Aims: While co-designing tailored interventions for specific populations and presenting concerns are the ideal, this process is costly and time consuming. One method for increasing the efficiency of the research to clinical care pipeline is to repurpose existing interventions. This presentation summarises the benefits, challenges and outcomes arising from adapting Finding My Way (FMW), an evidence-based digital health intervention, to new clinical populations and settings.
Methods: FMW is a 6-week/6-module psychosocial program that addresses the most commonly-experienced issues that arise following diagnosis of curatively treated cancer. Following the successful randomised controlled trial (RCT) of FMW, we scaled up the program as a free-access resource in Australia, and scaled out to different settings (e.g., UK) and clinical populations (e.g., metastatic breast cancer).
Results: Since scaling up, FMW has had more diverse and distressed users than during the RCT, with lower uptake and usage, yet achieving larger changes in outcomes. When scaling out to other settings and populations, all FMW adaptations retained: (a) the core overall structure (6 modules, multi-media, interactive) and (b) the therapeutic framework (CBT-based), but altered aspects of (c) content to tailor it to the setting (e.g., links to UK resources, use of local representatives for video content) or clinical population (e.g., metastatic breast cancer specific examples). These adaptation studies have consistently demonstrated feasibility, with acceptable to strong uptake (60% of eligible individuals signing up), and engagement (e.g., 55% available UK content viewed; 2.2 modules completed for MBC), but clinical outcomes have differed notably from the original trial (e.g., no significant between-group effects in the UK replication study).
Conclusions: While support for the scalability of Finding My Way has been demonstrated in terms of feasibility of this approach, findings also demonstrate that one size may not fit all in terms of content. Implications for future research will be discussed.