title: Randomized Trial of a Social Networking Intervention for Cancer-Related Distress.
abstract: BACKGROUND
  Web and mobile technologies appear to hold promise for delivering evidence-informed and evidence-based intervention to cancer survivors and others living with trauma and other psychological concerns. Health-space.net was developed as a comprehensive online social networking and coping skills training program for cancer survivors living with distress.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the effects of a 12-week social networking intervention on distress, depression, anxiety, vigor, and fatigue in cancer survivors reporting high levels of cancer-related distress.
  
  
  METHODS
  We recruited 347 participants from a local cancer registry and internet, and all were randomized to either a 12-week waiting list control group or to immediate access to the intervention. Intervention participants received secure access to the study website, which provided extensive social networking capabilities and coping skills training exercises facilitated by a professional facilitator.
  
  
  RESULTS
  Across time, the prevalence of clinically significant depression symptoms declined from 67 to 34 % in both conditions. The health-space.net intervention had greater declines in fatigue than the waitlist control group, but the intervention did not improve outcomes for depression, trauma-related anxiety symptoms, or overall mood disturbance. For those with more severe levels of anxiety at baseline, greater engagement with the intervention was associated with higher levels of symptom reduction over time.
  
  
  CONCLUSIONS
  The intervention resulted in small but significant effects on fatigue but not other primary or secondary outcomes. Results suggest that this social networking intervention may be most effective for those who have distress that is not associated with high levels of anxiety symptoms or very poor overall psychological functioning.
  
  
  BACKGROUND
  The trial was registered with the ClinicalTrials.gov database ( ClinicalTrials.gov #NCT01976949).
authors.affiliation: National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA. jason.owen@va.gov.
authors.forename: Jason E
authors.initials: JE
authors.lastname: Owen
authors.affiliation: Cancer Prevention & Control Program, University of Hawai'i Cancer Center, Honolulu, HI, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: O'Carroll Bantum
authors.affiliation: Cancer Prevention & Control Program, University of Hawai'i Cancer Center, Honolulu, HI, USA.
authors.forename: Ian S
authors.initials: IS
authors.lastname: Pagano
authors.affiliation: Departments of Psychology and Psychiatry/Biobehavioral Sciences, Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Annette
authors.initials: A
authors.lastname: Stanton
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000150:complications / Q000628:therapy; D000073116:Cancer Survivors / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000628:therapy; D005221:Fatigue / Q000150:complications / Q000628:therapy*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D012042:Registries; D060756:Social Networking; D013315:Stress, Psychological / Q000628:therapy*; D016896:Treatment Outcome
keywords: Cancer; Distress; Social networking; Trial; e-Health