Predictors and Effects of Usage of an Online Mindfulness Intervention for Distressed Cancer Patients: Usability Study.
Linda Cillessen, Monique Om Van de Ven, Felix R. Compen, Else Bisseling, Marije L. van der Lee, Anne EM Speckens
Journal of Medical Internet Research October 2, 2020 DOI: 10.2196/17526 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary analysis of a randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 125 |
| Population | Cancer patients with psychological distress |
| Intervention | Online mindfulness-based cognitive therapy (eMBCT) |
| Topics | Meditation |
| Keywords | Adherence Cancer Ehealth Internet intervention Log data Mindfulness-based cognitive therapy Oncology Uptake Usage |
| Key findings | Adherence to online mindfulness-based cognitive therapy was related to better outcomes: intended users (52%) showed larger reductions in psychological distress and greater improvements in positive mental health than less active users. Nonusers had more fear of cancer recurrence at baseline, and intended users were more conscientious than minimal and low users. |
Abstract
One in three cancer patients experience high psychological distress. Mindfulness-based interventions are effective in reducing psychological distress in this patient group. However, these interventions lack availability and flexibility, which may compromise participation in the intervention for cancer patients experiencing late symptoms like fatigue or pain. Therefore, mindfulness-based interventions are increasingly offered via the internet. However, little is known about the usage of these online mindfulness-based interventions. The aim of this study was to (1) predict uptake of and adherence to online mindfulness-based cognitive therapy (eMBCT) using baseline patient characteristics (demographic, cancer-related, personality, and psychological variables) and (2) examine the relations between adherence and treatment outcomes in eMBCT for cancer patients. A total of 125 cancer patients were assigned to eMBCT in a parent randomized controlled trial comparing MBCT and eMBCT with treatment as usual in distressed cancer patients. Various usage measures of eMBCT were automatically tracked within the online program. Based on activity of use, participants were classified as nonusers, minimal users, low users, and intended users. Questionnaires were used to assess baseline characteristics (preintervention) and outcomes (pre- and postintervention). To answer the research questions, data were analyzed with t tests, χ2 tests, and linear regression models. Based on weekly activity, participants were classified as nonusers (n=17, 13.6%), who completed no exercises in MBCT; minimal users (n=31, 24.8%), who completed at least one exercise of one to three sessions; low users (n=12, 9.6%), who completed at least one exercise of four to seven sessions; and intended users (n=65, 52.0%), who completed at least one exercise of eight to nine sessions. Nonusers had more fear of cancer recurrence at baseline than users (uptake), and intended users were more conscientious than minimal and low users (adherence). Intended users reported a larger reduction in psychological distress and more improvement of positive mental health (ie, emotional, psychological, and social well-being) after the intervention than other participants. This study showed that adherence was related to improved patient outcomes. Patients with strong fear of recurrence or low levels of conscientiousness should receive extra attention, as they are less likely to respectively start or complete eMBCT. Future research may focus on the development of flexible and adaptive eMBCT programs to fit individual needs.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 12
- Effectiveness of Web-Based Mindfulness-Based Interventions for Patients With Cancer: Systematic Review and Meta-Analyses. Journal of Medical Internet Research June 25, 2024
- The association of mindfulness and psychological well-being among individuals who have recovered from COVID-19 in Jianghan District, Wuhan, China: A cross-sectional study Journal of Affective Disorders September 23, 2022
- Exploring the Effects of Variety and Amount of Mindfulness Practices on Depression, Anxiety, and Stress Symptoms: Longitudinal Study on a Mental Health-Focused eHealth System for Patients With Breast or Prostate Cancer. JMIR Mental Health November 21, 2024
- A Mindfulness Breast Care App to reduce body image distress and stigma for breast cancer survivors: Development and preliminary quality assessment. International Journal of Nursing Sciences May 1, 2025
- Online mindfulness interventions in the care of people with physical and mental health conditions: a scoping review. BMJ Open July 18, 2025
and 7 more in the library
Cites 16
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Mindfulness-based cognitive therapy for depression August 21, 2006
- Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse Psychotherapy Research March 1, 2003
- Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes Behaviour Research and Therapy May 10, 2017
- Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials Psycho-Oncology September 11, 2019
and 11 more in the library