Feasibility and Acceptability of a Mobile Phone App Intervention for Coping With Cancer as a Young Adult: Pilot Trial and Thematic Analysis

Abstract

Background Many young adult patients do not receive adequate psychosocial services to help them cope with cancer. Objective This study aims to assess the feasibility and acceptability of a smartphone app (iaya) intervention that was designed to create an engaged community of young adult patients and help them learn emotional coping skills. Methods For this single-group pilot trial, 25 young adult patients aged 18-39 years who were receiving active cancer treatment were asked to use the iaya app for 12 weeks. To collect app use data, we used Mixpanel, an analytics platform for apps. Feasibility was assessed through rates of app sessions and the number of coping exercises engaged, and intervention acceptability was evaluated by using an app usability questionnaire and through qualitative interviews at study completion. We collected patient-reported outcome data at baseline and at week 12 to explore self-efficacy for coping with cancer, self-efficacy for managing emotions, perceived emotional support, and quality of life. Results Baseline patient-reported outcome data indicated that participants scored relatively low on perceived emotional support but reasonably high on self-efficacy for coping with cancer and managing emotions as well as quality of life. Participants had a mean of 13 app sessions (SD 14) and 2 coping exercises (SD 3.83) in 12 weeks. Only 9% (2/23) of participants met our combined feasibility definition of ≥10 app sessions and ≥3 coping skills from different categories. The participants’ mean usability score was 73.7% (SD 10.84), which exceeded our predefined threshold of ≥70%, and qualitative feedback was generally positive. Conclusions Although perceived acceptable by patients, the iaya smartphone app did not meet the a priori feasibility criteria as a stand-alone app intervention. Future studies should screen participants for unmet coping needs and consider integrating the app as part of psychosocial care for young adult patients.

A Scoping Review and a Taxonomy to Assess the Impact of Mobile Apps on Cancer Care Management

“…The current review included studies with both younger and older cohorts. Paediatric and adolescent cancer studies [ 27 , 28 , 29 , 30 ] accounted for four of the fifty-five cancer trials. The remaining 51 studies focused on adults and older patients.…”

“…Positive outcomes were found in 19 of 20 breast cancer studies, 19 of 23 mixed cancer studies, two studies each for prostate and lung cancer, and one study each for oral, brain, pancreatic, and aerodigestive cancer. Neutral outcome implied no significant improvement in the health outcomes of the participants and was seen in nine studies [ 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. Improvements in cancer health outcomes are summarized in Table 1 .…”

“…Several studies reported that testing the effectiveness of their intervention was challenging due to a small sample size [ 28 , 30 , 32 ]. One study identified a communication barrier between cancer patients and healthcare professionals, which negatively impacted the patients’ health outcomes.…”

“…One study identified a communication barrier between cancer patients and healthcare professionals, which negatively impacted the patients’ health outcomes. The report suggested that if healthcare providers had offered additional support, the patients would have used the app more frequently [ 30 ].…”

“…This is consistent with a review that found that two-way text messaging improves medication adherence [ 86 ]. Our review also identified other factors that could affect the effectiveness of mobile-based interventions, such as small sample size, paper-based questionnaires, and the absence of a control group [ 30 , 31 , 59 , 61 ]. Lower usage rates were also associated with how data was obtained, with objective measures (such as number of log-ins) being more reliable than self-reported questionnaires [ 37 ].…”