Owen, J., O'Carroll Bantum, E., Pagano, I., Stanton, A., Owen, J.E., & Pagano, I.S. (2017). Randomized trial of a social networking intervention for cancer-related distress. Annals of Behavioral Medicine, 51, 661–672.

To evaluate the effects of a web-based social networking and coping skills training intervention on cancer-related patient based outcomes: distress, depression, anxiety, and psychological well-being. Secondary outcomes are vigor and fatigue.

Participants initially completed a baseline survey following which they were given access to the online health space intervention or waitlisted for the intervention (waitlist control group) randomly. Intervention included an evidence-based online distress management intervention for a period of 12 weeks, including modules, chats, discussion boards, and web mails.

• N = 347   
• AGE: Treatment group, mean = 52.9 years; waitlist control group, mean = 53.1 years; all combined, mean = 53.1 years
• MALES: 21%; n = 73
• FEMALES: 79%; n = 274
• CURRENT TREATMENT: Other
• KEY DISEASE CHARACTERISTICS: Multiple tumors: Most common were breast cancer (n = 161, 46.4%) followed by prostate cancer (n = 43, 12.4%)
• OTHER KEY SAMPLE CHARACTERISTICS: Participants with multiple cancers and participants with female reproductive cancers were at 6.1% each (n = 21)

• SITE: Multi-site (tumor registry, outreach to websites, and cancer forums)
• SETTING TYPE: Other (online)
• LOCATION: Online

PHASE OF CARE: Multiple phases of care

Randomized controlled clinical trial

• Primary outcomes: distress measured by Distress Thermometer, psychological functioning by Outcomes questionnaire-45, depression by Center for Epidemiologic Studies Depression scale, and trauma-related anxiety by Impact of Event Scale-revised 
• Secondary outcomes: Fatigue and vigor by the subscales from Profile of Mood States (POM-SF) 
• Engagement on outcomes: Time spent online with the intervention  
• Outcomes measured at baseline and 12 weeks.

No baseline difference was noted between the intervention and control group in terms of demographic and clinical characteristics. All the five outcomes improved over time, but no significant difference between the treatment and control group for psychological functioning, depression, anxiety, and vigor. Interaction between time and treatment group fatigue (time fatigue declined in the treatment group compared to control group). No significant reduction in distress and depression between the groups, although it reduced within the groups over time, association between intervention and engagement.

Health space social networking did not improve the cancer-related distress outcomes.

• Unintended interventions or applicable interventions not described that would influence results
• Questionable protocol fidelity
• Subject withdrawals ≥ 10%  
• Other limitations/explanation: Attrition

Online interventions could be suggested to patients as it is associated with strong engagement.