A Stress Management App Intervention for Cancer Survivors: Design, Development, and Usability Testing

Børøsund, Elin; Mirković, Jelena; Clark, Matthew M.; Ehlers, Shawna L.; Andrykowski, Michael A.; Bergland, Anne; Westeng, Marianne; Nes, Lise Solberg

doi:10.2196/formative.9954

Cited by 66 publications

(84 citation statements)

References 46 publications

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“…In the current study, cancer survivors receiving StressProffen , 26,27 an app‐based cognitive‐behavioral stress‐management intervention program, reported significant reductions in perceived stress compared with cancer survivors receiving care as usual only. Results demonstrate that 3‐months access to an app‐based program, delivered in a blended health‐care delivery model (ie, a single face‐to‐face introduction session, two telephone follow‐up calls, and availability of telephonic support assist with technology use) can significantly improve cancer distress.…”

Section: Discussionmentioning

confidence: 71%

“…In addition, project team, including the licensed clinical health psychologist (ie, last author), met weekly to further ensure fidelity to the intervention protocol for the introductory sessions and follow‐up phone calls. For more details about StressProffen please see Børøsund and colleagues 2018, 2019 26,27 …”

Section: Methodsmentioning

confidence: 99%

“…The 10 modules in StressProffen are also described elsewhere 26 and included the following themes (see Figure 1 for screenshots): (a) What is stress; (b) stress, QoL and planning; (c) thoughts, feelings and self‐care; (d) mindfulness, rational thought‐replacement and guided imagery; (e) stress and coping; (f) Social support, humor and meditation; (g) anger management and conflict style awareness; (h) assertiveness and communication; (i) health behaviors and setting goals; and (j) review and summary. Participants could choose between reading and listening to the program at any time.…”

Section: Methodsmentioning

confidence: 99%

“…Based on existing research and the potential of psychosocial eHealth interventions to reach a high number of cancer survivors, the current research team developed StressProffen TM© , an app‐based cognitive‐behavioral stress‐management intervention program for cancer survivors 26,27 . The current study aimed to examine preliminary results from an RCT testing the StressProffen intervention program.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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) followup 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. 3776 | BØRØSUND et al.

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Section: Discussionmentioning

confidence: 71%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…It is also important to adapt the intervention to health care providers' work flow and the organization of intended use. As examples, when health care researchers and a software team developed appbased programs for stress management in cancer and chronic pain self-management, patients, health care providers, eHealth experts, and the hospital privacy and security department were involved in the development process (18,19) . The Center for eHealth Research and Disease Management comprehensive roadmap (CEHRES ROADMAP) (20) was used to guide the development process as it recommends a multidisciplinary approach and a continuous systematic evaluation throughout the development process.…”

Section: Design and Development Of Ehealth Interventionsmentioning

confidence: 99%

INNOVATIVE eHEALTH INTERVENTIONS IN NURSING RESEARCH. HOW TO UTILIZE A MIXED METHOD APPROACH TO DESIGN, DEVELOPMENT, EVALUATION AND IMPLEMENTATION

Børøsund

Varsi

2019

Cienc. enferm.

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Electronic health (eHealth) interventions have shown promising results in optimizing self-management and care for patients. eHealth offers a large range of solutions to be used by the patient, nurses and other health professionals when providing care and follow-up for patients, families, and communities. Nurses, as the largest group of health care providers, have a responsibility in the development, research and implementation of eHealth interventions. The aim of this article is to describe methods, frameworks and models for development and testing of eHealth interventions, including security and privacy considerations and methods for implementation into the health care service. To succeed with development, testing and implementation of eHealth interventions, the following steps could be addressed: 1) base the intervention on existing evidence when available, 2) include all relevant stakeholders in the development phase, 3) develop a business model at project start and plan for implementation, 4) establish usability, acceptability, compliance, and delivery of the intervention through a feasibility pilot prior to larger studies, 5) test for intervention effect by using an appropriate study design and perform process-and economic evaluation to supplement findings, and 6) use appropriate implementation strategies to implement efficient interventions and evaluate the implementation.

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Mobile application to support oncology patients during treatment on patient outcomes: Evidence from a randomized controlled trial

Graetz

Curry

et al. 2022

Cancer Medicine

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Background: Cancer treatment requires substantial demands on patients and their caregivers. Mobile apps can provide support for self-management during oncology treatment, but few have been rigorously evaluated.Methods: A 3-month randomized controlled trial was conducted at a large cancer center to evaluate the efficacy of an app (LivingWith®) that provides selfmanagement support during cancer treatment on quality of life and health care utilization. Patients in chemotherapy treatment were randomized into the intervention (n = 113) and control group (n = 111). Intervention group participants agreed to use the app weekly for 3 months, and all participants completed a survey at enrollment and after 3 months to evaluate changes in quality of life and health care utilization.Results: Retention rate was 75.4% with 169 participants completing the follow-up survey. The intervention group reported 0.74 fewer medical office visits (p = 0.043) and 0.24 fewer visits with a mental health professional (p = 0.061) during the 3 and month intervention compared with controls. There were no significant changes by study group in quality of life, or emergency room and urgent care visits. Among intervention participants, 75.3% reported using the app and on average, used it 11.7 times during the 3-month intervention. Reasons for not using the app among intervention participants included lack of time, lack of interest in apps, and usability challenges. Conclusions and Relevance:Apps are inexpensive and scalable tools that can provide additional support for individuals coping with complex cancer treatments. This trial provides evidence that a well-designed oncology support app used during chemotherapy resulted in fewer clinic visits. Still, nearly a quarter of participants randomized to the intervention arm reported never using the app due to personal preference and usability challenges, which points to future

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A Stress Management App Intervention for Cancer Survivors: Design, Development, and Usability Testing

Cited by 66 publications

References 46 publications

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

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

INNOVATIVE eHEALTH INTERVENTIONS IN NURSING RESEARCH. HOW TO UTILIZE A MIXED METHOD APPROACH TO DESIGN, DEVELOPMENT, EVALUATION AND IMPLEMENTATION

Mobile application to support oncology patients during treatment on patient outcomes: Evidence from a randomized controlled trial

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