Online Mindfulness-Based Cancer Recovery Program for People Living with Cancer in Alberta: A Randomized Wait-List Controlled Trial

Abstract

Objective Through a randomized treatment-as-usual (TAU) wait-list controlled trial, the current studies examined the feasibility and impact of an online “real-time” synchronous Mindfulness-Based Cancer Recovery (MBCR) group program for distressed people diagnosed with cancer, who did not have access to in-person MBCR. Sub-analyses combined both the immediate and TAU wait-list groups to evaluate potential medical and physical demographic effects on participant mindfulness facets and symptom subscale scores to determine which participants improved most after the online MBCR intervention. Methods Sixty-two men and women exhibiting moderate-to-high distress were randomized to either immediate online MBCR or to wait for the next available program. Intent-to-treat mixed-model analyses for repeated measures were conducted. Subsequent, pre-post linear mixed model analysis was conducted on all participants who completed MBCR, and standardized change scores were calculated for subscales of mood and stress symptom measures. Results Feasibility targets for recruitment and retention were achieved. Participants were satisfied and would recommend online MBCR to other cancer survivors. Completion rates were comparable to in-person MBCR. Improvements and moderate effect sizes were reported in the online MBCR group relative to a TAU wait-list following MBCR for total scores of mood disturbance, stress symptoms, spirituality, and mindfully acting with awareness. Significant main effects of time were observed for posttraumatic growth and remaining mindfulness facets. Sub-analyses revealed younger participants had greater reductions in stress symptoms, increases in spirituality, and non-reactivity to experience over time. Over time, men experienced significantly greater posttraumatic growth than women. Subscale analyses of mood disturbance and symptoms of stress revealed greatest relative improvements in the subscales of Vigor, Fatigue, and Sympathetic Nervous System Arousal. Conclusions Results provided evidence for the feasibility and efficacy of an online adaptation of MBCR, facilitating reduction of mood disturbance and stress symptoms, and increasing participant-reported spirituality and mindfully acting with awareness. Online MBCR also reduced the negative physical impact of distress by improving energy levels and inducing relaxation. Future study is warranted using larger active control RCT designs. Programs utilizing similar technology could potentially improve access to other specialized psychosocial programs.