Implementing online mental health supports into community-based survivorship care for adolescents and young adults with cancer

The intersection of developmental vulnerabilities and cancer-related stressors means that adolescents and young adults (AYAs) with cancer show more complex distress relative to other age groups.

View slides on SlideShare:

Implementing online mental health supports into community-based survivorship care for adolescents and young adults with cancer from Cancer Institute NSW

Authors

Ursula M. Sansom-Daly, Claire E. Wakefield, Brittany C. McGill, Eden G. Robertson, Pandora Patterson, and Richard J. Cohn.

Background

Following cancer treatment, little evidence-based support is available in the community. To meet this need, our team developed a manualised online intervention named ‘ReCaPTure LiFe’, for AYA cancer survivors. Recapture Life uses online video-conferencing to deliver 6x1.5 hour weekly group sessions led by a psychologist. It addresses mechanisms of adjustment using efficacious cognitive-behavioural therapy. Data from the current phase II trial indicates that it is feasible, acceptable, and reduces AYAs’ distress over time. Groups have been delivered to AYAs living >4000kms apart and across timezones. Despite promising efficacy data, there is a lack of mental-health professionals in Australian AYA oncology available to roll-out this evidence-based model of care. Partnerships with the community sector provide opportunities for the widespread dissemination of mental-health interventions. 

Aims

This trial aims to demonstrate that community-delivered Recapture Life is, (i) acceptable, (ii) feasible to deliver, from both AYA survivor and organisation stand-points, and (iii) effective in improving AYAs’ quality of life (QoL) and reducing their distress.

Method

A planned 4-year randomised Phase III trial will use a hybrid implementation-dissemination design to evaluate the impact of community-delivered Recapture Life, compared with a peer-support control. 128 AYAs aged 15-29 will be recruited through partner community organisations (yielding 80% power to detect a medium effect size). As per gold-standard implementation research, the impact of the intervention itself will be measured (using validated mental health and QoL measures), as well as the implementation process (fidelity, feasibility/reach and financial sustainability, and the longevity of real-world effects).

Results

This presentation will discuss the plan for implementing Recapture Life within the community sector, using our team’s collaboration with CanTeen Australia as a case example.

Implications

Transitioning the delivery of e-mental health programs to community settings will reduce the burden on health systems while enabling service provision to be dispersed across stakeholders. This will improve AYAs’ long-term mental health outcomes and contribute to reducing the lag between Phase II and III trials in mental health research.