Supportive Care in Cancer

, Volume 25, Issue 8, pp 2539–2548 | Cite as

A qualitative exploration of barriers and facilitatorsto adherence to an online self-help intervention for cancer-related distress

  • Lisa Beatty
  • Claire Binnion
  • Emma Kemp
  • Bogda Koczwara
Original Article



This study qualitatively explored barriers and facilitators of adherence to an online psychological intervention for cancer-related distress.


Semi-structured interviews were conducted with 13 adults with cancer, randomised to receive either a 6-week intervention (n = 8) or attention control (n = 5) as part of a larger RCT. Transcripts were coded for themes and subthemes, and recruitment ceased when saturation of themes occurred.


Adherence overall was high: six participants completed all six modules, three completed five modules, two completed four modules, one completed one module, and one did not access the program. The total numbers of barriers (n = 19) and facilitators (n = 17) identified were equivalent and were categorised into five overarching themes: illness factors, psychological factors, personal factors, intervention factors and computer factors. However, the prevalence with which themes were discussed differed: illness factors (specifically cancer treatment side effects) were the main reported barrier to adherence; intervention factors (email reminders, program satisfaction, ease of use, program content) were the most common facilitators.


While some factors were cited as both facilitating and barring adherence, and therefore reflective of personal preferences and circumstances, a number of recommendations were derived regarding (i) the best timing for online interventions and (ii) the need for multi-platform programs.


Cancer Distress Online intervention Adherence Facilitators Barriers Qualitative 



This work was conducted as part of a larger clinical trial, supported by the National Health and Medical Research Council (grant number 1042942). The authors would like to thank the men and women who participated in this qualitative study and, in the larger clinical trial, during a difficult stage of their lives. I confirm that all patient/personal identifiers have been removed or disguised so the patient/person(s) described is not identifiable and cannot be identified through the details of the story.

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. We acknowledge the women involved in Review & Survey Group who participated in this project.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

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

Informed consent was obtained from all individual participants in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.School of PsychologyFlinders UniversityAdelaideAustralia
  2. 2.Flinders Centre for Innovation in CancerFlinders UniversityAdelaideAustralia

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