• Web-based psychological interventions for people living with and beyond cancer: A meta-review of what works and what doesn’t for maximising recruitment, engagement, and efficacy

      Leslie, Monica; Beatty, Lisa; Hulbert-Williams, Lee; Pendrous, Rosina; Cartwright, Tim; Jackson, Richard; The Finding My Way UK Trial Steering Group; Hulbert-Williams, Nicholas J; Edge Hill University; University of Chester; Flinders University; University of Liverpool (JMIR, 2022-07-08)
      Background: Despite high levels of psychological distress experienced by many patients with cancer, previous research has identified several barriers to accessing traditional face-to-face psychological support. In response, web-based psychosocial interventions have emerged as a promising alternative. Objective: This meta-review aimed to synthesise evidence on: (1) recruitment challenges and enablers; (2) factors that promote engagement and adherence to web-based intervention content; and (3) factors that promote the efficacy of web-based psychosocial interventions for cancer patients and survivors. Methods: We conducted a systematic search for previous reviews which have investigated the recruitment, engagement, and efficacy of online and app-based psychosocial interventions in adult cancer populations. We searched PubMed, CINAHL, PsycINFO, and the Cochrane Library database for relevant literature. Search terms focussed on a combination of topics pertaining to neoplasms and telemedicine. Two independent authors conducted abstract screening, full-text screening, and data extraction for each identified article. Results: Twenty articles met eligibility criteria. There was inconsistency in the reporting of uptake and engagement data; however, anxiety around technology and perceived time burden were identified as two key barriers. Online psychosocial oncology interventions demonstrated efficacy in reducing depression and stress but reported weak to mixed findings for distress, anxiety, quality of life, and wellbeing. While no factors consistently moderated intervention efficacy, preliminary evidence indicated that multi-component interventions and greater communication with a healthcare professional were preferred by participants and associated with superior effects. Conclusions: Several consistently cited barriers to intervention uptake and recruitment emerged, which we recommend future intervention studies address. Preliminary evidence also supports the superior efficacy of multi-component interventions and interventions which facilitate communication with a healthcare professional. However, a greater number of appropriately powered clinical trials, including randomised trials with head-to-head comparisons, are needed to enable more confident conclusions around which online psychosocial oncology interventions work best and for whom.