The BREAst cancer e-healTH [BREATH] intervention aims to facilitate post-treatment adjustment of all breast cancer patients. The effectiveness of BREATH compared to usual care is currently being evaluated in a multicenter randomized controlled trial. We conducted a pilot study to gain insight in the usage statistics and usability evaluation.
The non-guided Internet-based self-management intervention BREATH is based on cognitive behaviour therapy and guides patients chronologically through universal post-treatment survivorship topics. The intervention has a fixed structure of four recovery phases after breast cancer. Intervention ingredients are Information (26 scripts), Assignments (48 tasks), Assessments (10 tests) and Videos (20 peer modeling clips). A consecutive sample of the first intervention-completers was obtained from the ongoing trial. All patients completed baseline measures, were randomly allocated to the intervention group, and had four-month access to the BREATH intervention. Baseline demographics, distress measures and usability evaluation were analyzed. Intervention use was analyzed with frequency of log-ins, duration of sessions and activity (defined as opened ingredients).
Of the 41 non-metastatic breast cancer patients (mean age 49.6 years), 16 patients (39% [95% Cl: 26.66-45.27]) experienced psychological distress (HADS-total ≥ 11). Based on last login, 19 patients viewed all four phases resulting in an intervention adherence of 46.3% [95% CI: 32.06-61.25]. Seven patients (17.1%) were non-users. Two groups of users were classified: low (n=17, 41.5%) and high users (n=17, 41.5%). High users logged in with a median of 19 times, had a median session duration of 30.4 minutes and opened all 104 ingredients. User groups did not differ significantly on age, education and psychological distress. Usability evaluation on a 10-point scale was significantly higher in high users (median 8) compared to low users (median 7), U=58.5, z=-2.07, p=0.039, r=-0.38.
When analysing the effectiveness of the BREATH intervention, different user groups need to be considered.