MindOnLine, a self-guided online mindfulness program supporting people living with cancer: Participant satisfaction analysis

MindOnLine, a self-guided online mindfulness program supporting people living with cancer: Participant satisfaction analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article MindOnLine, a self-guided online mindfulness program supporting people living with cancer: Participant satisfaction analysis Lahiru Russell, Natalie Winter, Liliana Orellana, Victoria White, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8972358/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Purpose This study evaluated participant satisfaction with MindOnLine, a 9‑week self‑guided online mindfulness program designed to support psychological wellbeing among people living with and beyond breast, prostate, or colorectal cancer. It examined perceptions of usability, emotional coping support, and influence on ongoing mindfulness practice. Methods Embedded within a larger randomised controlled trial, this survey‑based study collected quantitative and qualitative data from intervention‑group participants at program completion. Program satisfaction, session usefulness, and overall helpfulness were assessed using Likert‑scale measures across multiple domains, alongside four open‑ended questions exploring mindfulness practice, managing difficulties, future use, and desired content. Quantitative data were summarised descriptively. Open‑ended responses were analysed thematically using Braun and Clarke’s framework, with categories generated by human coders and Microsoft Copilot© compared to enhance analytical rigour. Results Of 233 intervention participants, 167 (72%) provided satisfaction data. Most reported that the program was easy to use (91%) and would recommend it to others (83%). Between 41% and 59% noted improved emotional understanding and coping, including decreased anxiety (54%) and increased control over thoughts (59%). Thematic analysis of 267 qualitative responses identified four overarching themes: (1) transformative benefits during and beyond cancer; (2) empowerment through sustained mindfulness practice; (3) individualised and practical program experiences; and (4) integration of mindfulness amid competing life demands. Conclusion MindOnLine was acceptable, empowering, and emotionally beneficial, with most participants intending to continue mindfulness practice. Findings highlight the value of flexible, person‑centred digital mindfulness interventions in cancer survivorship care and offer guidance for scalable implementation. Introduction The survival rates of people living with cancer have improved due to screening programs, earlier interventions, and advancements in treatment. As of 2022, approximately 53.5 million people worldwide were living within five years of a cancer diagnosis [ 1 ]. In Australia, over one million individuals are living with a history of cancer, a figure expected to increase due to population growth and ageing [ 2 ]. While this trend reflects substantial progress in oncology, it also underscores the pressing need for effective and sustainable survivorship care. Many people living with cancer experience long-term physical symptoms, psychological distress, and fear of recurrence, all of which can impact their quality of life and recovery [ 3 ] [ 4 ] [ 5 ] [ 6 ]. Addressing these challenges requires the development and implementation of psychosocial supportive care programs that are not only evidence-based but also scalable and accessible to people with limited access to health services. There is a growing body of evidence demonstrating that digital health offers accessible and cost-effective means of delivering psychosocial support technologies in cancer survivorship care [ 7 ]. Interventions particularly targeting mental health have shown reduction in symptoms of depression, anxiety, and distress among cancer survivors [ 8 , 9 ]. Among these, mind-body interventions, such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) have gained considerable attention. A recent meta-analysis provided evidence to support the efficacy of mindfulness-based programs in improving quality of life and alleviating symptoms such as pain, fatigue, and emotional distress in cancer populations [ 10 ]. Furthermore, digital adaptations of these programs have demonstrated comparable benefits in the general population, with recent trials indicating that self-guided online mindfulness interventions can reduce depression and enhance emotional regulation [ 11 ]. These findings were observed in cancer populations in a few studies [ 12 , 13 ]. Despite these promising outcomes, challenges remain in the implementation and uptake of online mindfulness programs. User engagement, adherence, and satisfaction are often suboptimal when programs are not tailored to individual needs, preferences, or life contexts, fail to resonate with end users, undermining motivation to engage or continue [ 14 ] [ 15 ]. In addition, assessing user engagement with digital interventions encompasses both objective usage metrics such as frequency, duration, and depth of interaction, and subjective experiential dimensions, including attention, interest, and emotional response [ 16 ]. Understanding the user experience is critical for intervention improvement, and to ensure that its design and are acceptable to users. MindOnLine , a self-guided online mindfulness program was developed drawing on