Background: Online self-help holds considerable promise for the provision of health services as a means of overcoming the access barriers to conventional therapist-administered psychosocial interventions. Our group was one of the first to develop and publish the feasibility of a 6-module self-help CBT-based program, Cancer Coping Online (CCO). This study summarises the next research stage, evaluating CCO in a phase II single-site RCT.
Methods: Participants (n=60) were cancer patients being treated with curative intent, and were recruited from March 2011-November 2012. Participants were randomised to receive either (a) CCO, or (b) an internet attention-control. Two measures of distress (cancer-specific and general), coping, and health-related quality of life were administered at baseline, post-treatment, then 3- and 6-months later. Changes over time between groups were analysed using Linear Mixed Models, using baseline scores as covariates.
Results: Participants were young (M=52 years), married (65%), women (95%) and had breast cancer (90%). An interim analysis of the first 53 participants data found a significant interaction effect for cancer-specific distress from pre- to post-treatment (F(1,92)=4.94, p=.04). Intervention participants experienced significant reductions compared to the slight increases observed in controls. A similar trend approaching significance was also obtained for anxious preoccupation (F(1,92)=3.29, p=.07). While these statistically significant effects were not sustained at 3-month follow-up, this was due to the later improvements in controls. Data collection was finalised in June 2013, and further results for all waves of data across full sample will be presented.
Conclusion: The intervention led to immediate and enduring reductions in distress outcomes compared to the slower improvements observed in controls. Providing early intervention online therefore has the potential to prevent distress from escalating over the survivorship period. This study provided further support for the feasibility and efficacy of the online provision for psychosocial health services.