CaringGuidance™ after breast cancer diagnosis eHealth psychoeducational intervention to reduce early post-diagnosis distress

Lally, Robin M.; Kupzyk, Kevin; Bellavia, Gina M.; Hydeman, Jennifer; Gallo, Steven M.; Helgeson, Vicki S.; Erwin, Deborah O.; Mills, Adam C.; Brown, Jean K.

doi:10.1007/s00520-019-05028-0

Cited by 30 publications

(92 citation statements)

References 44 publications

(82 reference statements)

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“…See Textbox 3 for clinical characteristics. Full demographic data on the 100 participants enrolled in the pilot study have been previously reported [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

“…Enrollment was limited to stage 0–II breast cancer to reduce variation in the treatment experience among subjects. Details of recruitment and eligibility for this study of 100 women have been previously reported [ 13 , 14 ]. Institutional Review Board approval was received, and written consent obtained from all participants before study assessments.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Published reports on completely unguided, web-based psychosocial distress self-management interventions for adults with cancer are limited [ 9 - 13 ]. To the best of our knowledge, CaringGuidance After Breast Cancer Diagnosis [ 13 - 16 ] is one of only two such interventions specifically designed to address the psychosocial needs of women with breast cancer. The primary differences between CaringGuidance and the other program (BREATHE) [ 11 ] are that CaringGuidance is presented in English; was developed with input from, and includes vignettes of, Black as well as White American breast cancer survivors [ 16 ]; and is intended for initial use by women as soon as possible after diagnosis as opposed to after treatment has ended.…”

Section: Introductionmentioning

confidence: 99%

“…The objective of this analysis was to evaluate how women newly diagnosed with breast cancer used the unguided web-based, psychoeducational distress self-management program CaringGuidance while enrolled in its first pilot study [ 13 - 15 ]. The overall goal is to further inform the science of unguided web-based interventions by describing the (1) frequency, duration, and activity of CaringGuidance use by women newly diagnosed with breast cancer in total and by the month of study participation; (2) baseline characteristics of women who demonstrated high, moderate, low, and no program use; and (3) to evaluate high, moderate, and low program users’ study completion, program satisfaction, enactment of distress management skills, and distress outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Use of an Unguided, Web-Based Distress Self-Management Program After Breast Cancer Diagnosis: Sub-Analysis of CaringGuidance Pilot Study

Lally¹,

Kupzyk²,

Gallo³

et al. 2020

J Med Internet Res

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Background Unguided, web-based psychoeducational interventions are gaining interest as a way to reach patients while reducing pressure on clinical resources. However, there has been little research on how patients with cancer use these interventions. Objective The objective of this analysis was to evaluate how women newly diagnosed with breast cancer used the unguided web-based, psychoeducational distress self-management program CaringGuidance After Breast Cancer Diagnosis while enrolled in a pilot feasibility study. Methods Women with stage 0 to II breast cancer diagnosed within the prior three months were recruited from clinics primarily in the Northeastern United States for participation in a 12-week pilot study of CaringGuidance plus usual care versus usual care alone. Usage prompts included sets of emails sent weekly for 12 weeks; standardized congratulatory emails after every two hours of program use, and informative emails for each cognitive-behavioral exercise. Individual user activity on the site was automatically tracked by an analytics system and recorded directly in the CaringGuidance database. Results Complete usage data were available for 54 subjects. Ninety-eight percent of the intervention group logged into CaringGuidance independently at least once. Thirty-eight (70%) logged in during all three months, 15 (28%) were intermittent users, and one (2%) was a non-user. Users (n=53) averaged 15.6 (SD 9.85) logins. Mean logins were greatest in month 1 (7.26, SD 4.02) and declined in months 2 (4.32, SD 3.66) and month 3 (4.02, SD 3.82). Eleven (21%) used CaringGuidance with both the frequency and activity level intended at study outset, 9 (17%) exceeded intended frequency and activity (high-high users), and 10 (19%) were below expected usage on both login frequency and activity (low-low users). Low-low users and high-high users differed significantly (P<.001) in the total number of views and unique views of all program components. Change in depressive symptoms and the number of sessions (r=.351) and logins (r=.348) between study months 1 and 2 were significantly correlated (P=.018, .019). Higher baseline distress was associated with more unique views of program resources (r=.281, P=.043). Change in intrusive/avoidant thoughts from baseline to month 3, and the number of users’ unique exercise views were negatively correlated (r=–.319, P=.035) so that more unique exercise views, equated with greater decline in intrusive/avoidant thoughts from baseline to month 3. Conclusions These findings favor the hypothesis that the key ingredient is not the amount of program use, but each user’s self-selected activity within the program. More research is needed on the ideal ways to maintain use, and capture and define engagement and enactment of behaviors by people with cancer accessing unguided, self-management web-based programs.