mindfulness‑based stress reduction principles, using an established framework for mindfulness‑based programs [ 17 ], and an iterative process of pilot testing and user feedback. The original program, a 6‑week online intervention for people with melanoma was tested in a randomised controlled pilot study [ 13 ]. Participants’ feedback highlighted the value of extending the program to enhance sustainability of practice, leading to a 9‑week program with greater flexibility of access and usage for cancer survivors. In our recent randomised controlled trial, we demonstrated that a 9‑week MindOnLine program significantly reduced fear of cancer recurrence (FCR), anxiety, and depression among cancer survivors [ 12 ]. The current paper presents feedback from participants about their satisfaction with, and perceptions of, MindOnLine . By exploring the user experience, this study aimed to provide deeper insights into the strategies through which digital mindfulness interventions may support psychological wellbeing in cancer survivorship. Method Information about the study design and recruitment process are detailed elsewhere [ 18 ]. In brief, a randomised controlled trial was conducted between October 2020 and June 2023 to evaluate the effectiveness and cost-effectiveness of MindOnLine for people diagnosed with breast, bowel and prostate cancer experiencing FCR. The program incorporated educational content, formal and informal mindfulness practices. Each week introduced a new topic (e.g., stress reduction, emotional regulation, self-compassion) via short videos that lasted between 1–9 minutes, and guided meditation audios ranging from 1–10 minutes each. Participants were encouraged to engage in daily practice and apply mindfulness in everyday activities. Engagement and adherence strategies included twice-daily email reminders with meditation links, goal setting and progress tracking features, reflective journaling prompts, and on-demand access to all program materials. People who were aged 18 or older living in Australia who had completed treatment for Stage I–III breast, prostate, or colorectal cancer within the past five years, had internet access, and reported clinically significant FCR on the Fear of Cancer Recurrence Inventory (FCRI), with a severity score ≥ 13, were eligible to participate. Participants were recruited using a range of platforms, including targeted paid social media advertisements with Facebook and Instagram (Meta), community and peak national consumer advocacy networks, as well as through health services, cancer registries and oncologists involved in the project. Satisfaction assessments were conducted at 9 weeks, and 9 months [ 12 ]. All procedures performed in this study were conducted in accordance with the ethical standards of the institutional research committee and with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study. The current paper reports on participants’ satisfaction with MindOnLine on completion of the 9-weeks intervention period. Measures Program satisfaction was assessed using 10 statements relating to the program’s look and feel (e.g. “I thought the program was easy to use”), and eight statements relating to its ability to help participants understand and cope with their emotions (e.g., “the program helped decrease my anxiety”). All18 statements were rated using a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Responses were categorised in three levels (strongly disagree/disagree, neutral, strongly agree/agree). The neutral responses were retained as a distinct category, reflecting ambivalence on program satisfaction. The statements are shown in Table 2 . Helpfulness of each weekly session (nine items) and engagement features of the program (six items) were measured on a 6-point scale, “N/A did not use this feature” (0), and very unhelpful (1) to very helpful (5). Responses were transformed in a 3-point scale (Did not use this feature, very unhelpful/unhelpful/neutral, very helpful/helpful,). The neutral responses were grouped with unhelpful responses, as both reflect insufficient perceived utility to support engagement and inform program design decisions. The list of items is reported in Table 3 . Overall helpfulness of the program was assessed across three domains:1) encouraging people to practice mindfulness, 2) manage difficulties, and 3) intention to maintain the practice. Responses were collected on a 4-point Likert scale. For domains 1 and 2, response options were: 1-Not helpful, 2-Quite helpful, 3-Very helpful, or 4-Unsure. For domain 3, options included: 1-Not at all, 2-Every now and then, 3-Quite often, or 4-Unsure. Four open-ended questions explored 1) perceived helpfulness of MindOnLine program overall in encouraging mindfulness practice; 2) usefulness of the program to help manage difficulties/ challenges; 3) likelihood of continued use of the MindOnLine program; and 4) additional information participants would have liked. Analysis Descriptive statistics were used to report the characteristics of participants in the intervention group. Thematic analysis was applied to examine participants’ responses to the four open-ended questions. Following Braun and Clarke’s (2006) framework [ 19 ], responses were first reviewed by a researcher for clarity and relevance. Only clearly articulated sentences were retained, while brief or ambiguous responses (e.g., “no,” “n/a,” “helpful”) were excluded to ensure analytical depth. Given