Adapting an acceptance and commitment therapy–based psychological intervention for fear of cancer recurrence in a digital format: a real-world evaluation during the COVID-19 pandemic

Abstract

Purpose: Service evaluation comparing the effectiveness and acceptability of an in-person and a digitally delivered acceptance and commitment therapy (ACT)–based group programme for fear of cancer recurrence (FCR) for breast cancer survivors. Methods: The programme was designed and delivered as part of a real-world, supportive care intervention and adapted for digital delivery in response to COVID-19 pandemic restrictions. FCR, quality of life (QoL), psychological flexibility, and psychological distress measures were routinely collected pre-participation, post-participation, and 12 weeks following completion. Results: Ninety-seven in-person and 61 digital participants completed the group programme. Uptake was 30% and retention 89% for in-person. Uptake was 23% and retention 64% for online referrals. Between group statistical analyses revealed non-significant differences between delivery modality on overall scores of FCR (p=0.76), QoL (p=0.06) and psychological distress (anxiety p=0.16; depression p=0.22). There was a significant difference in psychological flexibility scores (p=0.04); digital participant scores were higher (mean=83) than in-person participants (mean=76.3). Within-group statistical analyses found a significant effect of time for all outcome measures, with a significant decrease in FCR and psychological distress and a significant increase in QoL and psychological flexibility (p<0.001 for all measures). There were no statistically significant interaction effects between delivery modality and timepoint. Conclusion: In-person and online delivery of a real-world FCR group programme offered to breast-cancer survivors was found to be beneficial and comparable. These results support the potential benefits of a flexible approach to delivery modality of supportive care interventions. Further investigation is required to determine if these results are replicable within diverse populations.

Rights

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Cite as

Downloadable citations

Identifiers

DOI

https://doi.org/10.1007/s00520-025-09946-0

Repository URI

https://eprints.gla.ac.uk/366756/