Background: Online self-help holds promise for overcoming access barriers to conventional therapist-administered psychosocial interventions. We have undertaken a multi-site RCT of a 6-module/6-week internet Cognitive Behaviour Therapy-based support program aiming to reduce cancer-related distress and improve coping (‘Finding My Way’), with the primary objective of evaluating the program’s efficacy and secondary objectives of examining program uptake, satisfaction and adherence.
Methods: Cancer patients treated with curative intent (n=191) were recruited from October 2013 to November 2015, and randomised to receive either the Finding My Way intervention or an attention-control. Measures of cancer-related distress, general distress, health related quality of life, coping, and health service usage were administered at baseline, post-intervention, then 3-months and 6-months later. Changes over time between groups were analysed using Mixed Models for Repeated Measures, using baseline scores as covariates.
Results: Of 461 eligible patients, 191 (41%) enrolled; 31% eligible breast cancer patients declined vs 55% eligible melanoma patients. The most common reasons for declining included the patient was coping well enough (23%), or not having time (17%). Enrolled participants (mean age 55.0 years, range 26-95) were predominantly female (84%), partnered (77%), breast cancer patients (63%), and were predominantly tertiary educated (71%) and employed (63%). Of note, 31% of the sample lived in rural or remote areas. While participant adherence overall was moderate-to-high, significant differences between groups emerged, with the control group completing more modules (M=4.45, SD=2.11) than intervention participants (M=3.29, SD=2.25; t(189)=3.70, p<.001). Post-treatment feedback indicated that 82% of respondents found the program quite/very helpful. Follow-up data collection was finalised in July 2016, and intervention-efficacy for all waves of data will be presented.
Conclusion: This study demonstrates the promise of web-based CBT for increasing the reach of psychological therapies. Clinical and research implications of this efficacy findings will be discussed. Funding: NHMRC Project Grant #1042942.