the overlap in content across the four open-ended questions, all responses were consolidated to provide a holistic understanding of participants’ experiences. The data were analysed in parallel by a researcher (LR) and Microsoft Copilot© an AI-powered assistant integrated into Microsoft 365. Copilot was used to generate initial categories based on recurring topics, following a generative coding approach similar to that described by Bryda and Sadowski (2024)[ 20 ], where large language models were employed to inductively identify patterns in qualitative data. To ensure rigor, the categories generated by Copilot were compared with those identified by the researcher. This comparative process examined theme overlap (categories present in both analyses), divergence (unique categories identified by either Copilot or the researcher), and terminology (differences in naming or framing of similar concepts). This approach aligns with the methodology used by Morgan (2023)[ 21 ], who demonstrated the value of comparing AI-generated themes with human-coded ones to assess consistency and interpretive depth. Each category was cross-referenced with the original dataset to confirm accuracy and contextual integrity. Categories were then grouped into broader themes, which were refined with the input from a second researcher (NW) to reduce redundancy and enhance clarity. This iterative process ensured that both human and AI contributions were critically evaluated, supporting a transparent and triangulated analysis. In the presentation of results below, each theme is supported by participants quotes and their respective study ID. Results A total of 434 participants with stage I–III breast, prostate, or colorectal cancer were recruited and randomly assigned to either the intervention or waitlist group. Of the 233 participants allocated to the intervention, 167 (72%) provided responses to satisfaction, helpfulness, or future intention to use MindOnline . Demographic and clinical characteristics of this group are presented in Table 1 . Table 1 – Demographic and clinical characteristics pf participants (n = 167) Demographics n (%) n (%) Clinical Characteristics Sex Cancer type Female 120 72.8 Breast 99 59.3 Male 47 28.2 Prostate 39 23.3 Other 0 0 Bowel 29 17.4 Age Years since treatment finished ≥60 years old 88 52.7 ≤1 year 87 52.1 1 to ≤ 5 years 80 47.9 Marital status Received surgery (n = 166) Married or de facto relationship 117 70.1 Yes 150 89.8 Not married 50 29.9 No 15 10.2 University degree Received chemotherapy (n = 166) Completed 98 58.7 Yes 94 56.6 Not completed 69 41.3 No 72 43.4 Employment status Received radiotherapy (n = 166) Retired 54 32.3 Yes 98 59.1 Working part time 49 29.3 No 68 40.9 Working full time 37 22.2 Other 27 16.2 Area of residence § Received hormonal therapy (n = 166) Metropolitan 114 68.2 No 106 63.9 Non-metropolitan 53 31.8 Yes 60 36.1 Mindfulness experience Negative impact of COVID19 on mental wellbeing (a) None 83 49.7 No 99 59.3 Both 35 21.0 Yes 38 22.8 Mediation 30 17.9 Neutral 30 17.9 Mindfulness 19 11.4 Program satisfaction The majority of participants reported they ‘liked the look and feel aspects’ of the program, and most (91.0%) found the program ‘easy to use’ and would ‘recommend it to a friend in a similar situation’ (82.6%) (Table 2 ). About half (41.3%-58.7%) reported that the program helped understanding and coping with their emotions, with larger proportions reporting to feel more in ‘control of their thoughts or worries’ (58.7%), ‘decreased their anxiety’ (54.2%), and helped them to ‘think more positively about their situation’ (51.5%). Table 2 Program satisfaction n = 167 Strongly disagree/Disagree Neutral Strongly agree/Agree Look and feel aspects n (%) n (%) n (%) 1. I liked using this program 15 (9.0) 27 (16.2) 125 (74.9) 2. I found it easy to login and log out of my account 5 (3.0) 11 (6.6) 151 (90.4) 3. I thought this program was easy to use 3 (1.8) 12 (7.2) 152 (91.0) 4. I felt very confident using this program 4 (2.4) 23 (13.8) 140 (83.8) 5. I enjoyed learning about mindfulness through this program 10 (6.0) 27 (16.2) 130 (77.8) 6. It is likely that I will continue to practice mindfulness in the future 12 (7.2) 26 (15.6) 129 (77.2) 7. I would recommend this program to friends in a similar situation 11 (6.6) 18 (10.8) 138 (82.6) 8. I found the exercises easy to do 7 (4.2) 30 (18.0) 130 (77.8) 9. The exercises kept me engaged with the program 19 (11.4) 38 (22.8) 110 (65.9) 10. I liked the look of the weekly sessions 13 (7.8) 47 (28.1) 107 (64.1) Understanding and coping with emotions 11. The program helped me feel more in control of my thoughts or worries 13 (7.8) 56 (33.5) 98 (58.7) 12. The program helped me cope better with any worries I have about cancer returning 16 (9.6) 70 (41.9) 81 (48.5) 13. The program helped me to understand my cancer worries better 16 (9.6) 78 (46.7) 73 (43.7) 14. The program helped decrease my anxiety 14 (8.4) 62 (37.3) 90 (54.2) 15. The program helped reduce my worries 20 (12) 69 (41.3) 78 (46.7) 16. The program helped me feel more hopeful 13 (7.8) 85 (50.9) 69 (41.3) 17. The program helped me to think more positively about my situation 12 (7.2) 69 (41.3) 86 (51.5) 18. The program helped me to think more positively about the future 10 (6.0) 77 (46.4) 79 (47.6) Helpfulness of weekly sessions and program features The majority of participants indicated that week 1 and 2 of the program were most helpful, and between one