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

Allan Ben Smith; Adeola Bamgboje-Ayodele; Phyllis Butow; Britt Klein; Jane Turner; Louise Sharpe; Joanna Fardell; Lisa Beatty; Alison Pearce; Belinda Thewes; Jane Beith; iConquerFear Community Advisory Group; Afaf Girgis

doi:10.1002/pon.5218

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

Psychooncology. 2020 Jan;29(1):98-106. doi: 10.1002/pon.5218. Epub 2019 Sep 10.

Authors

Allan Ben Smith^{1

2}, Adeola Bamgboje-Ayodele¹, Phyllis Butow², Britt Klein³, Jane Turner⁴, Louise Sharpe^{2

5}, Joanna Fardell⁶, Lisa Beatty⁷, Alison Pearce^{8

9}, Belinda Thewes², Jane Beith¹⁰; iConquerFear Community Advisory Group^{1

2

11

12

13}; Afaf Girgis¹

Affiliations

¹ Centre for Oncology Education & Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.
² Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia.
³ Biopsychosocial and eHealth Research & Innovation (BeRI) and the DVC-R&I Portfolio, Federation University Australia, Ballarat, Australia.
⁴ Department of Psychiatry, University of Queensland, Brisbane, Australia.
⁵ School of Psychology, University of Sydney, Sydney, NSW, Australia.
⁶ School of Women's and Children's Health, UNSW Medicine, University of New South Wales, NSW, Australia.
⁷ School of Psychology, Flinders University, Adelaide, SA, Australia.
⁸ Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia.
⁹ School of Public Health, University of Sydney, Sydney, NSW, Australia.
¹⁰ Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
¹¹ Cancer Council NSW, NSW, Australia.
¹² Ovarian Cancer Australia, Melbourne, Australia.
¹³ Melanoma Patients Australia, Brisbane, Australia.

PMID: 31483911
DOI: 10.1002/pon.5218

Abstract

Objective: To develop and evaluate the usability of iConquerFear, an online self-management adaptation of an efficacious face-to-face therapist-delivered treatment for fear of cancer recurrence (FCR).

Methods: iConquerFear development was theory based and person based. Development was guided by Ritterband et al's behaviour change model for internet interventions. iConquerFear end users (cancer survivors) provided iterative feedback in accordance with Yardley et al's person-based approach to maximise engagement and usability. Online focus groups and cognitive interviews were conducted to evaluate the usability of iConquerFear. Discussions were recorded, transcribed verbatim, and thematically analysed.

Results: Five online FCR modules were developed. Twenty-three cancer survivors (47% of those eligible) participated; 11/23 (58%) were breast cancer survivors, and average age was 53 years (SD = 10.8). Thematic saturation was reached after six focus groups (n = 16) and seven individual think-aloud interviews. Thematic analysis produced five overarching themes: easy navigation essential; satisfaction and engagement with content; flexible access is key; normalising and empowering; and a useful first step.

Conclusions: Online self-management interventions like iConquerFear have the potential to address the unmet supportive care needs reported by burgeoning numbers of cancer survivors. However, that potential may not be realised unless interventions are rigorously developed and user tested, as benefits are constrained by limited engagement. Themes from the usability testing of iConquerFear highlight the importance of developing flexible, tailored, interactive, and contextual online self-management interventions for people with cancer.

Keywords: cancer; eHealth; fear of cancer recurrence; oncology; online; psycho-oncology; self-management; survivorship; web-based.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Breast Neoplasms / psychology*
Cancer Survivors / psychology*
Female
Humans
Internet-Based Intervention*
Male
Middle Aged
Neoplasm Recurrence, Local / psychology*
Outcome and Process Assessment, Health Care*
Phobic Disorders / therapy*
Self-Management*

Supplementary concepts

Phobia, Specific