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

Cancer Med. 2020 Jun;9(11):3775-3785. doi: 10.1002/cam4.3000. Epub 2020 Apr 3.

Abstract

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.

Keywords: cancer; cancer survivor; cognitive behavioral; digital; distress; health-care delivery; psycho-oncology; stress-management.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / etiology
  • Anxiety / psychology
  • Anxiety / therapy*
  • Cancer Survivors
  • Case-Control Studies
  • Combined Modality Therapy
  • Depression / etiology
  • Depression / psychology
  • Depression / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Internet-Based Intervention / statistics & numerical data*
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / therapy
  • Prognosis
  • Psychotherapy / methods*
  • Stress, Psychological / etiology
  • Stress, Psychological / psychology
  • Stress, Psychological / therapy*
  • Survival Rate
  • Telephone / statistics & numerical data