Phase II trial of a depression self-care intervention for adult cancer survivors

Abstract

Supported self-care interventions are a low-intensity treatment for depression that has received little research attention in the cancer population. This is a phase II intervention only study to test the feasibility, acceptability and preliminary effectiveness of a depression self-care intervention for cancer patients who have completed their primary treatment and have moderate depressive symptoms. The self-care intervention was adapted from a successful model for people with chronic physical conditions, following focus groups with cancer care professionals and patients. The support was delivered by telephone by a trained lay coach who provided up to 8 weekly coaching contacts. A variety of recruitment methods were tested; those with the highest yield of eligible subjects per research staff time were electronic mailings to community support group members and social media posting. Sixty-eight people were contacted about the study over an 11-month period, of whom 34 (49%) were eligible; 32 were enrolled (94% recruitment rate); and 25 completed 2-month follow-up (78% retention). The mean severity of PHQ-9 depression decreased significantly from screening to 2 months (12.8 to 7.0, p < .0001). The intervention is a promising treatment option for cancer survivors, demonstrating sufficient effectiveness and feasibility to proceed with a phase III clinical trial. K E Y W O R D Scancer survivorship, depression, feasibility, intervention, self-care, self-management

Digital Health Interventions for Depression and Anxiety Among People With Chronic Conditions: Scoping Review

“…An additional 3 articles were identified by screening the reference lists. Overall, 53 articles [ 46 - 99 ] were included in this review ( Multimedia Appendix 3 [ 46 , 47 , 50 , 52 , 54 , 55 , 57 - 60 , 62 ,​ 64 - 66 , 70 - 72 , 74 , 77 , 78 , 80 , 81 , 84 , 86 , 88 , 90 - 92 , 95 , 96 , 98 , 99 ]). The following sections outline the characteristics of the included studies and report the details related to study objectives 1 and 2.…”

“…Indeed, although several interventions relied on guidance to promote engagement with the intervention [ 50 , 55 , 57 , 60 , 64 , 91 , 99 ], studies have noted that this limited the scalability of the intervention. Guidance provided by lay individuals and peer supporters was feasible and well accepted [ 46 , 60 ], whereas interventions supported by nurses at times faced challenges in integrating additional workload into their roles [ 90 ]. Although several alternatives exist to improve the feasibility of guidance (eg, reduced frequency of guidance, partial guidance, no guidance, blending guided sessions with self-help modules [ 110 ], and automated guidance via chatbots [ 80 ]), the findings of this review and previous studies underscore the potential for allied health professionals and nonclinicians in guiding DHIs.…”

CanDirect: Effectiveness of a Telephone-Supported Depression Self-Care Intervention for Cancer Survivors

“…Overall, we achieved our recruitment goals although we were unable to recruit an adequate community sample in one province, limiting our ability to investigate differences in effectiveness between participants recruited in clinical versus community sites, and limiting the generalizability of the findings. 30 The SCI tested in this study is a potentially cost-effective intervention for female cancer survivors with mild-moderate depressive symptoms, with or without major depression. The use of trained lay coaches fills a gap in mental health services because of shortages of qualified psychologists, particularly in the post-primary treatment phase of survivorship.…”

“…28,29 The Cancer Depression Intervention via Referral, Education and Collaborative Treatment (CanDirect) intervention was adapted for cancer survivors from an evidence-based telephone-supported depression SCI for primary care patients with chronic physical conditions. 28 Pilot data in cancer survivors 30 supported its feasibility and acceptability. We conducted a pragmatic 31 randomized controlled superiority trial to assess the effectiveness of CanDirect in cancer survivors with mild-moderate depressive symptoms, with or without major depression.…”

Heeding the psychological concerns of young cancer survivors: a single-arm feasibility trial of CBT and a cognitive behavioral conceptualization of distress

“…This applies to mode of participant communication as well as the initial identification of potential participants, contrary to merely utilizing cancer registries and centers (Gorman et al, 2014). Indeed, social media and internet-based recruitment strategies have been found to be effective in recruitment of cancer (McCusker et al, 2018) and young adult (Musiat et al, 2016) populations. Whilst in-person recruitment (e.g., inperson recruitment at oncology clinics) has been demonstrated as a successful recruitment strategy in comparison to mail-out, telephone-based, and social media recruitment (Rabin, Horowitz & Marcus, 2013), the necessity of approval for site-specific recruitment can cause delays and negatively affect recruitment (Sansom-Daly et al, 2017).…”