Integrating top-down and bottom-up requirements in eHealth development: The case of a mobile self-compassion intervention for people with newly diagnosed cancer (Preprint)

L’ACOP et l’ACIO joignent leurs forces pour faire valoir l’oncologie psychosociale à l’échelle nationale

La défense des intérêts des patients demeure une grande priorité de l’Association canadienne d’oncologie psychosociale (ACOP) et de l’Association canadienne des infirmières en oncologie (ACIO). À l’ère où nous accordons de plus en plus d’importance à la voix des patients et de leurs proches aidants, il devient crucial d’optimiser la collaboration entre les organismes de défense des intérêts, les établissements de santé et les autres parties concernées. Le présent article décrit les efforts en cours de défense des intérêts, un terme qui, en gros, désigne les processus et les comportements relatifs au soutien proactif d’une cause (dans ce cas-ci, les soins oncologiques). Grâce à leurs partenariats actifs avec tous les acteurs concernés, les deux associations sont bien placées pour revendiquer un programme national d’oncologie psychosociale à la fois inclusif et représentatif.

CAPO and CANO joining forces to advance a national psychosocial oncology advocacy agenda

Patient advocacy remains a key priority within the Canadian Association of Psychosocial Oncology (CAPO) and the Canadian Association of Nurses in Oncology (CANO). Optimizing collaboration across advocacy organizations, institutions, and other stakeholders is timely as we enter an era where patients and their caregivers' voices are front and centre. In this paper, we report on ongoing efforts to advance patient advocacy - broadly defined as processes and behaviours related to proactively supporting a cause - herein specific to cancer care. Through active partnering, both organizations are well positioned to push for a representative and inclusive national psychosocial oncology advocacy agenda.

Compas-Y: A mixed methods pilot evaluation of a mobile self-compassion training for people with newly diagnosed cancer

Objective

Compas-Y is a compassionate mind training app that was co-designed to be fully adapted to mobile technology and to people with newly diagnosed cancer. This study aimed to evaluate the use, appreciation and impact of the app.

Methods

Seventy-one people with cancer who created an app account were included (38% breast cancer, 72% diagnosed <4 months ago, 76% received chemotherapy). Participants had very high baseline scores of self-compassion. In a convergent mixed methods design, back-end log-data (n = 71), pre-post surveys (n = 34) and semi-structured interviews (n = 23) collected for >8 weeks and were concurrently analysed using joint displays.

Results

About half of the participants (45%) used 4 of the 6 modules. Compas-Y was highly appreciated, with all content considered relevant and a source of support. Experienced benefits related to improved mental health. Particularly, we found significant changes in anxiety, but not in depression or well-being. In the interviews, people reported experiencing more rest and more positive emotions due to using the app. Process benefits included significant reductions in self-criticism (inadequate self and self-blame), but not self-compassion. In the interviews, people reported improved self-compassion and less self-criticism, more self-awareness, recognition and support, and improved emotion regulation and coping. The surveys did not capture the full range of outcomes that participants reported in the interviews.

Conclusions

Compas-Y is a highly appreciated mobile intervention that supported users in aspects of their mental health. Findings are discussed in terms of reach and adherence, app functionalities, co-design and tailoring of cancer-related and compassion-based eHealth.

Appreciating the Good Things in Life During the Covid-19 Pandemic: A Randomized Controlled Trial and Evaluation of a Gratitude App

The Covid-19 pandemic has had many negative consequences on the general public mental health. The aim of this study was to test the effectiveness of and satisfaction with an app with gratitude exercises to improve the mental health of people with reduced mental well-being due to the Covid-19 pandemic, as well as potential mechanisms of well-being change and dose-response relationships. A two-armed randomized controlled trial design was used, with two groups receiving the 6-week gratitude intervention app either immediately (intervention group, n = 424) or after 6 weeks (waiting list control group, n = 425). Assessments took place online at baseline (T0), six weeks later (T1) and at 12 weeks (T2), measuring outcomes (i.e., mental well-being, anxiety, depression, stress), and potential explanatory variables (i.e., gratitude, positive reframing, rumination). Linear mixed models analyses showed that when controlled for baseline measures, the intervention group scored better on all outcome measures compared to the control group at T1 (d = .24-.49). These effects were maintained at T2. The control group scored equally well on all outcome measures at T2 after following the intervention. Effects of the intervention on well-being were partially explained by gratitude, positive reframing, and rumination, and finishing a greater number of modules was weakly related to better outcomes. The intervention was generally appealing, with some room for improvement. The results suggest that a mobile gratitude intervention app is a satisfactory and effective way to improve the mental health of the general population during the difficult times of a pandemic.