Pilot testing an app-based stress management intervention for cancer survivors
Open accessAbstract
Psychosocial eHealth intervention programs for cancer survivors are still in their infancy, with inconsistent findings so far in the scientific literature. The aim of this study was to explore system use, usefulness, ease of use, and preliminary effects of Stress Proffen, an app-based cognitive-behavioral stress management intervention for patients with cancer. A feasibility pilot project tested the intervention with cancer survivors (N = 25). The intervention contained (a) one face-to-face introduction session, (b) 10 app-based modules with stress management educational material and exercises, and (c) one follow-up phone call. Post-intervention interviews were conducted and user log-data were extracted. Outcome measures—Perceived Stress Scale (PSS), Anxiety and Depression (Hospital Anxiety and Depression Scale [HADS]), Health-Related Quality of Life (HRQoL; SF-36), and Self-Regulatory Fatigue (SRF-18)—were completed at baseline and post-intervention. Participants were primarily women (84%), age 34–71 (mean 48) and represented a variety of cancer diagnoses (majority breast cancer: 40%). Twenty-two participants completed all (pre–post) questionnaires. Sixteen participants (67%) completed at least 7 of 10 modules within the 8-week study period. Post-intervention interviews described StressProffen as providing a new, appreciated, and easily accessible stress management tool for the cancer survivors. Dependent/paired t-tests showed significant pre–post intervention effects with significant decrease in stress (p = .008), anxiety (p = .019), and self-regulatory fatigue (p = .025), and improved HRQoL (Role Physical, General Health, Vitality, and Role Emotional, all p’s <.01). App-based stress management interventions such as StressProffen can provide appreciated support for cancer survivors, should be easy to use, can provide significant stress reduction, and improve emotional well-being. Further testing in a randomized controlled trial is warranted and is in progress. Clinicaltrials.gov: NCT0293961.
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The Self-Regulatory Fatigue 18 has been translated and tested in Norwegian cancer populations and has acceptable internal consistency and reliability.
“The measure has been translated and tested in Norwegian cancer populations [42,43] and has acceptable internal consistency and reliability [41]”
From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [42]
The Methods (Participants and recruitment) describe testing the SRF-18 in cancer patients who could read and understand Norwegian. The Methods (Data collection and outcome measures) report acceptable internal consistency and reliability and a baseline Cronbach’s alpha of .88. Neither passage says the scale was translated into Norwegian or that its Norwegian version underwent validation testing. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe usefulness and ease-of-use questionnaire was based on the research team's previous experience and inspired by Davis.
“At the 3-month follow-up, participants completed a 6-item study-specific questionnaire related to usefulness and ease of use based on the research team’s previous experience [30,42], inspired by Davis [50].”
From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [42]
Other CBT-based digital interventions combining educational and relaxation-based content, tested in other patient groups, support the notion that EPIO targets self-regulation, showing positive self-regulatory impact.
“Other CBT-based digital interventions combining educational and relaxation-based content, tested in other patient groups, support this notion, showing positive self-regulatory impact [42,43].”
From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [42]
The study-specific questionnaire was based on previous experience with developing eHealth apps in the research team and was guided by the Technology Acceptance Model (TAM).
“The study-specific questionnaire was based on previous experience with developing eHealth apps in the research team [26,48] and was guided by the Technology Acceptance Model (TAM) [49].”
From Digital Self-Management in Support of Patients Living With Chronic Pain: Feasibility Pilot Study (2020) · cites this paper as [48]
The intervention material was based on the same concepts and foundations, written by the same experienced team, led by the same PI, and using the same therapeutic language and structure.
“However, the intervention material was based on the same concepts and foundations, written by the same experienced team [76,77], led by the same PI, and using the same therapeutic language and structure.”
From A User-Centered Approach to an Evidence-Based Electronic Health Pain Management Intervention for People With Chronic Pain: Design and Development of EPIO (2020) · cites this paper as [77]
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Self-citationAdvancing geohazard risk assessment – A digital tool for steep slope management
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Use of Virtual Oncology in Hepatopancreatobiliary Cancers: A Scoping Review
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Additional file 1 of Engaging with EPIO, a digital pain self-management program: a qualitative study
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Delivery Model Matters for Digital Interventions in Pain Self-Management: Mixed Methods Study
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- Authors
- Børøsund, E., Varsi, C., Clark, M. M., Ehlers, S. L., Andrykowski, M. A., Sleveland, H. R. S., Bergland, A., & Nes, L. S.
- Affiliations
- Oslo University Hospital (NO)
- Mayo Clinic (US)
- University of Kentucky (US)
- Corresponding author
- Børøsund, Elin
- ORCID
- Venue
- Translational Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-04-24
- Volume
- 10
- Issue
- 3
- Pages
- 770-780
- ISSN
- 1613-9860 (ISSN-L)
- 1869-6716
- PMC
- PMC7413188
- OpenAlex
- W2972899058
- Cited by
- 49
- References
- 47
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 7 · 2023: 7 · 2022: 8 · 2021: 4 · 2020: 7 · 2019: 3 · 2015: 1
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Translational Behavioral Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc)
- Funders
- Norwegian Cancer Society (4602492-2013)
- Center for Shared Decision Making and Collaborative Care Research
- Committee for Medical and Health Research Ethics in Norway (2016/14369)
- Oslo University Hospital Privacy Protection Committee/Institutional Review Board (2015/10204)
- 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
- cancer survivors, stress management, mobile health apps, cognitive-behavioral intervention, e-health, perceived stress, anxiety, depression, self-regulatory fatigue, health-related quality of life, feasibility, user acceptance
- MeSH terms
- Cancer Survivors, Adult, Aged, Breast Neoplasms, Female, Humans, Middle Aged, Pilot Projects, Quality of Life, Mobile Applications
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