Characterizing patterns of engagement with a social-networking intervention to treat cancer-related distress (#88)
INTRODUCTION: Studies suggest benefits of Internet-based psychosocial interventions for cancer survivors, but little is known about how to ensure that participants are fully engaged with key intervention materials. Increasingly, social-networking components are thought to improve the overall “stickiness” of websites and could also increase engagement with ehealth treatments. We sought to characterize patterns of engagement with a social-networking intervention for cancer-related distress.
METHODS: Participants in a phase 2 trial of healthspace.net were randomized to receive immediate intervention or to a wait-list control. Once assigned to a group, participants received access to a discussion board, coping-skills training exercises, a professional facilitator, a weekly group chat, and personal pages. Time spent using each component of the intervention was monitored throughout the 12-week intervention.
RESULTS: Two hundred sixty-nine participants were given access to healthspace.net (ntx = 174, nwait = 95). Time spent using the intervention did not differ between treatment and wait-list groups (mean = 7.5 hours over 12 weeks), and 40% were classified as moderately/highly engaged (i.e., at least 30 minutes/wk using healthspace; mean = 86 minutes/wk). Those who made greater use of social-networking on the website spent more time engaged with the coping-skills training components of the intervention (r = .48, p < .001). Engagement was not associated with most demographic factors, functional status, cancer stage, surgery, radiation, or levels of depression but was positively associated with education (p < .001), history of chemotherapy (p = .006), and surprisingly, age (p < .001).
DISCUSSION: Engagement with healthspace.net compares favorably with other major social-networking sites (e.g., Google+, Pinterest), suggesting that these types of ehealth interventions have strong potential for delivering psychosocial interventions to cancer survivors. Additional efforts a) to identify predictors of engagement and b) to more tightly integrate social-networking and coping-skills training components could further improve exposure to treatment and outcomes of Internet-based interventions.