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“…See Textbox 3 for clinical characteristics. Full demographic data on the 100 participants enrolled in the pilot study have been previously reported [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Use of an Unguided, Web-Based Distress Self-Management Program After Breast Cancer Diagnosis: Sub-Analysis of CaringGuidance Pilot Study

Lally¹,

Kupzyk²,

Gallo³

et al. 2020

J Med Internet Res

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Adjustment of young women with breast cancer after chemotherapy: A mediation model of emotional competence via emotional distress

et al. 2022

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Objective Emotional competence (EC) is considered a substantial resource in the adjustment of cancer patients, especially via its effect on anxiety and depression symptoms. This research aimed at assessing the impact of intrapersonal EC in young women (≤45 years) with breast cancer (YWBC) on their specific quality of life (i.e. subjective experience related to daily difficulties and perceived repercussions of the disease and treatments) related to chemotherapy, via anxiety and depression symptoms. Methods Two hundred fifty YWBC from 24 French centers completed a self‐reported questionnaire after diagnosis (T1) and after the chemotherapy phase (T2), comprising the Young Women Breast Cancer Inventory, the Profile of EC and the Hospital Anxiety and Depression Scale. The indirect effect of EC (T1) on subjective experience (T2) via anxiety and depression symptoms (T2) was tested using regressions and the Macro PROCESS. Results Emotional competence predicted fewer anxiety and depression symptoms at T1 and T2, and a better subjective experience at T2 via fewer anxiety and depression symptoms. Depression symptoms appeared to be a stronger mediator than anxiety symptoms on four dimensions (Support from close relatives, feeling of couple cohesion, body image and sexuality, management of children and everyday life), whereas anxiety symptoms appeared to be a stronger mediator on two dimensions (negative affectivity and apprehension about the future, deterioration of relationships). Conclusions These results support the importance of developing psycho‐affective interventions to reinforce the EC of YWBC during chemotherapy in order to facilitate the cognitive and emotional processes necessary for a better adjustment and subjective experience.

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Impact of connected health interventions on psychological wellbeing and quality of life in patients with cancer: A systematic review and meta‐analysis

et al. 2022

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Objective:Connected health technologies have the potential to improve access to cancer care and support and reduce costs. We aimed to assess the impacts of interventions delivered using connected health technologies on psychological and quality of life (QoL) outcomes in people living with and beyond cancer. Methods: PUBMED, PsycINFO, Web of Science, and EMBASE were searched using terms relating to (i) cancer, (ii) connected health, and (iii) QoL/psychological wellbeing. Studies were included if they evaluated interventions using connected health technologies and assessed psychological and/or QoL outcomes for adults at any stage of cancer treatment or survivorship. Results: Thirty-seven studies met the inclusion criteria with a total of 8956 participants. Connected health technologies included web-based applications (n = 24), smart applications (n = 12), and wearable devices (n = 1). Studies were heterogeneous in terms of intervention components. We identified five clusters: (i) Psychosocial support and rehabilitation, (ii) psychoeducation and information support, (iii) symptom monitoring, reporting and self-management, (iv) peer and social support, and (v) health coaching and physical activity training. Due to heterogeneity of outcome measures, the meta-analysis included only seven RCTs; pooled mean estimates showed connected health interventions were moderately effective in reducing symptoms of depression (SMD: −0.226, 95% CI −0.303/−0.149) and anxiety (SMD: −0.188, 95% CI: 0.279/−0.0963) compared with usual care. Conclusion: While the considerable heterogeneity observed highlights the need for more rigorous studies to improve reproducibility and efficiency, results suggest that connected health interventions have the potential to improve psychological wellbeing and QoL outcomes in people living with and beyond cancer.K E Y W O R D S cancer, connected health interventions, oncology, psycho-oncology, psychological wellbeing, quality of life This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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CaringGuidance™ after breast cancer diagnosis eHealth psychoeducational intervention to reduce early post-diagnosis distress

Cited by 30 publications

References 44 publications

Use of an Unguided, Web-Based Distress Self-Management Program After Breast Cancer Diagnosis: Sub-Analysis of CaringGuidance Pilot Study

Use of an Unguided, Web-Based Distress Self-Management Program After Breast Cancer Diagnosis: Sub-Analysis of CaringGuidance Pilot Study

Adjustment of young women with breast cancer after chemotherapy: A mediation model of emotional competence via emotional distress

Impact of connected health interventions on psychological wellbeing and quality of life in patients with cancer: A systematic review and meta‐analysis

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