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Mediators of an Internet-based psychosocial intervention for women with breast cancer.

OBJECTIVE
Many interventions have been designed to promote psychological adjustment in cancer survivors; however, notably few studies have specified the mediating processes through which these interventions work. The primary aim of this research is to examine theoretically and empirically grounded mediators of an Internet-based psychosocial intervention for women with breast cancer.


METHOD
Women (N = 88) diagnosed with breast cancer were randomly assigned to participate in a 3-hr workshop for creation of personal websites or a waitlist control. Mediating variables and dependent variables were assessed at baseline, 1 month, and 6 months following workshop participation. Indirect effects were tested using single and multiple mediator models.


RESULTS
Relative to control participants, women randomized to Project Connect Online (PCO) evidenced statistically significant benefit 6 months after the workshop on depressive symptoms, positive mood, and life appreciation, as well as on hypothesized mediators (i.e., coping self-confidence, loneliness, social support from friends, but not emotional processing and expression). Change over 6 months in coping self-confidence, loneliness, and social support from friends mediated the relationship between the intervention and improvement in depressive symptoms. Coping self-confidence mediated the relationship between PCO and enhanced positive mood, and social support from friends mediated the relationship between PCO and increased life appreciation.


CONCLUSIONS
Findings indicate how PCO promoted adaptive change and highlighted modifiable factors, including coping self-confidence, loneliness, and social support from friends, which contributed to positive adjustment to breast cancer. Additional potential mediators and ways in which the intervention can be enhanced are addressed.