Feasibility and acceptability of a digital intervention including exercise and mindfulness in the management of cancer-related fatigue in a gynaecological cancer population

Abstract

Aim:
Cancer-related fatigue (CRF) is an issue for many people living with and beyond cancer. Evidence suggests that exercise and mindfulness may help in management of CRF, adherence to such interventions remains poor and there is little evidence for combining these interventions or for digital delivery. Few interventions have been conducted with women who have gynaecological cancer therefore, the aims of the PhD were to develop and explore feasibility of digital delivery of mindfulness and exercise interventions to manage CRF in this population.

Methods:
The MRC Guidance for Developing and Evaluating Complex Interventions and the
Behaviour Change Wheel guided intervention development and implementation. Phase 1 was a systematic review and meta-analysis that evaluated the effects of mindfulness on CRF and psychological well-being in women with a cancer diagnosis. Findings were used to inform intervention development and delivery. Phase 2 involved app development which was the platform used to deliver the interventions. Phase 3 was an 8-week feasibility randomised control trial interventions were delivered via a mobile app to two groups (mindfulness only; mindfulness and exercise). Feasibility was assessed through retention, adherence and attrition rates. Participant-reported outcome measures (PROMs)
were collected at baseline and post-interventions for fatigue, anxiety, depression, sleep and health-related quality of life. Phase 3 was a process evaluation (online focus groups) of experiences, acceptability and satisfaction of the intervention.
Results:
Twenty-five participants took part (mindfulness only n=13, mindfulness and exercise n=12) with an overall retention rate of 88%, adherence was 72.72% and attrition was 12%. PROMs showed improvements in all outcomes and focus groups themes included, benefits of participation, barriers to participation and digital delivery of the intervention.

Conclusion
Feasibility was achieved through retention, adherence and attrition rates. The
interventions were acceptable and satisfaction reported. However, for effectiveness of PROMs to be established a fully powered randomised control trial is required. Study limitations and directions for future research are discussed.

Date of Award	May 2024
Original language	English
Sponsors	Department for the Economy
Supervisor	Ciara Hughes (Supervisor) & Lynn Dunwoody (Supervisor)