title: Project onward: an innovative e-health intervention for cancer survivors.
abstract: OBJECTIVE
  This study examined the feasibility and acceptability of an Individual Internet Intervention (III) embedded and integrated into an Internet Support Group (ISG) with the ultimate goal of enhancing adherence and learning, compared with an individual internet invention alone.
  
  
  METHODS
  Thirty-one posttreatment cancer survivors were randomized in groups of seven to nine to either the 8-week III + ISG intervention or the 8-week III condition. Seventeen participants met the Hospital Anxiety and Depression Scale (HADS) criteria for depressive symptoms (HADS ≥ 8).
  
  
  RESULTS
  Among all participants, the mean number of logins over 8 weeks was 20.8 ± 17.7 logins for the III + ISG compared with 12.5 ± 12.5 in III-only (p = 0.15). Two participants in the III + ISG dropped out, compared with five in III (p = 0.39). Among the 17 participants with depressive symptoms at baseline, both the Onward and the III-only condition showed large reductions in the depression scale of HADS (d = 1.27 and 0.89, respectively). Improvement over time and time x treatment effects only reached trend significance levels (ps = 0.07 & 0.12) as this pilot was not powered to detect these differences.
  
  
  CONCLUSIONS
  Both the III + ISG and III-only demonstrated pre-post reductions in depressive symptoms and high rates of utilization compared with other web-based treatments for depression. Although it is premature to make any determination as to the efficacy of the interventions tested in this feasibility study, these results indicate that pursuing the III + ISG model, as well as standard IIIs, may be fruitful areas of future research.
authors.affiliation: Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. d-mohr@northwestern.edu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Duffecy
authors.forename: Stacy
authors.initials: S
authors.lastname: Sanford
authors.forename: Lynne
authors.initials: L
authors.lastname: Wagner
authors.forename: Mark
authors.initials: M
authors.lastname: Begale
authors.forename: Ewa
authors.initials: E
authors.lastname: Nawacki
authors.forename: David C
authors.initials: DC
authors.lastname: Mohr
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000523:psychology / Q000628:therapy*; D004059:Diffusion of Innovation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012657:Self-Help Groups; D012959:Socioeconomic Factors; D017741:Survivors; D017216:Telemedicine; D016896:Treatment Outcome