Andrykowski, Michael A.

BACKGROUNDCognitive‐behavioral stress management interventions are associated with improved psychological well‐being for cancer survivors. The availability of, access to, and outreach of these in‐person interventions are limited, however. The current study, therefore, evaluated the efficacy of StressProffen, a digital application (app)–based stress management intervention for cancer survivors, in a 12‐month randomized controlled trial.METHODSCancer survivors 1 year or less after their treatment (N = 172) were randomized to the StressProffen intervention (n = 84) or a usual‐care control group (n = 88). The intervention was delivered in a simple blended care model: 1) 1 in‐person introduction session, 2) 10 app‐based cognitive‐behavioral stress management modules, and 3) 2 follow‐up phone calls. Stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety and Depression Scale), self‐regulatory fatigue (Self‐Regulatory Fatigue 18), and health‐related quality of life (HRQOL; RAND‐36) were examined at the baseline and at 6 and 12 months. Generalized linear models for repeated measures were fitted to compare effects over time.RESULTSParticipants were mainly female (82%), had a mean age of 52 years (standard deviation, 11.3 years; range, 20‐78 years), and had a variety of cancer types (mostly breast cancer [48%]). Over the 12‐month study time, the intervention group reported significantly decreased stress (P < .001), depression (P = .003), and self‐regulatory fatigue (P = .002) as well as improved HRQOL (for 6 of 8 domains, P ≤ .015) in comparison with controls. The largest favored effects for the intervention group were observed at 6 months: stress (estimated mean difference [MD], –5.1; P < .001), anxiety (MD, –1.4; P = .015), depression (MD, –2.1; P < .001), self‐regulatory fatigue (MD, –4.9; P < .001), and HRQOL (7 of 8 domains; P ≤ .037).CONCLUSIONSDigital stress management interventions such as StressProffen have the potential to extend the outreach of psychological interventions and provide easily available and effective psychosocial support for cancer survivors.

AbstractBackgroundIn‐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.MethodsCancer 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.ResultsParticipants 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.ConclusionsDigital‐based cancer stress‐management interventions, such as StressProffen, have the potential to provide easily accessible, effective psychosocial support for cancer survivors.

Abstract Psychosocial eHealth intervention programs for cancer survivors are still in their infancy, with inconsistent findings so far in the scientific literature. The aim of this study was to explore system use, usefulness, ease of use, and preliminary effects of Stress Proffen, an app-based cognitive-behavioral stress management intervention for patients with cancer. A feasibility pilot project tested the intervention with cancer survivors (N = 25). The intervention contained (a) one face-to-face introduction session, (b) 10 app-based modules with stress management educational material and exercises, and (c) one follow-up phone call. Post-intervention interviews were conducted and user log-data were extracted. Outcome measures—Perceived Stress Scale (PSS), Anxiety and Depression (Hospital Anxiety and Depression Scale [HADS]), Health-Related Quality of Life (HRQoL; SF-36), and Self-Regulatory Fatigue (SRF-18)—were completed at baseline and post-intervention. Participants were primarily women (84%), age 34–71 (mean 48) and represented a variety of cancer diagnoses (majority breast cancer: 40%). Twenty-two participants completed all (pre–post) questionnaires. Sixteen participants (67%) completed at least 7 of 10 modules within the 8-week study period. Post-intervention interviews described StressProffen as providing a new, appreciated, and easily accessible stress management tool for the cancer survivors. Dependent/paired t-tests showed significant pre–post intervention effects with significant decrease in stress (p = .008), anxiety (p = .019), and self-regulatory fatigue (p = .025), and improved HRQoL (Role Physical, General Health, Vitality, and Role Emotional, all p’s &lt;.01). App-based stress management interventions such as StressProffen can provide appreciated support for cancer survivors, should be easy to use, can provide significant stress reduction, and improve emotional well-being. Further testing in a randomized controlled trial is warranted and is in progress. Clinicaltrials.gov: NCT0293961.