@Article{info:doi/10.2196/38515,
author="Meinlschmidt, Gunther
and Grossert, Astrid
and Meffert, Cornelia
and Roemmel, Noa
and Hess, Viviane
and Rochlitz, Christoph
and Pless, Miklos
and Hunziker, Sabina
and W{\"o}ssmer, Brigitta
and Geuter, Ulfried
and Schaefert, Rainer",
title="Smartphone-Based Psychotherapeutic Interventions in Blended Care of Cancer Survivors: Nested Randomized Clinical Trial",
journal="JMIR Cancer",
year="2023",
month="Aug",
day="28",
volume="9",
pages="e38515",
keywords="digital therapeutics; ecological momentary assessment (EMA); ecological momentary intervention (EMI); internet- and mobile-based intervention; microintervention; neoplasm; smartphone-based intervention; postcancer treatment; body psychotherapy; mobile phone",
abstract="Background: Cancer is related to not only physical but also mental suffering. Notably, body image disturbances are highly relevant to cancer-related changes often persisting beyond recovery from cancer. Scalable and low-barrier interventions that can be blended with face-to-face psychotherapy for cancer survivors are highly warranted. Objective: The aim of the study is to investigate whether smartphone-based bodily interventions are more effective to improve the mood of patients with cancer than smartphone-based fairy tale interventions (control intervention). Methods: We recruited patients with cancer in 2 Swiss hospitals and conducted daily, fully automated smartphone-based interventions 6 times a week for 5 consecutive weeks, blended with weekly face-to-face group body psychotherapy. We applied 2 types of smartphone-based interventions using a within-subject design, randomly assigning patients daily to either bodily interventions or fairy tales. Each intervention type was presented 3 times a week. For this secondary analysis, 3-level mixed models were estimated with mood assessed by the 3 Multidimensional Mood Questionnaire subscales for good-bad mood, wakefulness, and calmness as key indicators. In addition, the effects on experience of presence, vitality, and burden assessed with visual analog scales were investigated. Results: Based on the data from s=732 interventions performed by 36 participants, good-bad mood improved ($\beta$=.27; 95{\%} CI 0.062-0.483), and participants became calmer ($\beta$=.98; 95{\%} CI 0.740-1.211) following smartphone-based interventions. Wakefulness did not significantly change from pre- to postsmartphone--based intervention ($\beta$=.17; 95{\%} CI --0.081 to 0.412). This was true for both intervention types. There was no interaction effect of intervention type with change in good-bad mood ($\beta$=--.01; 95{\%} CI --0.439 to 0.417), calmness ($\beta$=.22; 95{\%} CI --0.228 to 0.728), or wakefulness ($\beta$=.14; 95{\%} CI --0.354 to 0.644). Experience of presence ($\beta$=.34; 95{\%} CI 0.271-0.417) and vitality ($\beta$=.35; 95{\%} CI 0.268-0.426) increased from pre- to postsmartphone--based intervention, while experience of burden decreased ($\beta$=--0.40; 95{\%} CI --0.481 to 0.311). Again, these effects were present for both intervention types. There were no significant interaction effects of intervention type with pre- to postintervention changes in experience of presence ($\beta$=.14; 95{\%} CI --0.104 to 0.384), experience of vitality ($\beta$=.06; 95{\%} CI --0.152 to 0.265), and experience of burden ($\beta$=--.16; 95{\%} CI --0.358 to 0.017). Conclusions: Our results suggest that both smartphone-based audio-guided bodily interventions and fairy tales have the potential to improve the mood of cancer survivors. Trial Registration: ClinicalTrials.gov NCT03707548; https://clinicaltrials.gov/study/NCT03707548 International Registered Report Identifier (IRRID): RR2-10.1186/s40359-019-0357-1 ",
issn="2369-1999",
doi="10.2196/38515",
url="https://cancer.jmir.org/2023/1/e38515",
url="https://doi.org/10.2196/38515",
url="http://www.ncbi.nlm.nih.gov/pubmed/37639296"
}