Understanding acceptability of and engagement with Web‐based interventions aiming to improve quality of life in cancer survivors: A synthesis of current research

Abstract

Objective: This review sought to summarize existing knowledge to inform the development of an online intervention that aims to improve quality of life after cancer treatment.Methods: To inform our intervention, we searched for studies relating to Web-based interventions designed to improve quality of life in adults who have completed primary treatment for breast, prostate, and colorectal cancer (as these are 3 of the most common cancers and impact a large number of cancer survivors). We included a variety of study designs (qualitative research, feasibility/pilot trials, randomized trials, and process evaluations) and extracted all available information regarding intervention characteristics, experiences, and outcomes. Data were synthesized as textual (qualitative) data and analyzed by using thematic analysis.Results: Fifty-seven full text articles were assessed for eligibility, and 16 papers describing 9 interventions were analyzed. Our findings suggest that cancer survivors value interventions that offer content specific to their changing needs and are delivered at the right stage of the cancer trajectory. Social networking features do not always provide added benefit, and behavior change techniques need to be implemented carefully to avoid potential negative consequences for some users. 14,15 ConclusionsReviews of heterogeneous, complex interventions frequently conclude that the evidence is "weak" or "mixed" 12,16 and often fail to address intervention usability and acceptability. 13 It is important to understand how an intervention works in and suits a given con- | METHODSTo inform decision making for intervention development purposes in a timely fashion, we followed rapid review methods [22][23][24][25] to identify studies of interest. We used thematic synthesis for analyzing the data, also drawing on approaches used in ICA. 19 We adhered to the AMSTAR: A Measurement Tool to Assess Reviews criteria 26 (see Appendix A for further details). | SearchInclusion and exclusion criteria are outlined in Inclusion Criteria Exclusion CriteriaParticipants Adults who have completed primary treatment for breast, prostate, and colorectal cancer (or interventions that included a variety of cancer types and focused on quality of life issues considered likely to be shared across all cancers)•Specific target groups that were not generalizable to breast, colorectal, or prostate cancer survivors (during primary treatment; pediatric samples, rare cancers, metastatic cancers, etc).•Studies where the focus was on needs associated with specific cancer types (e.g., a focus on specific needs associated with gynecological/head and neck cancers) •Interventions that took place during primary treatment Interventions Online, e-health, or Web-based interventions designed to improve QoL in adults who have completed primary treatment for cancer•Interventions delivered offline or analyses of online forum groups and interventions delivered solely via social media Web sites (e.g. Facebook)Comparators We did not include "comparison" (C...

Randomised controlled trial of internet‐delivered cognitive behaviour therapy for clinical depression and/or anxiety in cancer survivors (iCanADAPT Early)

“…In future effectiveness trials, it could be further evaluated under clinician‐guidance (as presented), in a stepped‐care model, or it could supplement face‐to‐face therapy (“blended therapy” ). These models of care may add acceptability and increase engagement which will ultimately add to their sustainability. Authors have called for the development of “ low cost, simple, specific, and effective (psychological) treatments ” as a way to increase access worldwide to interventions .…”

Development and usability evaluation of an online self‐management intervention for fear of cancer recurrence (iConquerFear)

“…Factors underlying the acceptability and efficacy of online self‐management interventions are not well known, with limited guidance available regarding design issues, such as ordering and scheduling of content delivery . iConquerFear used a tunnelled design, which participant feedback indicated made website navigation straightforward and aided skill acquisition, consistent with previous literature .…”

Peer‐to‐peer connections: Perceptions of a social support app designed for young adults with cancer

“…This feeling of being with peers (ie, social presence) is an important motivator for seeking and sharing support online . To our knowledge, there is no evidence for how YA cancer apps could be optimized to increase feelings of being with peers and reliable access to social support that facilitates engagement to meet YAs changing needs …”