quarter and one third of participants indicated that they did not use sessions 5 through 9. Around two thirds of participants found the daily reminders (67%) and the weekly mindfulness exercises (63%) helpful (Table 3 ). However, nearly two-thirds did not use the journalling option (63.3%), 56.6% did not use the goal setting feature and around a quarter of participants did not find the progress monitoring feature (24.2%) or the goal setting feature (25.3%) helpful. Table 3 – Helpfulness of weekly sessions and program features Did not use this feature Very unhelpful/ Unhelpful Very helpful /Helpful N n (%) n (%) n (%) Week 1 Introduction 166 11 (6.6) 22 (13.3) 133 (80.1) Week 2 Reducing stress 165 13 (7.9) 24 (14.5) 128 (77.6) Week 3 Relating to emotions 165 23 (13.9) 34 (20.6) 108 (65.5) Week 4 Self-compassion 165 31 (18.8) 34 (20.6) 100 (60.6) Week 5 Communicating mindfully 164 38 (23.2) 31 (18.9) 95 (57.9) Week 6 Living mindfully 164 41 (25.0) 26 (15.9) 97 (59.1) Week 7 Reducing worry 164 54 (33.1) 29 (17.8) 80 (49.1) Week 8 Reducing worries mindfully 164 43 (26.2) 31 (18.9) 90 (54.9) Week 9 Maintaining a mindfulness practice 164 53 (32.3) 37 (22.6) 74 (45.1) Guided meditation library 163 54 (33.1) 29 (17.8) 80 (49.1) Daily reminders 165 21 (12.7) 33 (20.0) 111 (67.3) The weekly mindfulness exercises 165 33 (20.0) 28 (17.0) 104 (63.0) Progress monitoring feature 165 71 (43.0) 40 (24.2) 54 (32.7) Journaling option 166 105 (63.3) 31 (18.7) 30 (18.1) Goals 166 94 (56.6) 42 (25.3) 30 (18.1) Overall helpfulness of the program in encouraging to practice mindfulness, manage difficulties, and maintain the practice The majority (126/166, 75.9%) found the program quite or very helpful in encouraging mindfulness practice. Two-thirds (108/165, 65.5%) found it helpful in managing difficulties, though around 20% (36/165, 21.8%) were unsure. Most (120/166,72.7%) expressed intention to continue mindfulness practice either quite often or occasionally (Table 4 ). Table 4 – Overall helpfulness of the program MindOnLine was helpful in… Not helpful Quite helpful Very helpful Unsure N n (%) n (%) n (%) n (%) …encouraging to practice mindfulness 166 17(10.2) 55(33.1) 71(42.8) 23(13.9) …manage difficulties 165 21(12.7) 66(40.0) 42(25.5) 36(21.8) Not at all Every now and then Quite often Unsure N n (%) n (%) n (%) n (%) Intention to maintain the practice 165 20(12.1) 48(29.1) 72(43.6) 25(15.2) Open-ended questions Of the 167 respondents, 106 (63.5%) provided responses to at least one open-ended question. Similar to the data in Table 1 , most respondents were female (n = 79, 74.5%), over 60 years (61, 57.5%), married or in a de facto relationship (74/106, 69.8%), had completed a university degree (60, 56.6%), and were living in a metropolitan area (75, 70.8%). The majority had a breast cancer diagnosis (63, 59.4%) with prostate and bowel cancer equally represented (22, 20.8%, and 21, 19.8%, respectively). A total of 267 open ended responses were included in the analysis. The thematic analysis showed four overarching themes that capture the experiences of individuals engaging with MindOnLine during and beyond their cancer journey. These four themes and their sub-themes are described in the sections below, and Table 5 provides additional information. Theme 1: Transformative during and beyond cancer In this theme participants describe the program as emotionally supportive, particularly during the post-treatment phase when feelings of isolation were common. This theme consisted of four sub-themes that encompasses the benefits of the program during and beyond cancer with practices learnt integrated into other areas of daily living. Sub-theme 1.1 – Supportive and inclusive This sub-theme illustrates how participants reported that MindOnLine provided a sense of care, support, and inclusion following cancer treatment, helping to reduce feelings of isolation. For example: “ It made me feel someone cared. End of cancer treatment leaves me feeling discarded and irrelevant and utterly alone with no help or care from anyone. ” — (Female, 68 yrs, Breast cancer) Sub-theme 1.2 – Leads to lifestyle changes MindOnLine also facilitated meaningful lifestyle changes, with participants reporting increased mindfulness and integration of practices into daily routines: “ I am now meditating about twice a week with a goal for every day… I am living more mindfully already. ” — (Female, 50 yrs, Breast cancer) “ I learnt to use these skills [body scan, breathing and sound meditations] when I swim… this process gave me tools that I have been able to implement directly into my life. ” — (Female, 58 yrs, Breast cancer) Sub-theme 1.3 – Outside of the cancer experience Beyond the cancer context, participants found that their experience with MindOnLine provided benefits for broader life challenges: “ I found the program very enjoyable and useful and helpful not just in relation to cancer but in all aspects of my life .” — (Female, 61 yrs, Breast cancer) “ The skills I have learnt… assisted me with some family challenges unrelated to my own diagnosis. ” — (Female, 58 yrs, Breast cancer) Sub-theme 1.4 – Developing new skills Participants also described acquiring new skills, such as self-compassion and emotional regulation, helped them to manage their emotions: “ Knowing it was ok to get distracted and bring yourself back without being hard on myself has encouraged me to continue .” — (Female, 65 yrs, Bowel cancer) “ [It] helped me with