Feasibility and acceptability of an online expressive writing intervention for rural breast cancer survivors: A randomized controlled trial

Purpose: Rural breast cancer survivors (BCS) have unique unmet psychosocial needs that affect quality of life (QOL). Expressive writing (EW) has been shown to improve QOL in cancer survivors, however, its applicability is unclear among rural individuals. This pilot study explores the feasibility and acceptability of an online expressive writing (EW) intervention among rural breast cancer survivors (BCS). Methods: Participants (N = 34) were recruited from a cancer hospital's registry and randomly assigned to either a control group or the EW intervention group to read positive messages and to write about their cancer experience three times, once per week. Health outcomes were assessed at baseline and 1 month after the intervention. Feasibility and acceptability were also assessed. Results: The study yielded a satisfactory response rate, adherence rate, and completion rate. The majority of the participants reported enjoying the study. Preliminary analyses also demonstrated promising efficacy of the intervention, with improvements (medium effect size) observed for QOL (d = 0.51) and fatigue (d = −0.64) in the intervention group compared to the control group at 1-month follow-up. Conclusions: The study demonstrates feasibility and acceptability of an online EW intervention among rural BCS. Future research is warranted to examine the efficacy of the intervention in larger samples of rural cancer survivors.