Exploring engagement with a web-based self-directed psychoeducational program for advanced cancer patients and their caregivers (iFOCUS): A sub study analysis of the DIAdIC trial.
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| Title: | Exploring engagement with a web-based self-directed psychoeducational program for advanced cancer patients and their caregivers (iFOCUS): A sub study analysis of the DIAdIC trial. |
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| Authors: | Schmidt, Ulrik Sørensen (AUTHOR), Van Rickstal, Romy (AUTHOR), Van Goethem, Vincent (AUTHOR), Bakker, Evi (AUTHOR), Pilch, Monika (AUTHOR), Connolly, Michael (AUTHOR), D'Alton, Paul (AUTHOR), Jordan, Catherine (AUTHOR), Larkin, Philip J. (AUTHOR), May, Peter (AUTHOR), Bristowe, Katherine (AUTHOR), de Leo, Silvia (AUTHOR), De Vleminck, Aline (AUTHOR), Cohen, Joachim (AUTHOR), Northouse, Laurel (AUTHOR), Hudson, Peter (AUTHOR), Guerin, Suzanne (AUTHOR) |
| Source: | Palliative Medicine. May2026, Vol. 40 Issue 5, p644-654. 11p. |
| Subjects: | Health literacy, Self-efficacy, Research funding, Medical care, Evaluation of human services programs, Logistic regression analysis, Kruskal-Wallis Test, Internet, Psychoeducation, Cancer patients, Teaching methods, Emotions, Psychological adaptation, Descriptive statistics, Mann Whitney U Test, Autodidacticism, Caregivers, Pre-tests & post-tests, Odds ratio, Statistics, Computer assisted instruction, Data analysis software, Patient participation, Patients' attitudes, Caregiver attitudes |
| Abstract: | Background: Supporting psychoeducational functioning for advanced cancer patients and informal caregivers (dyads) can be challenging. Self-managed digital interventions offer a possible cost-effective alternative but often face low engagement. Aim: To examine engagement with the iFOCUS intervention and to understand why it failed to improve the expected outcomes. Design: iFOCUS, a four-session digital self-managed 12-week intervention for dyads, was tested in six European countries as part of a randomized controlled trial. However, it showed no effects on outcomes. Using process evaluation data with 121 dyads, measures of engagement were examined to identify how engagement predicts dropout and to identify associations with patient/caregiver characteristics, post-intervention outcomes, and patient/caregiver evaluation of the intervention. Results: Measures of engagement showed variation in associations with participant characteristics. Lower engagement with the intervention among dyads at the outset, was associated with greater odds of dropout and engagement with the intervention decreased as the dyads progressed. Patients' level of education and caregivers' baseline emotional function, self-efficacy, dyadic coping, and knowledge of cancer were associated with engagement. However, there was no consistent evidence that engagement was associated with outcomes or evaluation of the intervention. Discussion: While we identified several associations between engagement and patient/caregiver characteristics, there were inconsistencies in the extent and nature of the associations, with more evidence that baseline characteristics impacted engagement, than evidence that engagement impacted on outcomes. However, using multiple measures of engagement did provide additional insights. A key recommendation from this study is the need for consideration of assessments of engagement for digital interventions. [ABSTRACT FROM AUTHOR] |
| Copyright of Palliative Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 193401852 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Exploring engagement with a web-based self-directed psychoeducational program for advanced cancer patients and their caregivers (iFOCUS): A sub study analysis of the DIAdIC trial. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Schmidt%2C+Ulrik+Sørensen%22">Schmidt, Ulrik Sørensen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Van+Rickstal%2C+Romy%22">Van Rickstal, Romy</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Van+Goethem%2C+Vincent%22">Van Goethem, Vincent</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bakker%2C+Evi%22">Bakker, Evi</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pilch%2C+Monika%22">Pilch, Monika</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Connolly%2C+Michael%22">Connolly, Michael</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22D'Alton%2C+Paul%22">D'Alton, Paul</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jordan%2C+Catherine%22">Jordan, Catherine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Larkin%2C+Philip+J%2E%22">Larkin, Philip J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22May%2C+Peter%22">May, Peter</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bristowe%2C+Katherine%22">Bristowe, Katherine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22de+Leo%2C+Silvia%22">de Leo, Silvia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22De+Vleminck%2C+Aline%22">De Vleminck, Aline</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cohen%2C+Joachim%22">Cohen, Joachim</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Northouse%2C+Laurel%22">Northouse, Laurel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hudson%2C+Peter%22">Hudson, Peter</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Guerin%2C+Suzanne%22">Guerin, Suzanne</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Palliative+Medicine%22">Palliative Medicine</searchLink>. May2026, Vol. 40 Issue 5, p644-654. 