self-compassion as I feel I am thinking of how others are coping with me having cancer and disregarding my own feelings .” — (Female, 70 yrs, Bowel cancer) Theme 2: Empowering through mindfulness practice In this theme, participants described MindOnLine as supporting the continuation of mindfulness practice beyond the intervention period. This theme comprises four sub‑themes reflecting how the program reinforced existing skills and motivated ongoing engagement with mindfulness strategies in everyday life. Sub-theme 2.1 – Reinforcing existing practice MindOnLine reinforced existing mindfulness practices and inspired continued engagement and learning. One participant noted: “ [The program] helped me consolidate the work I've done previously on mindset… techniques I have used in the past… were explained further .” — (Female, 47 yrs, Breast cancer) Sub-theme 2.2 – Inspired to continue this practice Others expressed motivation to continue using the program materials beyond the 9-week intervention period: “ I have saved the MindOnLine emails and plan to use them… ” — (Female, 55 yrs, Breast cancer) “ I have kept info [from MindOnLine] to use at a later date .” — (Female, 58 yrs, Breast cancer) Sub-theme 2.3 – Encouraged to engage with similar programs Due to positive experiences when using MindOnLine , several participants showed interest in exploring similar programs or resources after the end of the study: “ I have joined a meditation group .” — (Female, 63 yrs, Breast cancer) “ It encouraged me to download an overnight mindfulness app, which I use nightly now .” — (Female, 67 yrs, Breast cancer) Sub-theme 2.4 – Motivated to further learn on the topic Similarly, people reported that MindOnLine sparked their interest in undertaking further learning about mindfulness practice: “ Some suggestions for courses or reading or information for further research either during the program or for after the program [would be useful] .” — (Female, 60 yrs, Breast cancer) Theme 3: Individualised and practical program experience In this theme, participants reflected on their experiences of specific program components and delivery features. This theme comprises three sub‑themes that capture varied responses to the meditations, weekly thematic content, and reminder prompts, highlighting the importance of flexibility and tailoring to individual preferences to support engagement. Sub-theme 3.1 – Meditations Feedback highlighted the importance of tailoring the program to individual preferences. Some found that they had a positive experience with the meditations and that they were calming: “ I did find the sessions calming .” — (Female, 57 yrs, Breast cancer) Contrastingly, others found aspects of the guided meditations challenging: “ I found the guided meditation very hard to listen to… instructions at indiscriminate times .” — (Female, 56 yrs, Breast cancer) “ I had difficulty with some of the shorter guided meditations… I would have preferred more gaps between the instructions .” — (Female, 63 yrs, Breast cancer) Sub-theme 3.2 – Weekly themes Weekly themes were generally appreciated: “ I enjoyed making the time to watch the weekly videos which were informative .” — (Female, 47 yrs, Breast cancer) However, some participants found repetition or focus on negative experiences disengaging: “ Weeks 2 and 3… turned me off the program — the thought of thinking of a negative experience, twice a day for a fortnight just struck me as an unnecessary pain .” — (Female, 51 yrs, Breast cancer) Sub-theme 3.2 – Reminders Reminders were helpful for habit formation: “ Daily reminders were helpful, particularly in early weeks to develop habit of setting aside time .” — (Female, 68 yrs, Bowel cancer) Yet, others found them intrusive: “ Twice daily reminders to meditate… extremely annoying and frustrating… turned me off the program completely .” — (Female, 66 yrs, Breast cancer) Theme 4: Integration into daily life amid competing demands In this theme, participants describe how the structure of MindOnLine supported regular mindfulness practice, alongside challenges related to competing health, work, and caregiving demands. This theme comprises two sub‑themes capturing sustained engagement through structured and relevant support and tensions arising from conflicting priorities. Sub-theme 4.1 – Structured support for sustained practice Participants reported that MindOnLine’s structured format supported regular mindfulness practice and sustained engagement, while also identifying a need for content tailored to work‑related contexts to better support practice during everyday role transitions.: “ It was good for scheduling of time to undertake the practice .” — (Female, 65 yrs, Breast cancer) “ I love this program because it helps to keep me engaged in regular meditation practice .” — (Female, 66 yrs, Breast cancer) “… a session targeting returning to work to help with mindfulness in work situations [would be helpful].” — (Female, 56 yrs, Breast cancer) Sub-theme 4.2 – Conflicting priorities Others struggled due to competing priorities noting that aspects of timing and intensity could be confronting and may benefit from greater flexibility or longer program duration: “ Work and family absorbed all of my time .” — (Male, 60 yrs, Bowel cancer) “ My husband also cancer patient… My difficulties are compounded by being his carer .” — (Female, 68 yrs, Breast cancer) “ Unfortunately, my brother in the USA was terminally sick… I lost