Developing CanACT - An Acceptance and Commitment Therapy intervention for rangatahi cancer survivors

Abstract

Background: In high-income countries like New Zealand and Australia cancer is the most common cause of disease-related death in adolescents and young adults (AYAs) (Wong et al., 2017). Survivorship rates are high, over 84% in New Zealand, with a growing number of rangatahi living with the impact of cancer long term (Ballantine, Moss, & Watson, 2020). Finishing treatment and remission is far from the end of the impact cancer has on a young person’s life. Most rangatahi will adjust well to long-term survivorship, however research shows distress does not end when treatment finishes (Enskär & von Essen, 2007). There are currently very few interventions developed to support survivors’ psychological wellbeing and coping (Barakat, Galtieri, Szalda, & Schwartz, 2016). Without appropriate support there are serious implications for long-term psychological adjustment and wellbeing, in particular for rangatahi experiencing poor mental health (Lu et al., 2013; Sansom-Daly, Wakefield, et al., 2012). Aim: The CanACT study is a co-design investigation of a brief, online Acceptance and Commitment Therapy (ACT) intervention for rangatahi cancer survivors aged between 16-24 years in New Zealand. The intention of the study was to co-develop a relevant and acceptable intervention supporting wellbeing of rangatahi cancer survivors. Method: The study surveyed rangatahi cancer survivors, adolescent, and young adult cancer specialists, and whānau in order to explore their views of a novel digital ACT intervention. Feedback was sought for the acceptability and engagement of the intervention, along with usability and cultural appropriateness. As part of the design consultation, we also investigated the appropriateness of the therapeutic approach (ACT) in the context of improving the quality of life and wellbeing of AYA cancer survivors. Results: Overall, the study found CanACT has the potential to be an acceptable and appropriate intervention with adjustment. Findings highlighted the challenges for young cancer survivors and their families, emphasising the importance of developing interventions like CanACT. Additionally, it highlighted the need for relevant content, practical activities, and robust support. Furthermore, it underlines the importance of accessibility, timing, cultural sensitivity, and user-friendly design for engagement. Overall, the findings offer valuable insights for enhancing CanACT's effectiveness and appeal to young survivors and their families. Conclusion: To my knowledge, there has never been a study that investigates an online wellbeing intervention targeting rangatahi cancer survivors in New Zealand. This study provides the opportunity to develop an effective intervention supporting the wellbeing and quality of life for rangatahi throughout Aotearoa who are adapting to their lives as survivors of AYA cancer.