Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial

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Abstract

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Adolescents and young adult cancer survivors are vulnerable to psychological distress after completing cancer treatment. Telehealth (online videoconferencing) interventions may be able to address the gap in tailored, evidence-based supportive interventions. We evaluated an online, group-based, videoconference-delivered cognitive-behavioral therapy intervention (‘Recapture Life’) in a randomized trial. Forty cancer survivors between the ages of 15–25 years participated. No positive impacts on participants’ quality of life emerged immediately following the intervention, but Recapture Life participants reported using more adaptive coping skills. Recapture Life participants also reported higher negative impact of cancer, anxiety and depression at a 12-month follow-up. Additional analyses suggested that survivors benefitted differently from the two online interventions (Recapture Life vs. peer-support group) depending on how recently they had completed their cancer treatment. Our data highlight that different survivor sub-groups may find group-based, telehealth psychological interventions more or less helpful at different points in survivorship.

Abstract

Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors’ mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention (‘Recapture Life’) in a 3-arm randomized-controlled trial comparing Recapture Life with an online peer-support group, and a waitlist control, with the aim of testing its impact on quality of life, emotional distress and healthcare service use. Forty AYAs (M _age = 20.6 years) within 24-months of completing treatment participated, together with 18 support persons. No groupwise impacts were measured immediately after the six-week intervention. However, Recapture Life participants reported using more CBT skills at the six-week follow-up (OR = 5.58, 95% CI = 2.00–15.56, p = 0.001) than peer-support controls. Recapture Life participants reported higher perceived negative impact of cancer, anxiety and depression at 12-month follow-up, compared to peer-support controls. Post-hoc analyses suggested that AYAs who were further from completing cancer treatment responded better to Recapture Life than those who had completed treatment more recently. While online telehealth interventions hold promise, recruitment to this trial was challenging. As the psychological challenges of cancer survivorship are likely to evolve with time, different support models may prove more or less helpful for different sub-groups of AYA survivors at different times.

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Most cited references 129

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Steve Walker, Martin Mächler, Ben Bolker … (2023)

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The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

P.F. Lovibond, S.H. Lovibond (1995)

The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.

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Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.

Ronald C Kessler, Patricia Berglund, Olga Demler … (2005)

Little is known about lifetime prevalence or age of onset of DSM-IV disorders. To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication. Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview. Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older. Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders. Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups. About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.

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Author and article information

Contributors

Saskia F.A. Duijts: Role: Academic Editor

Evelien R. Spelten: Role: Academic Editor

Journal

Journal ID (nlm-ta): Cancers (Basel)

Journal ID (iso-abbrev): Cancers (Basel)

Journal ID (publisher-id): cancers

Title: Cancers

Publisher: MDPI

ISSN (Electronic): 2072-6694

Publication date (Electronic): 18 May 2021

Publication date Collection: May 2021

Volume: 13

Issue: 10

Electronic Location Identifier: 2460

Affiliations

[1 ]School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; c.wakefield@ 123456unsw.edu.au (C.E.W.); sarah.ellis@ 123456unsw.edu.au (S.J.E.); b.mcgill@ 123456unsw.edu.au (B.C.M.); m.donoghoe@ 123456unsw.edu.au (M.W.D.); antoinette.anazodo@ 123456unsw.edu.au (A.A.); r.cohn@ 123456unsw.edu.au (R.J.C.)

[2 ]Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia

[3 ]Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; Fiona.Maguire@ 123456health.nsw.gov.au (F.M.); Cath.ODwyer@ 123456health.nsw.gov.au (C.O.)

[4 ]Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, NSW 2033, Australia

[5 ]Centre for Medical Psychology & Evidence-Based Decision-Making (CeMPED), School of Psychology, University of Sydney, Sydney, NSW 2050, Australia; phyllis.butow@ 123456sydney.edu.au

[6 ]School of Psychology, UNSW Sydney, Kensington, NSW 2033, Australia; r.bryant@ 123456unsw.edu.au

[7 ]Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia; susan.sawyer@ 123456rch.org.au

[8 ]Royal Children’s Hospital Centre for Adolescent Health, Melbourne, VIC 3052, Australia

[9 ]Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia

[10 ]Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia; pandora.patterson@ 123456canteen.org.au

[11 ]Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia

[12 ]Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia

[13 ]Western Australia Youth Cancer Service, Sir Charles Gairdner Hospital, WA 6009, Australia; Megan.Plaster@ 123456health.wa.gov.au

[14 ]Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia; kate.thompson@ 123456petermac.org

[15 ]Department of Social Work, The University of Melbourne, Melbourne, VIC 3010, Australia

[16 ]Queensland Child and Youth Clinical Network, Clinical Excellence Queensland, Herston, QLD 4006, Australia; Lucy.Holland@ 123456qut.edu.au

[17 ]School of Nursing, Queensland University of Technology, Brisbane, QLD 4000, Australia

[18 ]Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, SA 5000, Australia; michael.osborn@ 123456sa.gov.au

[19 ]Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW 2000, Australia; richard.deabreulourenco@ 123456chere.uts.edu.au

Author notes

[* ]Correspondence: ursula@ 123456unsw.edu.au ; Tel.: +61-2-9382-3114

[†]

Membership of The Recapture Working Party is provided in Acknowledgments.

Author information

Ursula M. Sansom-Daly https://orcid.org/0000-0003-4200-8900

Sarah J. Ellis https://orcid.org/0000-0003-3074-5831

Brittany C. McGill https://orcid.org/0000-0002-2134-2988

Mark W. Donoghoe https://orcid.org/0000-0003-0212-6443

Michael Osborn https://orcid.org/0000-0002-1288-9930

Catherine O’Dwyer https://orcid.org/0000-0002-3879-5801

Article

Publisher ID: cancers-13-02460

DOI: 10.3390/cancers13102460

PMC ID: 8158368

PubMed ID: 34070134

SO-VID: 25095585-af0f-4651-b5c8-c501f8f394da

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial

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Abstract

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Asian Journal of Quality of Life (AjQoL)

Most cited references 129

Fitting Linear Mixed-Effects Models Usinglme4

The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.

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