Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Can a self-guided online intervention for fear of cancer recurrence (iConquerFear) be feasibly, acceptably, and safely delivered to women affected by ovarian cancer? Results from a pilot randomised wait-list controlled trial (#277)

Ben Smith 1 2 3 4 , Hayley Russell 5 , Adeola Bamgboje-Ayodele 6 , Lisa Beatty 4 7 , Haryana Dhillon 4 8 9 , Joanne Shaw 4 8 , Jan Antony 5 , Joanna Fardell 10 , Verena Wu 3 11 , Anupama Pangeni 3 11 , Cyril Dixon 5 , Orlando Rincones 3 11 , Laura Langdon 5 , Daniel Costa 8 , Afaf Girgis 1
  1. South West Sydney Clinical Campuses, University of New South Wales (UNSW) Sydney, Liverpool, NSW, Australia
  2. The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
  3. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  4. Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, NSW, Australia
  5. Ovarian Cancer Australia, Melbourne, VIC, Australia
  6. Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  7. Flinders University Institute for Mental Health and Wellbeing, Flinders University, , Adelaide, SA, Australia
  8. School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  9. Centre for Medical Psychology & Evidence-Based Decision Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  10. UNSW Medicine & Health, UNSW Sydney, Sydney, NSW, Australia
  11. South West Sydney Clinical Campuses, University of New South Wales (UNSW) Sydney, Liverpool, NSW, Australia

Aims

Women affected by ovarian cancer (OC) face an uncertain prognosis and report high fear of cancer recurrence (FCR). This pilot randomised wait-list controlled trial aimed to evaluate the acceptability, feasibility and safety of iConquerFear, a self-guided online FCR intervention for OC survivors.

Methods

We recruited women (≥18 years) post-treatment for stage I-III OC via Ovarian Cancer Australia from October-December 2022. Eligible women were randomised to access iConquerFear immediately (intervention) or after 8 weeks (wait-list control). Outcomes assessed were: feasibility – ≥50% of women expressing interest access iConquerFear, and ≥50% of those complete ≥3/5 therapeutic modules; acceptability – mean post-intervention satisfaction rating ≥75/100; safety – ≤5% withdrawals due to worsened FCR/distress from iConquerFear. Semi-structured interviews with a sub-sample explored factors influencing iConquerFear uptake, engagement, and benefit.

Results

90 women expressed interest, 62 completed eligibility screening; 58 (64%) were randomised (intervention n=27, wait-list n=31). Most participants had stage III OC (n=34, 59%); Mean FCR = 20/36 (SD=6.7). Of those randomised 27 (47%) accessed iConquerFear (13 intervention, 14 wait-list participants), and 59% completed ≥3/5 therapeutic modules. Post-randomisation, 19 women (33%) withdrew, 8 (14%) due to recurrence, 3 (5%) due to increased FCR/distress. Mean post-intervention satisfaction (n=25) was 80/100 (SD=26). Thematic analysis of 14 interviews generated six themes: 1) Varying perspectives on timing and method of recommending iConquerFear, 2) Participant factors influencing engagement, 3) Website factors influencing engagement, 4) Need to balance flexibility of self-guided online programs and opportunities for personal connection, 5) Desire for deeper, more specific discussions of lived experiences, 6) Personal impact of iConquerFear.

Conclusions

Feasibility of iConquerFear was limited by low uptake. Women who accessed iConquerFear generally completed the recommended dose and were satisfied. More tailored website content and greater personal support are needed, particularly in cases of increased distress during iConquerFear use.