Finding My Way-Advanced: Can a web-based psychosocial intervention improve mental quality of life for women with metastatic breast cancer?

The intervention consists of the Finding My Way - Advanced web-based psychological intervention. This consists of six modules, each consisting of three main components: (1) psychoeducation/information, (2) interactive empirically-supported cognitive-behavioural and mindfulness-based worksheets/strategies, including: worksheets, quizzes, detached mindfulness, relaxation, acceptance of emotions, assertive communication, values clarification, and goal setting; and (3) testimonials of women with advanced breast cancer (ABC). Content is provided in a multimedia format, including text, graphics, audio-clips (mindfulness and relaxation), and video (testimonials; psychoeducation/information clips from health professionals). Each of the six modules focuses on a different topic, namely (1) Navigating healthcare and making decisions; (2) Living well with a progressing illness (managing fear of progression and coping with uncertainty); (3) Managing physical symptoms (particularly focusing on fatigue and pain); (4) Managing emotional distress; (5) Managing identity and role changes; and (6) Social support: receiving support and supporting family. The intervention is delivered individually and entirely online. While the intervention is co-designed by cancer consumers, advocates, and health professionals, and registration is facilitated by the project coordinator as needed, the intervention is self-guided. Based on pilot feedback and the adult learning literature, after viewing an introductory video and 'how to use' tutorial, all six modules will be immediately accessible; with weekly reminder emails/text messages released to participants to encourage engagement. Each module is anticipated to take approximately one hour in total to complete; however participants may log in and out of each module as many times as they like. Participants will be informed that the total duration of the intervention is 6-weeks (based on an average of accessing one module per week), however they are welcome to access to modules at a pace that suits them, which may be more or less frequent than once-weekly. The setting for intervention delivery is online, with the intervention accessed from the participant's location of choice (e.g. home, work). Some self-tailoring is built into the program, with participants able to access the modules in the order of their preference so as to tailor for their interests and concerns, as well as log in and out of the program as needed so as to allow for varying availability and capability. However the program content provided to each intervention participant is the same. Adherence to the intervention is encouraged using weekly emails/text messages reminding participants of each module release as described above. Adherence is assessed via the web program using indices of program usage, including number of modules accessed, number of logins, number of days logged in, number of pages viewed, and total time logged in. In the intervention condition, the Finding My Way - Advanced intervention is received in addition to usual care materials described below.