Online psychological self-management intervention for testicular cancer survivors (e-TC 2.0): promising acceptability and preliminary efficacy, but limited feasibility

Abstract

Background: Testicular cancer (TC) survivors experience greater psychological morbidity than the general population. Two-thirds of TC survivors report unmet supportive care needs regarding issues such as fear of cancer recurrence (FCR), but many are reluctant/unable to seek face-to-face help. This study prospectively assessed the feasibility, acceptability, and preliminary efficacy of an interactive web-based self-management intervention (e-TC 2.0) in reducing borderline/clinical levels of anxiety, depression, and/or FCR among TC survivors. Methods: TC survivors who had completed treatment were recruited to this single-arm phase I trial through clinicians and online advertisements. Consenting participants completed baseline questionnaires, had 12 weeks’ access to e-TC 2.0, then completed post-intervention questionnaires. Feasibility was determined by the proportion of e-TC 2.0 completed (website usage data). Acceptability was assessed with purpose-designed satisfaction measures. Preliminary efficacy was indicated by changes in anxiety/depression (HADS), distress (thermometer), and FCR (Fear of Cancer Recurrence Inventory-Short Form). Results: Thirty-nine participants started the intervention; 48% completed the first module, but only 20% completed all modules. Mean participant age was 37.1 years; mean time since diagnosis was 3.6 years. Mean acceptability scores were > 8/10. Mean unmet needs, distress, FCR, anxiety, and depression levels decreased after the intervention, as di…