momentum .” — (Male, 67 yrs, Prostate cancer) Table 5 Mindonline Experience Thematic Analysis Themes Sub-themes Quotes 1. Transformative during and beyond cancer 1.1 Supportive and inclusive ” It made me feel someone cared. End of cancer treatment leaves me feeling discarded and irrelevant and utterly alone with no help or care from anyone” — BMF821 "It has been of great help and support, thank you for allowing me to be part of the trial group." - GGY079 "If I continue, I’m sure it will have a greater [positive] impact on my anxiety" — AWL274 "Having a program that reminding me that I was part of something specifically related to cancer treatment helped." — IDI443 1.2 Leads to lifestyle changes "I am now meditating about twice a week with a goal for every day. I often practise mindful pauses through the day and know I am living more mindfully already. Thanks very much, so very useful! Wish I had access to this YEARS ago!" — SER725 "I learnt to use these skills [body scan, breathing and sound meditations] when I swim, on the occasions when my sleep has been disrupted and other times I want to clear my mind. It has also been really useful in controlling my breathing when I run. ... this process gave me tools that I have been able to implement directly into my life." FCZ357 "Really helpful - I learnt the skills and was able to use them throughout the day if necessary." — RDA028 1.3 Outside of the cancer experience "I found the program very enjoyable and useful and helpful not just in relation to cancer but in all aspects of my life" — GIU967 "...I find the recordings soothing and it helps me focus it makes it easier to meditate and practice mindfulness and stop the anxiety and worrying thoughts spiralling in my head at night!" — GGY079 "The skills I have learnt in this course have ... also assisted me with some family challenges unrelated to my own diagnosis but intrinsically linked to border closures with [COVID 19] and my elderly parents’ situation." — FCZ357 "[MindOnLine] helped me notice thoughts especially negative ones and question their validity" — CWI505 “The MindOnLine Program addresses my very real and troubling challenges and helps me look at them with more hope and a more optimistic view...I can be and am starting to be more compassionate and understanding of my feelings and thoughts, and that's a good feeling and reassuring." BZY556 1.4 Developing new skills “It is something I have not done before and was quite challenging to sit still however knowing it was ok to get distracted and bring yourself back without being hard on myself has encouraged me to continue with the practice and particular to give thanks” — EHV312 “I've never meditated before and didn’t understand how it worked. This program was excellent in explaining the practice.” - BAS170 "I found the use of breathing as an "anchor" quite profound, yet so simple. My mind jumps around a lot. To anchor it and re-focus on the task at hand was very helpful." — PBR375 “It is something I have not done before and was quite challenging to sit still however knowing it was ok to get distracted and bring yourself back without being hard on myself has encouraged me to continue with the practice and particular to give thanks” — EHV312 “[it] helped me with self-compassion as I feel I am thinking of how others are coping with me having cancer and disregarding my own feelings” — JGE445 2. Empowering through mindfulness practice 2.1 Reinforcing existing practice "[the program] helped me consolidate the work I've done previously on mindset… Many of the techniques I have used in the past (without really realising - they were just a way of coping!) were explained further in this program." UQE031 “It complemented the meditation app I was already using, good using a different approach.” — CTK982 “It encouraged me to reconnect with practices I loved.” — MKH454 2.2 Inspired to continue this practice "I would always use it." — BOT013 "Have done [mindfulness] before, happy to take it up again." - MQW283 “I have kept info [from MindOnLine] to use at a later date.” — PMT594 "I have saved the [MindOnLine] emails and plan to use them…" — KXJ346 2.3 Encouraged to engage with similar programs “I found some books on mindfulness and intend to continue learning.” — JVR741 ” It encouraged me to download an overnight mindfulness app, which I use nightly now.” — OZL689 “I have been enrolled in a local mindfulness program” — PMT594 "I have joined a meditation group.” — KZY260 2.4 Motivated to further learn on the topic "Perhaps some guides for further reading or recommendations for continuing to develop and explore mindfulness" — KZY260 “Perhaps some suggestions regarding where to from here. What further programs or materials might provide appropriate encouragement (e.g. links to reading material, websites, mindfulness apps).” — BEA036 "Some suggestions for courses or reading or information for further research either during the program or for after the program [would be useful]" — CWI505 3. Individualised and practical program experience 3.1 Meditations "I did find the sessions calming” — CDL581 “I like the meditations, they are short, easy to access and enjoyable and I feel a lot better after doing them” — GIU967 contrast (meditations) "I found the guided meditation very hard to listen to. I would have preferred that any instructions be given in at the beginning not at indiscriminate times throughout. - AEE024 "I found several of the session had