It's time to address fear of cancer recurrence in family caregivers: usability study of an virtual version of the Family Caregiver—Fear Of Recurrence Therapy (FC-FORT)
Open accessAbstract
Background: Family caregivers of cancer survivors experience equal or greater levels of fear of cancer recurrence (FCR) than survivors themselves. Some interventions have demonstrated their ability to reduce FCR among cancer survivors and dyads (patient and caregivers). However, to date, no validated intervention exists to focus solely on family caregiver's FCR. Objectives: This study aimed to (1) adapt the evidence-based in-person Fear Of Recurrence Therapy (FORT) for family caregivers (referred here in as FC-FORT) and to a virtual delivery format and (2) test its usability when offered virtually. Methods: The adaptation of FC-FORT was overseen by an advisory board and guided by the Information Systems Research Framework. Following this adaptation, female family caregivers and therapists were recruited for the usability study. Participants took part in 7 weekly virtual group therapy sessions, a semi-structured exit interview and completed session feedback questionnaires. Therapists were offered a virtual training and weekly supervision. Fidelity of treatment administration was assessed each session. Quantitative data were analyzed using descriptive statistics. Exit interviews were transcribed verbatim using NVivo Transcription and coded using conventional content analysis. Results were presented back to the advisory board to further refine FC-FORT. Results: The advisory board (n = 16) met virtually on 7 occasions to adapt FC-FORT (i.e., patient manuals, virtual format) and discuss recruitment strategies. Minor (e.g., revised text, adapted materials to virtual format) and major adaptations (e.g., added and rearranged sessions) were made to FC-FORT and subsequently approved by the advisory board. Four family caregivers and three therapists took part in the first round of the usability testing. Six family caregivers and the same three therapists took part in the second round. Overall, participants were very satisfied with FC-FORT's usability. Qualitative analysis identified 4 key themes: usability of FC-FORT, satisfaction and engagement with content, group cohesion, and impact of FC-FORT. All participants indicated that they would recommend FC-FORT to others as is. Conclusions: Using a multidisciplinary advisory board, our team successfully adapted FC-FORT and tested its usability using videoconferencing. Results from this study indicate that the efficacy and acceptability of FC-FORT are now ready to be tested in a larger pilot study.
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Initial evaluation of FC-FORT revealed high user satisfaction and usability.
“Initial evaluation of FC-FORT revealed high user satisfaction and usability.”
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“Our adaptation process aligns with a virtual adaptation model [56], which stresses iterative stakeholder input to maintain core elements while improving emotional accessibility.”
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Holy, C., Brinson, J., Gibson-Haerle, J., Russell, K. B., Abbott, L. S., Giguère, L., Givogue, A., Guilcher, G. M. T., Heathcote, L. C., Johnson, E., et al. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1815418
“Fidelity was rated using an adapted version of the fidelity checklist from our previous FORT studies (Lamarche et al., 2023; Lebel et al., 2014; Maheu et al., 2023; Tomei et al., 2018), which includes the following aspects: specific content and tasks, rated by completion (0 for no, 1 for yes);…”
Self-citation
- Authors
- Lamarche, J., Cusson, A., Nissim, R., Avery, J., Wong, J., Maheu, C., Lambert, S. D., Laizner, A. M., Jones, J., Esplen, M. J., & Lebel, S.
- Affiliations
- University of Ottawa (CA)
- University Health Network (CA)
- McGill University (CA)
- St Mary's Hospital Centre (CA)
- University of Toronto (CA)
- Corresponding author
- Lamarche, Jani
- ORCID
- Venue
- Frontiers in Digital Health
- Publisher
- Frontiers Media SA
- Published
- 2023-08-21
- Volume
- 5
- Pages
- 1129536-1129536
- ISSN
- 2673-253X (ISSN-L)
- PMC
- PMC10475944
- OpenAlex
- W4386033111
- Cited by
- 18
- References
- 55
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 5
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Digital Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship@McGill (McGill) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- University of Ottawa
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- fear of cancer recurrence, family caregivers, cancer survivors, virtual group therapy, videoconferencing, intervention adaptation, usability testing, acceptability, group cohesion
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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