Couplelinks - an online intervention for young women with breast cancer and their male partners: study protocol for a randomized controlled trial

Karen Fergus, Saunia Ahmad, Deborah L McLeod, Joanne Stephen, Sandra Gardner, Amanda Pereira, Ellen Warner, Wendy Carter, Karen Fergus, Saunia Ahmad, Deborah L McLeod, Joanne Stephen, Sandra Gardner, Amanda Pereira, Ellen Warner, Wendy Carter

Abstract

Background: Young breast cancer survivors (aged 50 years and under) and their partners are at an elevated risk for relationship distress and poor psychological adjustment relative to older age couples. Limited availability of time and resources and the distance to travel are major barriers to engaging in evidence-based psychosocial support programs. This paper describes the study protocol of a novel, manualized online intervention called Couplelinks that was developed to improve relationship adjustment and psychological wellbeing of young couples affected by breast cancer. Couplelinks is a custom-designed website offering a professionally facilitated, couple-centered intervention that entails informational, experiential, and interactive components.

Methods/design: A total of 80 heterosexual couples from across Canada in which the female partner has been diagnosed with a primary breast cancer will be recruited and randomized to a treatment or waitlist control group. Six dyadic learning modules form the core of the program and will be undertaken on a weekly basis. The manualized online intervention involves psycho-education and experiential exercises to enhance communication, coping ability, mutual empathy, and perspective-taking in relation to cancer. An online facilitator who is a trained mental health professional will guide and support couples throughout the process. Data collection will occur at baseline, at post-treatment or eight weeks into the waiting period, and at the three-month follow-up assessment. Primary outcome measures include the Revised Dyadic Adjustment Survey (RDAS) and Dyadic Coping Inventory (DCI) scores, and secondary outcome measures include the Hospital Anxiety and Depression Survey (HADS) score.

Discussion: Couplelinks is one of the first internet-based psychological interventions to improve the psychosocial adjustment of couples coping with a life-threatening illness such as cancer. If successful, the design of this program as described in this paper makes a valuable contribution to the literature on the delivery of couple-focused psychosocial interventions, both within and outside of oncology.

Trial registration: This trial was registered with ClinicalTrials.gov (identifier: NCT01089764 ) on 17 March 2010.

Figures

Figure 1
Figure 1
Flowchart of a randomized controlled trial (RCT) of Couplelinks.1Outcome Questionnaires include: BCRM = Breast Cancer and Relationship Measure, DCI = Dyadic Coping Inventory, FACT-B = Functional Assessment of Cancer Treatment - Breast (female only), HADS = Hospital Anxiety and Depression Scale, KMSS = Kansas Marital Satisfaction Survey, MMQ = Maudsley Marital Questionnaire, RDAS = Revised Dyadic Adjustment.

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