David Wiesenfeld

Feasibility and Acceptability of the Fear‐Less Screening and Stratified‐Care Model for Fear of Cancer Recurrence Among People Affected by Early‐Stage Cancer

ABSTRACTObjectivesFear of cancer recurrence (FCR) is a prevalent unmet need for people affected by cancer, in the context of limited healthcare resources. Stratified‐care models have potential to meet this need, while reducing resource demands. This study aimed to evaluate the feasibility and acceptability of screening procedures and interventions within the Fear‐Less stratified‐care model among those impacted by early‐stage cancer.MethodsPeople affected by breast, head and neck, or gynaecological cancer, who had completed curative treatment, were screened for FCR. Individuals experiencing moderate FCR (scored 13–21 on the Fear of Cancer Recurrence Inventory‐Short Form; FCRI‐SF) were offered a purpose‐developed clinician‐guided self‐management intervention, while those experiencing severe FCR (FCRI‐SF score ≥ 22) were offered individual therapy (ConquerFear). Re‐screening and evaluation measures were completed post‐intervention.ResultsSeventy‐six (70%) of 109 eligible people completed screening, with 53/76 participating in the Fear‐Less model evaluation. Thirty‐nine of 53 participants reported FCR and were referred to an intervention; 30/39 (77%) accepted the referral. Fifteen (83%) of 18 participants completing the self‐management intervention reported reading ≥ 75% of the resource at 5 weeks, with 10/18 (56%) reporting clinically meaningful (≥ 10%) reductions on the FCRI‐SF post‐intervention. Qualitative feedback indicated screening and the stratified‐care received were acceptable.ConclusionsScreening procedures and interventions forming the Fear‐Less model appear feasible and acceptable for identifying and treating FCR among people affected by early‐stage cancer. Although further research is required to evaluate its efficacy, this model has the potential to meet a major unmet need, where psychosocial services are limited amid increased demand.Trial RegistrationThis study was retrospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622000818730) on 10/6/2022.