. 2021 May 18;13(10):2460.

doi: 10.3390/cancers13102460.

Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial

Ursula M Sansom-Daly^{1

2

3}, Claire E Wakefield^{1

2}, Sarah J Ellis^{1

2}, Brittany C McGill^{1

2}, Mark W Donoghoe^{1

2

4}, Phyllis Butow⁵, Richard A Bryant⁶, Susan M Sawyer^{7

8

9}, Pandora Patterson^{10

11}, Antoinette Anazodo^{1

3

12}, Megan Plaster¹³, Kate Thompson^{14

15}, Lucy Holland^{16

17}, Michael Osborn¹⁸, Fiona Maguire³, Catherine O'Dwyer³, Richard De Abreu Lourenco¹⁹, Richard J Cohn^{1

2}, The Recapture Life Working Party

Affiliations

¹ School of Women's and Children's Health, UNSW Sydney, Kensington, NSW 2033, Australia.
² Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
³ Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia.
⁴ Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, NSW 2033, Australia.
⁵ Centre for Medical Psychology & Evidence-Based Decision-Making (CeMPED), School of Psychology, University of Sydney, Sydney, NSW 2050, Australia.
⁶ School of Psychology, UNSW Sydney, Kensington, NSW 2033, Australia.
⁷ Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia.
⁸ Royal Children's Hospital Centre for Adolescent Health, Melbourne, VIC 3052, Australia.
⁹ Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia.
¹⁰ Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia.
¹¹ Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia.
¹² Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
¹³ Western Australia Youth Cancer Service, Sir Charles Gairdner Hospital, WA 6009, Australia.
¹⁴ Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.
¹⁵ Department of Social Work, The University of Melbourne, Melbourne, VIC 3010, Australia.
¹⁶ Queensland Child and Youth Clinical Network, Clinical Excellence Queensland, Herston, QLD 4006, Australia.
¹⁷ School of Nursing, Queensland University of Technology, Brisbane, QLD 4000, Australia.
¹⁸ Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
¹⁹ Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW 2000, Australia.

PMID: 34070134
PMCID: PMC8158368
DOI: 10.3390/cancers13102460

Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial

Ursula M Sansom-Daly et al. Cancers (Basel). 2021.

. 2021 May 18;13(10):2460.

doi: 10.3390/cancers13102460.

Authors

Affiliations

¹ School of Women's and Children's Health, UNSW Sydney, Kensington, NSW 2033, Australia.
² Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
³ Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia.
⁴ Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, NSW 2033, Australia.
⁵ Centre for Medical Psychology & Evidence-Based Decision-Making (CeMPED), School of Psychology, University of Sydney, Sydney, NSW 2050, Australia.
⁶ School of Psychology, UNSW Sydney, Kensington, NSW 2033, Australia.
⁷ Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia.
⁸ Royal Children's Hospital Centre for Adolescent Health, Melbourne, VIC 3052, Australia.
⁹ Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia.
¹⁰ Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia.
¹¹ Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia.
¹² Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
¹³ Western Australia Youth Cancer Service, Sir Charles Gairdner Hospital, WA 6009, Australia.
¹⁴ Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.
¹⁵ Department of Social Work, The University of Melbourne, Melbourne, VIC 3010, Australia.
¹⁶ Queensland Child and Youth Clinical Network, Clinical Excellence Queensland, Herston, QLD 4006, Australia.
¹⁷ School of Nursing, Queensland University of Technology, Brisbane, QLD 4000, Australia.
¹⁸ Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
¹⁹ Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW 2000, Australia.

PMID: 34070134
PMCID: PMC8158368
DOI: 10.3390/cancers13102460

Abstract

Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors' mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention ('Recapture Life') in a 3-arm randomized-controlled trial comparing Recapture Life with an online peer-support group, and a waitlist control, with the aim of testing its impact on quality of life, emotional distress and healthcare service use. Forty AYAs (M_age = 20.6 years) within 24-months of completing treatment participated, together with 18 support persons. No groupwise impacts were measured immediately after the six-week intervention. However, Recapture Life participants reported using more CBT skills at the six-week follow-up (OR = 5.58, 95% CI = 2.00-15.56, p = 0.001) than peer-support controls. Recapture Life participants reported higher perceived negative impact of cancer, anxiety and depression at 12-month follow-up, compared to peer-support controls. Post-hoc analyses suggested that AYAs who were further from completing cancer treatment responded better to Recapture Life than those who had completed treatment more recently. While online telehealth interventions hold promise, recruitment to this trial was challenging. As the psychological challenges of cancer survivorship are likely to evolve with time, different support models may prove more or less helpful for different sub-groups of AYA survivors at different times.

Keywords: adolescent; cancer continuum; cancer survivorship; cognitive-behavioral therapy; online videoconferencing; psychological interventions; quality of life; survivor; telehealth; young adult.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
CONSORT flowchart depicting recruitment across Recapture Life trial.

**Figure 2**
Differences between Recapture Life and peer-support group on negative impact of cancer, over time. Note. Individual scores are displayed, overlaid with thicker lines showing group-specific means and 95% confidence intervals. Three-way analyses comparing Recapture Life, peer-support group and waitlist are depicted in Supplementary Data S4).

**Figure 3**
Depression and anxiety symptoms between Recapture Life and peer-support groups over time. Note. Individual scores are displayed, overlaid with thicker lines showing group-specific means and 95% confidence intervals. Dotted line indicates the upper end of ‘Normal’ range of symptoms on each subscale, with scores above this indicating Mild symptoms and above.

**Figure 4**
Between-group differences in change in depression and anxiety scores according to participants’ time since treatment-completion, across time-points. Note. Individual scores are displayed, overlaid with thicker lines showing group-specific means and 95% confidence intervals. Participants’ length of time since completing cancer treatment is represented along the X-axis (range: 0–18 months post-treatment); while each column of panels depicts data measured at different study time-points (6-weeks, 12-weeks, 12-months).

**Figure 5**
Cognitive-behavioral therapy skills confidence and use, by treatment arm. Note. Individual scores are displayed, overlaid with thicker lines showing group-specific means and 95% confidence intervals.

**Figure 6**
AYAs’ health service use over the past six months by healthcare professional type. Note. Individual scores are displayed, overlaid with thicker lines showing group-specific means and 95% confidence intervals.

See this image and copyright information in PMC

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Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial

Affiliations

Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial

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Conflict of interest statement

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