What the study found
The study found that engagement with the iFOCUS web-based self-directed psychoeducational program varied, and that lower engagement at the start was associated with greater odds of dropout. It also found that engagement decreased as dyads progressed through the program.
Why the authors say this matters
The authors conclude that assessing engagement in digital interventions may be important. The study suggests that multiple measures of engagement can provide additional insights into how people use these programs.
What the researchers tested
The researchers examined iFOCUS, a four-session digital self-managed 12-week intervention for dyads, meaning advanced cancer patients and their informal caregivers, in six European countries as part of a randomized controlled trial. They used process evaluation data from 121 dyads to study engagement, dropout, patient and caregiver characteristics, post-intervention outcomes, and participants' evaluation of the intervention.
What worked and what didn't
Lower engagement at the outset was associated with greater odds of dropout. Patient education level and caregivers' baseline emotional function, self-efficacy, dyadic coping, and knowledge of cancer were associated with engagement, but there was no consistent evidence that engagement was associated with outcomes or with evaluation of the intervention.
What to keep in mind
The abstract reports inconsistencies in the extent and nature of the associations found. It also says there was more evidence that baseline characteristics affected engagement than evidence that engagement affected outcomes.
Key points
- iFOCUS was a four-session, 12-week digital self-managed program for advanced cancer patient-caregiver dyads.
- The program showed no effects on outcomes in the main trial.
- Lower engagement at the beginning was linked to higher odds of dropout.
- Engagement declined as dyads moved through the program.
- Several patient and caregiver baseline characteristics were associated with engagement.
- There was no consistent evidence that engagement was tied to outcomes or intervention evaluation.
Disclosure
- Research title:
- Engagement with iFOCUS varied and was linked to dropout
- Authors:
- U Schmidt, Romy Van Rickstal, Vincent Van Goethem, Evi M. Bakker, Monika Pilch, Michael Connolly, Paul D’Alton, Catherine Jordan, Philip Larkin, Peter May, Katherine Bristowe, Silvia de Leo, Aline De Vleminck, Joachim Cohen, Laurel Northouse, P Hudson, DIAdIC Author Group, Suzanne Guérin
- Institutions:
- Azienda Sanitaria Unità Locale di Reggio Emilia, Cicely Saunders International, Cicely Saunders International, Erasmus MC, Our Lady's Hospital, St Vincent's Health, Trinity College Dublin, University College Dublin, University College Dublin, University College Dublin, University College Dublin, University College Dublin, University of Copenhagen, University of Lausanne, University of Michigan, Vrije Universiteit Brussel, Vrije Universiteit Brussel, Vrije Universiteit Brussel, Vrije Universiteit Brussel, Vrije Universiteit Brussel
- Publication date:
- 2026-04-21
- OpenAlex record:
- View
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