Design of a Cognitive Bias Modification eHealth app to improve implicit vitality in breast cancer patients: a co-creation process (Preprint)
BACKGROUND More than 50% of all breast cancer patients experience fatigue symptoms during and after their treatment course. Recent evidence shows that fatigue is partly driven by cognitive biases, such as the self-as-fatigued identity bias, which may be corrected with computer-based Cognitive Bias Modification (CBM) techniques. OBJECTIVE The aim of the current study was to design such a CBM-training by adopting a co-creation approach. METHODS Semi-structured interviews were conducted with seven health professionals, three breast cancer patients and two patient advocates. Aim of the interviews was to collect input for the design of the CBM-training, taking the values and preferences of the stakeholders into account and to determine the timing and implementation of the training in the treatment course. RESULTS Overall, the interviews showed that the concept of CBM was accepted among all stakeholders. Important requirements were revealed, such as that the training needs to be simple, undemanding, yet engaging and persuasive. Based on the results, eHealth app IVY (Implicit VitalitY) was created. Interviews suggested that IVY should be offered early in the treatment course and should be carefully aligned with clinical treatment. CONCLUSIONS Using CBM to target cancer-related fatigue in a preventive approach is an innovative technique, which is embraced by breast cancer stakeholders. The current study suggests CBM has several benefits, such as being easy to use, and potentially increasing perceived self-control in patients. CLINICALTRIAL