curative intent. Adherence was assessed by login frequency, duration and activity level; analyses examined demographic, medical and psychological predictors of uptake and adherence.
The study enrolled 191 adults (aged 26–94 years) undergoing active treatment for cancer of any type. Uptake was highest for females and for individuals with ovarian (80%) and breast cancer (49.8%), and lowest for those with melanoma (26.5%). Adherence was predicted by older age and control-group allocation. Baseline distress levels did not predict adherence. High adherers to the full intervention had better emotion regulation and quality of life than low adherers.
Uptake of online intervention varies according to age, gender and cancer type. While uptake was higher amongst younger individuals, once enrolled, older individuals were more likely to adhere to online interventions for cancer-related distress.
KeywordsOnline intervention Cancer Cognitive behavioural therapy Uptake Adherence
The authors would like to thank the men and women who participated in this clinical trial, during a difficult stage of their lives.
The authors would like to acknowledge all Finding My Way Investigators and Recruiters for their assistance and support on this project.
This research was supported by a number of hospital sites and organisations. This includes recruitment support by Register4 through its members’ participation in research and/or provision of samples and information; and from Breast Cancer Network Australia’s (BCNA) Review & Survey Group, a national, online group of Australian women living with breast cancer who are interested in receiving invitations to participate in research.
Compliance with ethical standards
Conflict of interest
This study was conducted as part of a larger clinical trial, for which L.B. is the recipient of a grant funded by the National Health and Medical Research Council (grant number 1042942). All other authors declare no conflict of interest.
All procedures in studies involving human participants were conducted in accordance with the ethical standards of the Southern Adelaide Clinical Human Research Ethics Committee, the Royal Brisbane and Women’s Hospital Human Research Ethics Committee, and the ACT Health Human Research Ethics Committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
This work was conducted as part of a larger clinical trial, supported by the National Health and Medical Research Council (grant number 1042942).
- 2.Brebach, R., Sharpe, L., Costa, D., Rhoes, P., & Butow, P. 2016 Psychological intervention targeting distress for cancer patients: a meta-analytic study investigating uptake and adherence. Psycho-OncologyGoogle Scholar
- 3.Cancer Australia and Cancer Council Australia (2010) Review of national cancer control activity in Australia. Cancer Australia, CanberraGoogle Scholar
- 9.Willems, R.A., et al. 2016, Short-term effectiveness of a web-based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: randomized controlled trial. Psycho Oncology: p. n/a-n/aGoogle Scholar
- 21.Beatty, L., & Binnion, Claire 2016, A systematic review of predictors of, and reasons for, adherence to online psychological interventions. International Journal of Behavioral MedicineGoogle Scholar
- 33.National Institute for Health and Care Excellence (2009) Depression in adults with a chronic physical health problem: recognition and management. National Institute for Health Care and Excellence, Manchester, UKGoogle Scholar
- 36.Beatty L, Koczwara B, Wade T (2011) ‘Cancer Coping Online’: a pilot trial of a self-guided CBT internet intervention for cancer-related distress. Electronic Journal of Applied Psychology 7(2):17–25Google Scholar
- 38.Strecher, V.J., et al. 2008, The role of engagement in a tailored web-based smoking cessation program: randomized controlled trial. Journal of Medical Internet Research. 10(5)Google Scholar
- 39.Australian Bureau of Statistics, 1991 1989–1990 National health survey users’ guide, Canberra: ABS. Cat No. 4363.0Google Scholar
- 41.Lovibond SH, Lovibond PH (1995) Manual for the Depression Anxiety Stress Scales (DASS). University of New South Wales, SydneyGoogle Scholar