Results from a randomized controlled trial testing StressProffen; an application‐based stress‐management intervention for cancer survivors

• Published in: Cancer medicine (Malden, MA) MA), 2020-06, Vol.9 (11), p.3775-3785
• Main Authors: Børøsund, Elin, Ehlers, Shawna L., Varsi, Cecilie, Clark, Matthew M., Andrykowski, Michael A., Cvancarova, Milada, Solberg Nes, Lise
• Format: Article
• Language: English
• Subjects: Anxiety; Anxiety - etiology; Anxiety - psychology; Anxiety - therapy; Breast cancer; cancer; cancer survivor; Cancer Survivors; Case-Control Studies; Clinical Cancer Research; Cognitive ability; cognitive behavioral; Combined Modality Therapy; Comorbidity; Coping; Depression - etiology; Depression - psychology; Depression - therapy; digital; Disease management; distress; Face; Female; Follow-Up Studies; health‐care delivery; Humans; Internet-Based Intervention - statistics & numerical data; Intervention; Licenses; Male; Mental depression; Middle Aged; Neoplasms - complications; Neoplasms - therapy; Original Research; Patients; Prognosis; Psychologists; Psychotherapy - methods; psycho‐oncology; Quality of life; Questionnaires; Regression analysis; Smartphones; Social networks; Stress, Psychological - etiology; Stress, Psychological - psychology; Stress, Psychological - therapy; stress‐management; Studies; Survival Rate; Telephone - statistics & numerical data
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.3000

Background In‐person cognitive‐behavioral stress‐management interventions are consistently associated with reduced cancer distress. However, face‐to‐face delivery is an access barrier for many patients, and there is a need to develop remote‐delivered interventions. The current study evaluated the preliminary efficacy of an application (app)‐based cancer stress‐management intervention, StressProffen, in a randomized controlled trial. Methods Cancer survivors, maximum 1‐year posttreatment (N = 172), were randomized to StressProffen (n = 84) or a usual care control group (n = 88). Participants received a blended delivery care model: (a) one face‐to‐face introduction session, (b) 10 app‐based cognitive‐behavioral stress‐management modules, and (c) follow‐up phone calls at weeks 2‐3 and 6‐7. Outcome measures included stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety Depression Scale), and health‐related quality of life (HRQoL; Short‐Form Health Surveys [SF‐36]) at 3‐months post‐intervention, analyzed with change scores as dependent variables in linear regression models. Results Participants were primarily women (82%), aged 20‐78 years (mean 52, SD 11.2), with mixed cancer types (majority breast cancer; 48%). Analysis of 149 participants completing questionnaires at baseline and 3 months revealed significant intervention effects: decreased stress (mean difference [MD] −2.8; 95% confidence interval [CI], [−5.2 to −0.4]; P = .022) and improved HRQoL (Role Physical MD = 17.7, [CI 3.7‐31.3], P = .013; Social Functioning MD = 8.5, [CI 0.7‐16.2], P = .034; Role Emotional MD = 19.5, [CI 3.7‐35.2], P = .016; Mental Health MD = 6.7, [CI 1.7‐11.6], P = .009). No significant changes were observed for anxiety or depression. Conclusions Digital‐based cancer stress‐management interventions, such as StressProffen, have the potential to provide easily accessible, effective psychosocial support for cancer survivors. In a randomized controlled trial, cancer survivors with access to an app‐based cognitive‐behavioral stress‐management intervention (StressProffen) compared with a control group reported a significant reduction in perceived stress level and a significant increase in health‐related quality of life at 3 months. Interventions such as StressProffen, with easy access and use, have the potential to provide low cost, highly accessible psychosocial support for a large group of cancer survivors.