Development and usability evaluation of an online self‐management intervention for fear of cancer recurrence (iConquerFear)
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OBJECTIVE: To develop and evaluate the usability of iConquerFear, an online self-management adaptation of an efficacious face-to-face therapist-delivered treatment for fear of cancer recurrence (FCR). METHODS: iConquerFear development was theory based and person based. Development was guided by Ritterband et al's behaviour change model for internet interventions. iConquerFear end users (cancer survivors) provided iterative feedback in accordance with Yardley et al's person-based approach to maximise engagement and usability. Online focus groups and cognitive interviews were conducted to evaluate the usability of iConquerFear. Discussions were recorded, transcribed verbatim, and thematically analysed. RESULTS: Five online FCR modules were developed. Twenty-three cancer survivors (47% of those eligible) participated; 11/23 (58%) were breast cancer survivors, and average age was 53 years (SD = 10.8). Thematic saturation was reached after six focus groups (n = 16) and seven individual think-aloud interviews. Thematic analysis produced five overarching themes: easy navigation essential; satisfaction and engagement with content; flexible access is key; normalising and empowering; and a useful first step. CONCLUSIONS: Online self-management interventions like iConquerFear have the potential to address the unmet supportive care needs reported by burgeoning numbers of cancer survivors. However, that potential may not be realised unless interventions are rigorously developed and user tested, as benefits are constrained by limited engagement. Themes from the usability testing of iConquerFear highlight the importance of developing flexible, tailored, interactive, and contextual online self-management interventions for people with cancer.
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Previous research suggests that single-page websites or apps with properly labeled interactions and different color depths, familiar icons, and images are more usable and acceptable to cancer survivors.
“Previous research has yielded comparable results [64,65,69-71], suggesting that single-page websites or apps that enable properly labeled interactions and make use of different color depths, familiar icons, and images are more usable and acceptable to cancer survivors.”
From Development and Evaluation of the Usefulness, Usability, and Feasibility of iNNOV Breast Cancer: Mixed Methods Study (2022) · cites this paper as [65]
In Results §3.1, participants found iConquerFear easy to navigate, though some wanted more images. Results §3.3 reports that some wanted greater colour depth for accessibility. The paper does not support a preference for single-page sites or familiar icons; it reports that participants were confused by the wheelchair-symbol accessibility control. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSurvivors valued access to ubiquitous evidence-based self-care information organized according to the cancer continuum, considering it could help them better manage and cope with their condition and problems.
“Similar to previous research [64-66], survivors valued having access to ubiquitous evidence-based self-care information that was organized in accordance with the cancer continuum, considering that it could help them better manage and cope with their condition and problems.”
From Development and Evaluation of the Usefulness, Usability, and Feasibility of iNNOV Breast Cancer: Mixed Methods Study (2022) · cites this paper as [65]
Sections 3.3 and 4 report that survivors valued flexible access to iConquerFear and found its online strategies helpful for managing fear of cancer recurrence. The study concerns a focused intervention for survivors after active treatment; it does not establish that they valued self-care information organized across the cancer continuum or addressing their condition and problems generally. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSelf-guided interventions generally had lower adherence than guided interventions.
“Self-guided interventions generally had lower adherence than guided interventions which highlights the challenges of maintaining engagement in entirely self-guided interventions [62].”
These findings echo many limitations and development requirements gathered in previous research aimed at developing digital programs for supporting cancer survivors.
“These findings echo many of the limitations and development requirements gathered in previous research aimed at developing digital programs for supporting cancer survivors [64,65,68-73].”
From Development and Evaluation of the Usefulness, Usability, and Feasibility of iNNOV Breast Cancer: Mixed Methods Study (2022) · cites this paper as [65]
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Oral self‐management of palbociclib (Ibrance®) using mobile technology protocol
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- Authors
- Smith, A. “., Bamgboje‐Ayodele, A., Butow, P., Klein, B., Turner, J., Sharpe, L., Fardell, J., Beatty, L., Pearce, A., Thewes, B., Beith, J., iConquerFear Community Advisory Group, & Girgis, A.
- Affiliations
- The University of Sydney (AU)
- UNSW Sydney (AU)
- Federation University (AU)
- The University of Queensland (AU)
- Flinders University (AU)
- University of Technology Sydney (AU)
- Chris O’Brien Lifehouse (AU)
- Corresponding author
- Smith, Allan “Ben”
- ORCID
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2019-09-10
- Volume
- 29
- Issue
- 1
- Pages
- 98-106
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- OpenAlex
- W2971877142
- Cited by
- 54
- References
- 39
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 5 · 2023: 6 · 2022: 10 · 2021: 14 · 2020: 8
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- FedUni ResearchOnline (Federation University Australia) (submittedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Funders
- Cancer Institute NSW
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- fear of cancer recurrence, cancer survivors, usability evaluation, person-based approach, user engagement, breast cancer survivors, supportive care needs, intervention development
- MeSH terms
- Cancer Survivors, Self-Management, Internet-Based Intervention, Breast Neoplasms, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Outcome and Process Assessment, Health Care, Phobic Disorders
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