Comparing online support groups with psychoeducation versus psychoeducation alone for distressed breast cancer survivors: a randomized controlled trial

Abstract Background: Online support groups are one forum that can help breast cancer survivors cope with negative mood states, but little is known about their effects compared to self-administered psycho-educational interventions. This randomized controlled trial compared the effects of synchronous, text-based professionally led online support groups (OSGs) plus a psychoeducational coping skills training program, called Nucare, versus Nucare alone in distressed survivors of breast cancer. Methods: Consented participants were randomized to an OSG (90-minute once-weekly session for 12 weeks) plus home-based Nucare or a self-directed home-based Nucare intervention alone. The primary outcome was the Profile of Mood States-Short Form – Total Mood Disturbance score (POMS-TMD). Secondary outcomes included measures of anxiety, depression, coping, illness intrusiveness, and loneliness. Outcomes were measured before and after the intervention, and 3 months post-intervention (follow-up). Results: One hundred twenty-five stage I–III breast cancer survivors enrolled with a mean age of 53 years (OSG plus Nucare [n = 68]; Nucare alone [n = 57]). There was a significant improvement in POMS-TMD scores among the entire study sample during the intervention period (Cohen's d = 0.25, P = .002), which was maintained over follow-up. The group × time interactions on POMS-TMD over the intervention and follow-up periods were not significant (all Ps > .05), indicating neither group outperformed the other. Group x time interactions on three coping domains (positive reframing, use of instrumental support, self-blame) favored Nucare alone over OSG plus Nucare during the intervention period (Cohen's d ranged from 0.40 to 0.48), while group x time interactions over the follow-up period favored OSG plus Nucare over Nucare alone on loneliness (Cohen's d = 0.34) and one coping domain (self-blame) (Cohen's d = 0.58). Anxiety, depression, and illness intrusiveness were not significantly different between groups at any time point (all Ps > .05). Conclusion: OSGs plus Nucare were not found superior to Nucare alone in improving mood disturbance. Mood improvement among the entire sample indicates that regular use of either Nucare alone or in combination with OSGs may have the potential to ameliorate negative mood states in breast cancer survivors.