Engagement with INSPIRE, an Online Program for Hematopoietic Cell Transplantation Survivors

Abstract PURPOSE In a secondary analysis of a randomized controlled trial (RCT), we examined engagement with INSPIRE , a personalized online program for hematopoietic cell transplantation (HCT) survivors that focused on cancer-related distress, depression, fatigue, and health care needs. METHODS We approached all adult, 3-18 year HCT survivors treated for hematologic malignancy, without relapse or second cancer in the previous 2 years, for participation in an RCT with either immediate or delayed access to INSPIRE . Participants with immediate access could view the online material at any time. Data included page view tracking, medical records, and patient reported outcomes including the Short Form-36 and Cancer and Treatment Distress (CTXD) measures. RESULTS Of 1322 eligible HCT survivors, 771 (58%) completed baseline assessment; 451 received immediate INSPIRE access and were included in analyses. They were 56% male, mean age 52 (SD 12.2), and 26% autologous transplant recipients. Most (77%) logged into the site at least once and 48% viewed 8+ pages. Survivors who viewed 2+ pages were more likely to be: age 40 or older (relative risk (RR) 1.41, confidence interval (CI) 1.10,1.80), female (RR 1.22, CI 1.07,1.40), with chronic graft versus host disease (RR 1.28, CI 1.08, 1.51), less than 10 years post-HCT (RR 1.19, CI 1.01,1.39), with moderate CTXD distress (RR 1.34, CI 1.14,1.57). Engagement did not differ by race, education, income, rural/urban residence, computer experience, donor type, or depression (all P >.50). CONCLUSIONS The online program was widely used, including by those who often have reduced access to care after treatment.