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A Randomized Wait-List Controlled Trial of Feasibility and Efficacy of an Online Mindfulness–Based Cancer Recovery Program: The eTherapy for Cancer Applying Mindfulness Trial

Zernicke, Kristin A. MSc; Campbell, Tavis S. PhD; Speca, Michael PsyD; McCabe-Ruff, Kelley MBA; Flowers, Steven MFT; Carlson, Linda E. PhD

doi: 10.1097/PSY.0000000000000053
Original Articles

Objective A treatment-as-usual randomized wait-list controlled trial was conducted to investigate the feasibility and impact of an online synchronous Mindfulness-Based Cancer Recovery (MBCR) group program for underserved distressed cancer survivors.

Methods Sixty-two men and women exhibiting moderate to high distress within 3 years of completing primary cancer treatment without access to in-person MBCR were randomized to either immediate online MBCR (n = 30) or to wait for the next available program (n = 32). Participants completed questionnaires preintervention and postintervention or wait period online. Program evaluations were completed after MBCR. Feasibility was tracked through monitoring eligibility and participation through the protocol. Intent-to-treat mixed-model analyses for repeated measures were conducted.

Results Feasibility targets for recruitment and retention were achieved, and participants were satisfied and would recommend online MBCR. There were significant improvements and moderate Cohen d effect sizes in the online MBCR group relative to controls after MBCR for total scores of mood disturbance (d = 0.44, p = .049), stress symptoms (d = 0.49, p = .021), spirituality (d = 0.37, p = .040), and mindfully acting with awareness (d = 0.50, p = .026). Main effects of time were observed for posttraumatic growth and remaining mindfulness facets.

Conclusions Results provide evidence for the feasibility and efficacy of an online adaptation of MBCR for the reduction of mood disturbance and stress symptoms, as well as an increase in spirituality and mindfully acting with awareness compared with a treatment-as-usual wait-list. Future study using larger active control RCT designs is warranted.

Trial Registration: Clinical NCT01476891.

From the Departments of Psychology (K.A.Z., T.S.C., M.S., L.E.C.) and Oncology (M.S., L.E.C.) University of Calgary, Calgary, Alberta, Canada; Department of Psychosocial Resources (K.A.Z., T.S.C., M.S., L.E.C.), Tom Baker Cancer Center, Calgary, Alberta, Canada; eMindful Inc (K.M.-R.), Vero Beach, Florida; Mindful Living Programs (S.F.), Chico, California; and Enloe Medical Center (S.F.), Chico, California.

Address correspondence and reprint requests to Linda E. Carlson, PhD, Tom Baker Cancer Centre, 1331 29th St NW, Calgary, Alberta, Canada T2N 4N2. E-mail:

Received for publication June 27, 2013; revision received February 26, 2014.

Copyright © 2014 by American Psychosomatic Society
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