Stress Management Program for Scanxiety in People With Advanced Lung Cancer: Intervention Adaptation and Stakeholder Feedback

Abstract

Background: Although scanxiety is common and impactful for people with advanced lung cancer, few interventions address this psychosocial concern. Aims: To create a stress management program for scanxiety. Methods: We conducted a structured intervention adaptation process guided by the ADAPT-ITT framework. We tailored materials from an existing evidence-based program, drafted additional modules, and obtained feedback on initial content. Following content revisions and website prototype development, 21 participants (patients with metastatic lung cancer, n = 8; family members, n = 3; clinicians, n = 10) reviewed the program. Participants rated the program's acceptability (Acceptability of Intervention Measure; AIM), feasibility (Feasibility of Intervention Measure; FIM), appropriateness (Appropriateness of Intervention Measure; IAM), helpfulness (module Likert ratings), and usability (Post-Study System Usability Questionnaire; PSSUQ), and completed semi-structured interviews. Results: Data revealed positive impressions of the program. Participants rated the program as acceptable (89%), feasible (89%), and appropriate (95%; proportion with average ratings ≥ 4 out of 5 on AIM, FIM, and IAM respectively). They rated 6 of the 7 modules as helpful, appropriate, and fitting with their experience (77%–100% with Likert ratings ≥ 4 out of 5); the below-threshold module (Introduction) was revised based on rapid qualitative analysis of interview data. Although 33% needed help to start using the website, its usability was rated highly after use (PSSUQ Mdn = 1.56, IQR = 1.11–1.82). The refined intervention is a largely self-guided program to enhance stress management skills using psychoeducation, recorded on-demand exercises, and 3 brief coaching calls. Conclusions: This highly-rated intervention has the potential to alleviate scanxiety among people with advanced lung cancer.