Research Portfolio Submitted in Part Fulfilment of the requirements for the Degree of Doctorate in Clinical Psychology

: 1) A Systematic Review Examining Engagement and Acceptability in Tailored mHealth Interventions for Younger Cancer Patients and Survivors; 2) Healthy Futures: Evaluation of a Pilot Groupbased Intervention within a Long-Covid Service; 3) An Investigation into Acceptability and Engagement with an Unguided Mobile Health Intervention (Untire app) for Adults with Cancer Related Fatigue: An Interim Analysis of an Ongoing Clinical Trial.

Abstract

An Investigation into Acceptability and Engagement with an Unguided Mobile Health Intervention (Untire app) for Adults with Cancer Related Fatigue: An Interim Analysis of an Ongoing Clinical Trial Cancer-related fatigue (CRF) significantly impacts patients' quality of life. Traditional interventions like Cognitive Behavioural Therapy (CBT) are effective but require trained clinicians. Mobile health (mHealth) interventions offer flexible self-management alternatives but often suffer from low adherence rates, and investigating participant engagement with these interventions is increasingly important.

This clinical study investigated the acceptability and engagement of the Untire app, an unguided mHealth intervention for adults with CRF. Adult cancer patients and survivors with moderate to severe fatigue were recruited between December 2023 to May 2024 through NHS cancer centres. Participants used the Untire app for six weeks and completed outcomes assessing acceptability, therapeutic alliance, fatigue and quality of life. Engagement metrics were also collected using in-app data.

Out of 23 participants, 8 completed the six-week measures. Mean acceptability scores were below the acceptability threshold, with 47.1% finding the app acceptable. Therapeutic alliance scores peaked at week four. Participants used the app for an average of 20.5 days. Attrition rates were high (65.2%), with many participants citing app-related glitches and the burden of study participation as reasons for withdrawal. Fatigue scores remained unchanged, but QoL scores showed slight improvement.

Overall, the Untire app was generally well received. High attrition rates highlight the challenges of maintaining engagement in unguided mHealth interventions. Feedback suggested a need for app personalisation and reduced participant burden. Further research into mHealth interventions in cancer would benefit from further investigation on how best to maximise participant engagement, hopefully leading to better health outcomes.

Date of Award	20 Sept 2024
Original language	English
Awarding Institution	University of Bath
Supervisor	Cara Davis (Supervisor)