The eCALM Trial: eTherapy for Cancer AppLying Mindfulness Online mindfulness-based cancer recovery program for underserved people living with cancer in Alberta: feasibility and trial results
Speaker: Kristin Zernicke, MA; Steve Flowers, MTF; Michael Speca
Format: Audio & Slides

Objective: A treatment-as-usual (TAU) randomized wait-list controlled trial was conducted to investigate the feasibility and impact of an online synchronous Mindfulness-Based Cancer Recovery (MBCR) program for underserved people with cancer in Alberta, Canada.

Methods: 62 men and women, exhibiting moderate to high distress, without access to in-person MBCR were randomized to either immediate synchronous online MBCR (n=30) or waitlist control (n=32). Feasibility was tracked through monitoring eligibility and participation through the protocol. Intent-to-Treat mixed model analyses for repeated measures were conducted. After the waitlist group also completed the intervention, both groups were combined and pre-post changes further assessed.

Results: Feasibility targets for recruitment and retention were achieved and participants were satisfied and would recommend online MBCR. There were statistically significant improvements and medium effect sizes in the online MBCR group relative to controls following 8-week MBCR for total scores of mood disturbance (p = .049), stress symptoms (p = .021), spirituality (p = .040), and the mindfulness facet acting with awareness (p = .026). Main effects of time were observed for posttraumatic growth and remaining mindfulness facets. When groups were combined, there were statistically significant improvements over time for four of five mindfulness facets and all other outcomes. Older participants had a greater reduction in stress symptoms, greater increases in spirituality, and higher scores on the non-react mindfulness facet. Male participants' post-traumatic growth scores increased more over time.

Conclusions: Online MBCR is feasible and effective for reducing mood disturbance and stress symptoms, and increasing spirituality and acting with awareness compared to a TAU wait-list. The intervention was most effective for older and male participants. Future studies employing larger active control RCT designs are warranted.