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Hence, we feasibility-tested <jats:italic>Finding My Way-Advanced (FMW-A)<\/jats:italic>, a self-guided program for women with metastatic breast cancer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A single-site randomised controlled pilot trial was conducted. Participants were recruited through clinicians, professional networks, and social media and randomised to intervention or usual-care control. Participants were randomly allocated to either the intervention (<jats:italic>FMW-A;<\/jats:italic> a 6-week, 6-module CBT-based online self-directed psychosocial program for women with MBC\u2009+\u2009usual care resources) or control (usual care resources: BCNA\u2019s Hope and Hurdles kit). Feasibility outcomes included rates of recruitment, uptake, engagement, and attrition. Distress, QOL, and unmet needs were evaluated for signals of efficacy, and qualitative feedback was collected to assess acceptability.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Due to COVID-19 and funding constraints, the target recruitment of 40 was not reached (<jats:italic>n<\/jats:italic>\u2009=\u200960 approached; <jats:italic>n<\/jats:italic>\u2009=\u200955 eligible; <jats:italic>n<\/jats:italic>\u2009=\u200935 consented). Uptake was high (<jats:italic>n<\/jats:italic>\u2009=\u200935\/55; 63.6%), engagement modest (median 3\/6 modules per user), and attrition acceptable (66% completed post-treatment). Efficacy signals were mixed: compared to controls, <jats:italic>FMW-A<\/jats:italic> participants experienced small improvements in fear of progression (<jats:italic>d<\/jats:italic>\u2009=\u20090.21) and global QOL (<jats:italic>d<\/jats:italic>\u2009=\u20090.22) and demonstrated a trend towards improvements in cancer-specific distress (<jats:italic>d<\/jats:italic>\u2009=\u2009<jats:italic>0.13<\/jats:italic>) and role functioning (<jats:italic>d<\/jats:italic>\u2009=\u20090.18). However, <jats:italic>FMW-A<\/jats:italic> participants experienced small-to-moderate deteriorations in general distress (<jats:italic>d<\/jats:italic>\u2009=\u20090.23), mental QOL (<jats:italic>d<\/jats:italic>\u2009=\u20090.51), and social functioning (<jats:italic>d<\/jats:italic>\u2009=\u20090.27), whereas controls improved. Qualitatively, participants <jats:italic>(n<\/jats:italic>\u2009=\u2009<jats:italic>4)<\/jats:italic> were satisfied with the program, perceived it as appropriate, but noted some sections could evoke transient distress.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The study demonstrated feasibility (high uptake and acceptable retention) and generated realistic recruitment estimates. While <jats:italic>FMW-A<\/jats:italic> appears promising for targeting cancer-specific distress and fear of progression, the mixed findings in quality of life and general distress warrant further revisions and testing.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00520-024-08924-2","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:02:38Z","timestamp":1729641758000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Feasibility, acceptability, and preliminary efficacy of a self-directed online psychosocial intervention for women with metastatic breast cancer: Finding My Way-Advanced"],"prefix":"10.1007","volume":"32","author":[{"given":"Amy","family":"Rigg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Kemp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogda","family":"Koczwara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyllis","family":"Butow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afaf","family":"Girgis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Hulbert-Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Billingsley","family":"Kaambwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riki","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penelope","family":"Schofield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Turner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desmond","family":"Yip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Combes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8847-8452","authenticated-orcid":false,"given":"Lisa","family":"Beatty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,22]]},"reference":[{"issue":"3","key":"8924_CR1","doi-asserted-by":"publisher","first-page":"e36255","DOI":"10.2196\/36255","volume":"8","author":"M Leslie","year":"2022","unstructured":"Leslie M et al (2022) Web-based psychological interventions for people living with and beyond cancer: meta-review of what works and what does not for maximizing recruitment, engagement, and efficacy. 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