audio which actually disrupted the ability to become mindful" — UCA168 "I had difficulty with some of the shorter guided meditations. I would have preferred more gaps between the instructions to allow me time to experience and settle in the practice." - KZY260 "I found I got lost in the emotion a lot, some meditations caused tears" — OEA965 Suggestion for improvement "It would also be better if you did not use generic scripts (I have heard the ones you have used many times before). A selection of different voices to listen to would also be better." - AEE024 "I have been exploring different guided meditations to find a pace that is slower… I feel like I need more variation if I continue." - KZY260 3.2 Weekly themes “A great program. I enjoyed making the time to watch the weekly video's which were informative.” - UQE031 contrast (weekly themes) "A week per session is too much… and I found the instructions continuing throughout the meditations very distracting." — AMU530 "Weeks 2 and 3 with focus on a minor negative experience really turned me off the program - the thought of thinking of a negative experience, twice a day for a fortnight just struck me as an unnecessary pain." - IVT382 "Rerunning the same session all week appeared totally pointless. I need variety to keep me interested." — GJU012 3.3 Reminders "The reminders were helpful." — FYK633 "Daily reminders were helpful, particularly in early weeks to develop habit of setting aside time" — GAU831 "Morning and evening routine very easy to follow and adhere to. Reminder emails very helpful." — SIL673 "Reminders were good, helped on busy days" — XJI868 contrast (reminders) "I received twice daily reminders to meditate which I found extremely annoying and frustrating... This turned me off the program completely and made me very annoyed so that after about three weeks, I gave up altogether... the constant reminders not only filled up my in-box but frustrated me no end." — GWX345 Suggestion for improvement "Perhaps some reminders about these aspects of the program [weekly videos, goals settings, and progress monitoring] would have been beneficial.” — MPV178 4. Integration into daily life amid competing demands 4.1 Structured support for sustained practice “It was good for scheduling of time to undertake the practice” — TJF596 "I love this program because it helps to keep me engaged in regular meditation practice" — ZLS243 " [I]...needed the discipline of your programme." — MQW283 “The MindOnLine program has been great for supporting me to practice regularly and feel the benefits of regular practice…" - KZY260 "I found the style of MOL sometimes confronting especially last thing at night ...." - CTK982 "[I] can see some positives so would like longer than 9 weeks” — CTK982 “... a session targeting returning to work to help with mindfulness in work situations [would be helpful]. I find this a struggle upon returning to work- dealing with the negative feelings of others and trying to cope with work strategies.” - WDB014 4.2 Conflicting priorities “I wasn’t in the headspace to do the program because of other health issues.” - AXJ158 “I found it difficult to make the time, especially in the morning when I started back at work.” - BAS170 “My husband also cancer patient.... My difficulties are compounded by being his carer.” - BMF821 “[The practice is] just hard to fit in with work and life at the moment...” - CSZ753 "Work and family absorbed all of my time.” - GVH9 “In the period of [the MindOnLine] course, I experienced several adversities happening to loved ones, and I had a Lymphocele aspiration so there was a lot going on.” - JVR741 “Unfortunately, my brother in the USA was terminally sick and I had to fly over 2 weeks after starting the program. He passed away less than a week after I arrived. I tried to continue but with so much to deal with I lost momentum.” - KMG472 Discussion This study evaluated participants’ satisfaction with a 9-week mindfulness online program, MindOnLine , by assessing its perceived helpfulness in supporting mindfulness practice and emotional coping, and intention for sustained engagement with the practice. Approximately 75% of participants found the program helpful in encouraging mindfulness and nearly two-thirds reported it helped them manage difficulties, with over 70% intending to continue the practice. Two-third of the participants responded to open-ended questions. Thematic analysis highlighted four key themes: the program was experienced as transformative, empowering participants to deepen or initiate mindfulness practice; it required a highly individualised and practical approach due to varied preferences; and while many successfully integrated it into daily life, others faced challenges due to competing demands. The findings suggest that MindOnLine is a broadly acceptable and potentially impactful intervention for people living with breast, colorectal or prostate cancer, with further refinement needed to enhance personalisation and long-term engagement. Our findings complement the evidence on MindOnline ’s effectiveness, which has demonstrated significant reductions in fear of cancer recurrence, anxiety, and depression among participants allocated to the intervention ( MindOnline ) compared to a waitlist control group [ 12 ]. Together these observations indicate that participants’ perceived helpfulness of the program in managing difficulties extends beyond measurable clinical improvements to