Aims: While fear of cancer recurrence (FCR) and fear of progression (FOP) are combined in the official definition, recent studies indicate they are distinct constructs. Given this, interventions that support individuals with metastatic cancer, where the cancer may continue to progress, need to be co-designed accordingly. Yet FCR/FOP interventions developed to date (a) have nearly exclusively focused on early-stage cancer survivors, and (b) have been intensive in nature and delivered by a highly specialized psychologist workforce, reducing accessibility. Our group sought to address some of these gaps by adapting our self-directed intervention for early-stage cancer, Finding My Way (FMW), to be appropriate for those with metastatic breast cancer (MBC): Finding My Way-Advanced (FMW-A). This presentation summarises the process and outcomes of adapting the FCR component of the program to target FOP.
Methods: Women with MBC participated in one of three iterative co-design phases: (1) User needs and requirements identification: through surveys (n=49), and semi-structured interviews (n=15) where women were provided access to the original FMW as a scenario/example, and asked for feedback; (2) Prototype usability evaluation: through a think-aloud protocol (n=8) where participants were given access to the adapted FMW-A and tested each program component; and (3) Final design - feasibility testing: through a pilot RCT of FMW-A (n=35).
Results: FOP was the top ranked concern in phase 1; psychoeducation and strategies for coping with FOP thus became a focus of ‘The Unique Challenges’ module of FMW-A. Usability testing found this module was well received, with highly relatable content. Pilot RCT results will be discussed.
Conclusions: This study highlights the importance of co-designing tailored interventions for metastatic populations, where FOP was seen as very distinct from FCR. Women with MBC want content, and coping strategies, for living well with a cancer that will eventually progress.