A Novel Prosocial Online Support Group for Distressed Breast Cancer Survivors

描述（由申请人提供）：乳腺癌（BC）幸存者经常使用在线支持小组（osg）来帮助他们应对癌症，但是关于osg减少心理困扰的有效性的证据很弱。本研究评估了一种创新的“亲社会”OSG （PRO-OSG）对痛苦的BC幸存者的潜在功效（估计效应量）、可接受性、可行性和中介因素。PRO-OSG提供结构化的帮助机会（博客，外展），并指导如何识别需求并为BC OSG中的其他人提供支持。该项目基于“帮助者治疗原则”，强调给予（相对于接受）帮助的心理益处。这是第一个评估OSG背景下的亲社会干预的研究。在目标1中，我们建议使用一项随机试验来评估PRO-OSG相对于标准促进OSG （S-OSG）的疗效和效应大小。我们将使用适用于人群的有效和可靠的测量方法收集干预前后1个月的痛苦BC幸存者的数据。意向治疗分析将用于比较两种干预措施对抑郁/焦虑症状（主要结果）和目的感（次要结果）水平的影响（n = 180；每组90）。我们假设，相对于S-OSG， PRO-OSG干预后的症状水平较低，目的感水平较高。参数估计技术（AIPE）的准确性将用于评估结果的效应大小。在目标2中，我们将探讨：(a) PRO-OSG对心理症状的益处是否通过PRO-OSG组与S-OSG组参与者在积极情绪、自尊和归属感方面的更大增加来调节；(b)与S-OSG相比，PRO-OSG对目标感的益处是否通过归属感的更大增加来调节；(c)如果归属感通过增加目标感间接改善心理症状。AIPE将用于评估对介质的效应大小。在目标3中，我们将检查PRO- OSG的可接受性（例如，保留，满意度）和可行性（例如，帮助的数量）。这个项目的重要成果将是一个创新的，基于理论的OSG干预模型，最大限度地减少心理困扰，增加痛苦的BC幸存者的目的感。这种干预是可持续的，因为它可以由癌症支持社区等组织实施。癌症支持社区是该项目的合作伙伴，也是北美最大的癌症幸存者免费社会心理支持服务提供者。这种干预也可以被其他组织采用，比如癌症中心，到目前为止，这些组织主要提供面对面的支持小组，病人接触范围有限。未来的发展方向包括开展更大规模的试验来进一步评估PRO- OSG；评估PRO-OSG在其他癌症人群中的作用；制定和评估PRO-OSG培训协议的有效性，使同行领导者（相对于帮助专业人员）能够促进osg。

DESCRIPTION (provided by applicant): Breast cancer (BC) survivors frequently use online support groups (OSGs) to help cope with their cancer, but evidence on the efficacy of OSGs for reducing psychological distress is weak. The proposed study assesses the potential efficacy (estimate effect sizes), acceptability, feasibility, and mediators of an innovative "prosocial" OSG (PRO-OSG) for distressed BC survivors. PRO-OSG provides structured helping opportunities (blogs, outreach) and coaching on how to recognize needs and give support to others in a BC OSG. The project is based on the "helper therapy principle," which emphasizes the psychological benefits of giving (vs. receiving) help. This is the first study to evaluate a prosocial intervention in the context of an OSG. In Aim 1, we propose using a randomized trial to assess the efficacy and effect sizes of PRO-OSG relative to a standard facilitated OSG (S-OSG). We will collect data from distressed BC survivors 1 month pre- and post-intervention using valid and reliable measures appropriate for the population. Intention-to-treat analyses will be used to compare the effects of the two interventions on levels of depression/anxiety symptoms (primary outcomes) and sense of purpose (secondary outcome) (n = 180; 90 per group). We hypothesize that relative to S-OSG, PRO-OSG will have a lower level of symptoms and a higher level of sense of purpose post-intervention. Accuracy in parameter estimation techniques (AIPE) will be used to assess effect sizes on outcomes. In Aim 2, we will explore: (a) if the benefits of PRO-OSG on psychological symptoms are mediated by greater increases in positive affect, self-esteem, and sense of belonging among participants in the PRO-OSG versus S-OSG group; (b) if the benefit of PRO-OSG on sense of purpose is mediated by a greater increase in sense of belonging in the PRO-OSG versus S-OSG; and (c) if sense of belonging indirectly improves psychological symptoms by increasing sense of purpose. AIPE will be used to assess effect sizes on mediators. In Aim 3, we will examine acceptability (e.g., retention, satisfaction) and feasibility (e.g., amount of helping) of the PRO- OSG. The significant outcome of this project will be an innovative, theory-based OSG intervention model that maximizes reductions in psychological distress and increases sense of purpose among distressed BC survivors. The intervention is sustainable, because it can be implemented by organizations such as the Cancer Support Community, a partner on this project and the largest provider of free psychosocial support services for cancer survivors in North America. The intervention also can be adopted by other organizations, such as cancer centers, which to date have mostly offered face-to-face support groups with limited patient reach. Future directions include developing a larger-scale trial to further evaluate PRO- OSG; evaluating PRO-OSG in other cancer populations; and developing and assessing the efficacy of PRO-OSG training protocols that will enable peer leaders (vs. helping professionals) to facilitate OSGs. PUBLIC HEALTH RELEVANCE: Depression and anxiety symptoms and disorder are highly prevalent among BC survivors and often undertreated. Depression is more prevalent among BC survivors than many other cancers populations, but existing interventions are not widely acceptable, accessible, or highly effective. The proposed study will develop and evaluate an innovative "prosocial" online support group that provides structured helping opportunities (blogs, outreach) and coaching on how to recognize needs and give support to others in an online support group for distressed BC survivors.