title: Preliminary results of a randomised controlled trial of an online psychological intervention to reduce distress in men treated for localised prostate cancer.
abstract: BACKGROUND
  Prostate cancer (PCa) poses many emotional and physical challenges for men following treatment. The unmet support needs of these men are well documented, and access to psychosocial support remains problematic.
  
  
  OBJECTIVE
  To assess the efficacy of an online psychological intervention for men who have localised PCa.
  
  
  METHODS
  We undertook a randomised controlled trial to evaluate the intervention. Participants were randomly allocated to one of three conditions: My Road Ahead (MRA) alone (MRA Only), MRA plus access to an online forum (MRA+Forum), and access to the forum alone (Forum).
  
  
  METHODS
  The intervention was a 10-week self-guided online psychological intervention called My Road Ahead that consisted of six themed modules designed to facilitate improved emotional well-being in the context of PCa as well as a moderated peer forum.
  
  
  METHODS
  Pre- and postintervention assessments of psychological distress (the 21-question Depression, Anxiety and Stress Scale) [1] and the Prostate Cancer-related Quality of Life scale [2] were conducted. Multivariate analysis of variance, regression, and structural equation modelling were used to analyse the data.
  
  
  CONCLUSIONS
  In total, 142 participants were randomly allocated to one of the three intervention arms. The mean age of participants was 61 yr of age (standard deviation: 7), and 88% had undergone radical prostatectomy. A significant improvement in psychological distress was observed for participants who had access to the combined condition (MRA+Forum) with a moderate effect size (p=0.02; partial η(2)=0.07). In particular, the decline in the mean level of psychological distress was 8.8 units larger for the MRA+Forum group than the Forum group (95% confidence interval [CI], 0.9-16.7). Although the decline in the mean level of psychological distress was 7.0 units larger for the MRA+Forum group than for the MRA Only group, this difference was not significant (95% CI, 1.1-15.1). Structural equation modelling indicated that reductions in health worry and regret contributed significantly to the reductions in psychological distress for the MRA+Forum condition.
  
  
  CONCLUSIONS
  This study is the first, to our knowledge, that has evaluated a self-guided online psychological intervention tailored to the specific needs of men who have PCa. The findings of this study indicate the potential for this programme to deliver support that men may not otherwise receive.
  
  
  RESULTS
  This study found that men who have localised prostate cancer who received access to the online psychological intervention called My Road Ahead combined with the online peer discussion forum had significantly improved reductions in distress compared with those who received access to the online intervention alone or the forum alone.
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Epworth Prostate Centre, Epworth Healthcare, Richmond, Victoria, Australia; Australian Prostate Cancer Research, East Melbourne, Victoria, Australia. Electronic address: addie.wootten@mh.org.au.
authors.forename: Addie C
authors.initials: AC
authors.lastname: Wootten
authors.affiliation: National eTherapy Centre, Swinburne University of Technology, Hawthorn, Victoria, Australia.
authors.forename: Jo-Anne M
authors.initials: JA
authors.lastname: Abbott
authors.affiliation: Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia.
authors.forename: Denny
authors.initials: D
authors.lastname: Meyer
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Psychology, Deakin University, Burwood, Victoria, Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Chisholm
authors.affiliation: Department of Psychology, Deakin University, Burwood, Victoria, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Austin
authors.affiliation: DVC-Research & Innovation Portfolio, the School of Health Sciences, and the Collaborative Research Network, Federation University, Ballarat, Australia; National Institute for Mental Health Research, The Australian National University, Canberra, Australia; Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia.
authors.forename: Britt
authors.initials: B
authors.lastname: Klein
authors.affiliation: Department of Psychology, Deakin University, Burwood, Victoria, Australia.
authors.forename: Marita
authors.initials: M
authors.lastname: McCabe
authors.affiliation: Epworth Prostate Centre, Epworth Healthcare, Richmond, Victoria, Australia; Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
authors.forename: Declan G
authors.initials: DG
authors.lastname: Murphy
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Epworth Prostate Centre, Epworth Healthcare, Richmond, Victoria, Australia; Australian Prostate Cancer Research, East Melbourne, Victoria, Australia.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Costello
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D006801:Humans; D020407:Internet; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010379:Peer Group; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology*; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D012657:Self-Help Groups; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome
keywords: Distress; Prostate cancer; Psychological intervention; Quality of life; Survivorship