Issue link: https://read.uberflip.com/i/1503820
not for HADS‐D (F(2,170) = 3.81, p = 0.078). Although the iCBT group had lower HADS‐T, HADS‐A, and HADS‐D scores at post‐ intervention than TAU, the differences were not statistically signifi- cant (see Table 2). However, large and significant between‐group differences were found at 2‐month follow‐up for HADS‐T (g = −0.94), HADS‐A (g = −0.76), and HADS‐D (g = −0.96). Time since finishing cancer treatment did not moderate the effects on HADS‐T. The iCBT group had significant and moderate reductions in HADS‐T (g = 0.59), HADS‐A (g = 0.48), and HADS‐D (g = 0.57) from baseline to post‐intervention, and large significant reductions from baseline to follow‐up, HADS‐T (g = 0.91), HADS‐A (g = 0.75), and HADS‐D (g = 0.83) (see Table 3). TAU reported no significant dif- ferences across any time points. 3.5 | Secondary outcomes No significant group‐by‐time interaction was found for QOL, CWC, Active Coping, Avoidant Coping, and MOS‐SSS. However, between‐ group comparisons revealed that the iCBT had significantly higher MOS‐SSS at follow‐up than TAU (t(45) = 2.08, p = 0.042). A trend approaching significance was obtained for active coping (F (2,170) = 2.66, p = 0.073), with the iCBT using greater active coping at follow‐up than TAU (t(45) = 1.90, p = 0.063). No mediation models were significant. 3.6 | Clinically reliable change A difference in the HADS‐T that exceeds 5.77 was considered a reliable change. 55.6%(n = 10) in iCBT compared to 8.3%(n = 1) of TAU had achieved reliable recovery on distress from baseline to post‐intervention. Moreover, 11.1%(n = 2) in iCBT had clinically meaningful improvements compared to none in TAU. While only 33.3%(n = 6) of iCBT had no reliable change, 75%(n = 9) of TAU had no reliable change at post‐intervention. Importantly, while none of the iCBT group had deterioration, two participants in TAU deterio- rated at post‐intervention. The differences between iCBT and TAU were significant, Χ 2 (3, N = 30) = 11.21, p = 0.011. From baseline to 2‐month follow‐up, 61.1%(n = 11) in iCBT compared to 16.7%(n = 2) in TAU had achieved reliable re- covery on distress. Furthermore, 5.6%(n = 1) of iCBT had clinically meaningful improvements compared to no participants in TAU. 33.3%(n = 6) in iCBT and 66.7%(n = 8) in TAU had no change at follow‐up. None of the iCBT participants had deterioration. T A B L E 1 (Continued) Control iCBT F/χ 2 p value N = 23 N = 49 Mental health factors Previous psychotherapy for depression or anxiety Yes 9 (39.1%) 19 (38.8%) χ 2 (1) = 0.001 0.977 No 14 (60.9%) 30 (61.2%) Computer literacy Confidence in using computers and internet Mildly confident 1 (4.3%) 1 (2.0%) χ 2 (3) = 4.95 0.176 Average 2 (8.7%) 5 (10.2%) Confident 9 (39.1%) 8 (16.3%) Very confident 11 (47.8%) 35 (71.4%) Baseline measures Control iCBT t(df) p M SD M SD HADS‐total 16.09 5.60 17.12 7.12 0.61 (70) 0.542 HADS‐anxiety 9.96 3.15 10.67 4.22 0.72 (70) 0.472 HADS‐depression 6.13 3.44 6.45 3.99 0.33 (70) 0.743 QOL 4.83 1.30 4.69 1.39 −0.38 (70) 0.702 CWC 15.91 3.63 16.82 4.50 0.84 (70) 0.403 Active coping 2.72 0.49 2.60 0.52 −0.96 (70) 0.343 Avoidant coping 1.97 0.34 1.99 0.44 0.17 (70) 0.864 MOS‐SSS 2.97 0.97 3.35 0.88 1.65 (70) 0.103 Note: N control = 23, N iCBT = 49. Abbreviations: CWC, Cancer Worry Scale; HADS, Hospital Anxiety and Depression Scale; iCBT, internet‐delivered cognitive behavioural therapy; MOS‐SSS, Medical Outcomes Study Social Support Survey; QOL, Quality of Life Scale. AKKOL‐SOLAKOGLU AND HEVEY - 451 10991611, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/pon.6097, Wiley Online Library on [28/06/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License