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Finding My Way: results of a multicentre RCT evaluating a web-based self-guided psychosocial intervention for newly diagnosed cancer survivors

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Abstract

Purpose

This multicentre randomised controlled trial examined the efficacy of Finding My Way (FMW), a 6-week/6-module online self-guided psychotherapeutic intervention for newly diagnosed curatively treated cancer survivors, in reducing cancer-related distress and improving quality of life compared to an online attention control.

Methods

Participants were randomised on a 1:1 ratio using a gender-stratified block design to intervention (n = 94) or attention control (n = 97), and were blinded to condition. Assessments were completed at baseline (T0), post-intervention (T1), 3 months (T2), and 6 months (T3) post-intervention. Mixed model repeated measures analyses examined differences between groups for cancer-specific distress (primary outcome) and general distress, quality of life (QoL), coping, and health service utilisation (secondary outcomes).

Results

While both groups reported reduced cancer-specific and general distress over time, between-group differences were not significant. Intervention participants reported lower total health service utilisation and supportive care utilisation post-intervention than controls (total HS use: between-group mean difference = − 1.07 (− 1.85 to − 0.28); supportive care use: between-group mean difference = − 0.64 (− 1.21 to − 0.06)) and significantly higher emotional functioning at 3 months (between-group mean difference = 7.04 (0.15 to 13.9)). At 6 months, the supportive care utilisation finding reversed (between-group mean difference = 0.78 points (0.19 to 1.37). Across remaining QoL and coping outcomes, no significant group differences emerged.

Conclusions

While both groups experienced reductions in distress, between-group differences were not significant. This contrasts with the significantly improved emotional functioning observed in FMW participants at 3 months and the short-term reductions in health service utilisation. Long-term increases in supportive care service utilisation suggest FMW only met needs while being actively used.

Trial registration

ACTRN12613000001796; http://www.ANZCTR.org.au/ACTRN12613000001796.aspx

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Acknowledgments

We thank all the men and women who participated in this trial; consumer representative Julie Marker, chair Cancer Voices SA, who reviewed the study protocol and provided input throughout the study; and the research assistants/clinicians/clinical trial/support staff who were critical to the successful recruitment of this study. We also thank the Breast Cancer Network Australia and Register4, and their staff, for their assistance in recruitment. We thank our associate investigator and valued colleague, the late Paul Katris, for his important contributions to all aspects of the study design, conduct, and promotion through his extensive network of contacts. The Finding My Way Authorship Group includes Prof Tracey Wade, Dr. Sarah McKinnon, Ms. Simone Noelker, Dr. Louise Gorman, Ms. Bernadette Zappa, Ms. Judy Allen, Ms. Caroline Richards, Mr. Michael Fitzgerald, Ms. Sally Sara, Ms. Lisa Mackenzie, Mr. Edward Craft, Ms. Kathryn Stafford, Ms. Ruby Lipson-Smith, and Ms. Rose Kamateros.

Funding

This RCT was funded by the National Health and Medical Research Council (Grant No. 1042942). Dr. Beatty is supported by a Cancer Council SA Postdoctoral Fellow (Cancer Support).

Author information

Authors and Affiliations

  1. Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia

    Lisa Beatty, Emma Kemp, Joseph R. Coll & Bogda Koczwara

  2. Flinders Centre for Innovation in Cancer, Adelaide, Australia

    Lisa Beatty, Emma Kemp & Bogda Koczwara

  3. Mental Health Centre, The University of Queensland, Herston, Australia

    Jane Turner

  4. University of Sydney, Sydney, New South Wales, Australia

    Phyllis Butow

  5. Peter MacCallum Cancer Centre, Parkville, Victoria, Australia

    Donna Milne

  6. Queensland University of Technology, Brisbane, Queensland, Australia

    Patsy Yates

  7. Ingram School of Nursing, McGill University, Wilson Hall, 3506 University Street, Montreal, H3A 2A7, Canada

    Sylvie Lambert

  8. Smiling Mind, Abbotsford, Victoria, Australia

    Addie Wootten

  9. Department of Medical Oncology, The Canberra Hospital, Garran, ACT, Australia

    Desmond Yip

  10. ANU Medical School, Australian National University, Acton, ACT, Australia

    Desmond Yip

Authors
  1. Lisa Beatty
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  2. Emma Kemp
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  4. Jane Turner
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Corresponding author

Correspondence to Lisa Beatty.

Ethics declarations

Ethical approvals were obtained from the Southern Adelaide Clinical (No. 372.10), Royal Brisbane and Women’s (No. HREC/13/QRBW/252) and ACT (No. Eth.2/14/032) Health Human Research Ethics Committees.

Conflict of interest

The authors declare that they have no conflict of interest.

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The authors have full control of all primary data and agree to allow the journal to review our data if requested.

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Written on behalf of the Finding My Way Authorship Group

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Beatty, L., Kemp, E., Coll, J.R. et al. Finding My Way: results of a multicentre RCT evaluating a web-based self-guided psychosocial intervention for newly diagnosed cancer survivors. Support Care Cancer 27, 2533–2544 (2019). https://doi.org/10.1007/s00520-018-4526-1

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  • DOI: https://doi.org/10.1007/s00520-018-4526-1

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