11p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Health+literacy%22">Health literacy</searchLink><br /><searchLink fieldCode="DE" term="%22Self-efficacy%22">Self-efficacy</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care%22">Medical care</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+of+human+services+programs%22">Evaluation of human services programs</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Kruskal-Wallis+Test%22">Kruskal-Wallis Test</searchLink><br /><searchLink fieldCode="DE" term="%22Internet%22">Internet</searchLink><br /><searchLink fieldCode="DE" term="%22Psychoeducation%22">Psychoeducation</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+patients%22">Cancer patients</searchLink><br /><searchLink fieldCode="DE" term="%22Teaching+methods%22">Teaching methods</searchLink><br /><searchLink fieldCode="DE" term="%22Emotions%22">Emotions</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+adaptation%22">Psychological adaptation</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Mann+Whitney+U+Test%22">Mann Whitney U Test</searchLink><br /><searchLink fieldCode="DE" term="%22Autodidacticism%22">Autodidacticism</searchLink><br /><searchLink fieldCode="DE" term="%22Caregivers%22">Caregivers</searchLink><br /><searchLink fieldCode="DE" term="%22Pre-tests+%26+post-tests%22">Pre-tests & post-tests</searchLink><br /><searchLink fieldCode="DE" term="%22Odds+ratio%22">Odds ratio</searchLink><br /><searchLink fieldCode="DE" term="%22Statistics%22">Statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Computer+assisted+instruction%22">Computer assisted instruction</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+participation%22">Patient participation</searchLink><br /><searchLink fieldCode="DE" term="%22Patients'+attitudes%22">Patients' attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Caregiver+attitudes%22">Caregiver attitudes</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Supporting psychoeducational functioning for advanced cancer patients and informal caregivers (dyads) can be challenging. Self-managed digital interventions offer a possible cost-effective alternative but often face low engagement. Aim: To examine engagement with the iFOCUS intervention and to understand why it failed to improve the expected outcomes. Design: iFOCUS, a four-session digital self-managed 12-week intervention for dyads, was tested in six European countries as part of a randomized controlled trial. However, it showed no effects on outcomes. Using process evaluation data with 121 dyads, measures of engagement were examined to identify how engagement predicts dropout and to identify associations with patient/caregiver characteristics, post-intervention outcomes, and patient/caregiver evaluation of the intervention. Results: Measures of engagement showed variation in associations with participant characteristics. Lower engagement with the intervention among dyads at the outset, was associated with greater odds of dropout and engagement with the intervention decreased as the dyads progressed. Patients' level of education and caregivers' baseline emotional function, self-efficacy, dyadic coping, and knowledge of cancer were associated with engagement. However, there was no consistent evidence that engagement was associated with outcomes or evaluation of the intervention. Discussion: While we identified several associations between engagement and patient/caregiver characteristics, there were inconsistencies in the extent and nature of the associations, with more evidence that baseline characteristics impacted engagement, than evidence that engagement impacted on outcomes. However, using multiple measures of engagement did provide additional insights. A key recommendation from this study is the need for consideration of assessments of engagement for digital interventions. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Palliative Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1177/02692163261424464 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 11 StartPage: 644 Subjects: – SubjectFull: Health literacy Type: general – SubjectFull: Self-efficacy Type: general – SubjectFull: Research funding Type: general – SubjectFull: Medical care Type: general – SubjectFull: Evaluation of human services programs Type: general – SubjectFull: Logistic regression analysis Type: general – SubjectFull: Kruskal-Wallis Test Type: general – SubjectFull: Internet Type: general – SubjectFull: Psychoeducation Type: general – SubjectFull: Cancer patients Type: general – SubjectFull: Teaching methods Type: general – SubjectFull: Emotions Type: general – SubjectFull: Psychological adaptation Type: general – SubjectFull: Descriptive statistics Type: general – SubjectFull: Mann Whitney U Test Type: general – SubjectFull: Autodidacticism Type: general – SubjectFull: Caregivers Type: general – SubjectFull: Pre-tests & post-tests Type: general – SubjectFull: Odds ratio Type: general – SubjectFull: Statistics Type: general – SubjectFull: Computer assisted instruction Type: general – SubjectFull: Data analysis software Type: general – SubjectFull: Patient participation Type: general – SubjectFull: Patients' attitudes Type: general – SubjectFull: Caregiver attitudes Type: general Titles: – TitleFull: Exploring engagement with a web-based self-directed psychoeducational program for advanced cancer patients and their caregivers (iFOCUS): A sub study analysis of the DIAdIC trial. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Schmidt, Ulrik Sørensen – PersonEntity: Name: NameFull: Van Rickstal, Romy – PersonEntity: Name: NameFull: Van Goethem, Vincent – PersonEntity: Name: NameFull: Bakker, Evi – PersonEntity: Name: NameFull: Pilch, Monika – PersonEntity: Name: NameFull: Connolly, Michael – PersonEntity: Name: NameFull: D'Alton, Paul – PersonEntity: Name: NameFull: Jordan, Catherine – PersonEntity: Name: NameFull: Larkin, Philip J. – PersonEntity: Name: NameFull: May, Peter – PersonEntity: Name: NameFull: Bristowe, Katherine – PersonEntity: Name: NameFull: de Leo, Silvia – PersonEntity: Name: NameFull: De Vleminck, Aline – PersonEntity: Name: NameFull: Cohen, Joachim – PersonEntity: Name: NameFull: Northouse, Laurel – PersonEntity: Name: NameFull: Hudson, Peter – PersonEntity: Name: NameFull: Guerin, Suzanne IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 05 Text: May2026 Type: published Y: 2026 Identifiers: – Type: issn-print Value: 02692163 Numbering: – Type: volume Value: 40 – Type: issue Value: 5 Titles: – TitleFull: Palliative Medicine Type: main |
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