influence daily functioning (theme 1 – Transformative during and beyond cancer) and confidence to independently expand mindfulness practice over time (theme 2 – Empowering through mindfulness practice). These findings also align with a growing body of evidence showing that most participants perceive digital mindfulness interventions as helpful for cultivating mindfulness and emotional coping. For example, a multinational study of patients with metastatic renal cell carcinoma receiving immunotherapy found that 75% achieved high adherence to a mindfulness app intervention and provided positive feedback on its usefulness, suggesting high perceived helpfulness in this population [ 22 ]. A systematic review and meta‑analysis of 14 RCTS with 1316 participants found that online MBIs supported emotional coping in cancer patients by significantly reducing anxiety, stress, and fatigue while improving quality of life [ 23 ]. The findings suggest that digital MBIs can effectively cultivate mindfulness skills and support emotional wellbeing in cancer populations. Our study found participants valued mindfulness as a transferable skill helpful during cancer recovery and in everyday life. Combined with the clinical improvements, the felt and perceived benefits may motivate participants to maintain their mindfulness practice beyond the intervention period. In our study, 70% of participants reported intention to continue mindfulness practice beyond the intervention period. A systematic review of 21 studies with 1811 participants reported that cancer survivors completed, on average, approximately 60% of prescribed mindfulness home practice, with greater adherence associated with improved psychological outcomes, including reduced distress and fear of cancer recurrence [ 24 ]. These findings are supported by the present study, in which participants described MindOnLine as supporting sustained engagement and integration of mindfulness into daily life beyond the intervention period. Together, this suggests that program features promoting perceived usefulness, flexibility, and autonomy, rather than prescribed practice dose alone may be critical for fostering long‑term engagement with online mindfulness interventions. Although journaling, goal setting, and progress tracking are established behaviour change techniques associated with sustained behaviour change [ 25 ], these features had limited uptake and perceived helpfulness within MindOnLine . Evaluative goal‑setting and self‑monitoring tools may inadvertently undermine engagement when users experience difficulty or symptom fluctuation, particularly in cancer populations. For example, Bradbury and colleagues (2019)[ 26 ] enhanced a fully self-guided digital health intervention to promote physical activity, improve diet, and support mood management. The intervention was optimised through interviews with 96 cancer survivors and 31 focus groups with health service staff and cancer charity workers whose specific concerns were addressed in subsequent modification of the program leading to improved acceptability and feasibility of the intervention [ 26 ]. One of these modifications related to goal setting. Interview findings suggested that participants risked disengaging if they failed to meet goals or experienced symptoms flare-ups. Consequently, goal setting was framed as flexible and adaptive to help prevent drop‑out following difficult periods. The authors recognised that evaluative goals such as quantifying progress (e.g. meditate 5min each day)[ 18 ] could foster feelings of failure and undermine engagement when participants experience challenges. Instead, they opted for a person-based adaptation that was more flexible and low-pressure compared to a classic measurable behaviour change technique. In our analysis, the contrast between low perceived usefulness of goal setting, journaling, and progress monitoring and high overall perceived helpfulness of MindOnLine suggests that sustained mindfulness engagement was driven primarily by experiential and contextual factors rather than self‑regulatory tools. Participants appeared to value the program’s flexibility, relevance, and emotional benefits, which may have supported intrinsic motivation and ongoing practice without reliance on evaluative behaviour change techniques. This study offers valuable insights into the experiences of people living with cancer engaging with a digital mindfulness program, combining quantitative and qualitative data to capture both perceived impact and lived experience. The thematic analysis highlighted the real-world relevance of the program. However, strong female representation limits generalisability among male users, and the smaller number of male participants precluded detailed exploration of gender differences. Additional research is needed to better understand how male participants engage with and experience the intervention. Additionally, the absence of long-term follow-up further constrains the scope of findings. Longitudinal designs are needed to assess sustained behavioural change and emotional outcomes beyond the intervention period. This mixed‑methods evaluation demonstrates that MindOnLine is an acceptable and potentially impactful digital mindfulness intervention for people living with and beyond cancer. High levels of participant satisfaction, combined with perceived improvements in emotional coping and intentions to sustain practice, complement evidence of clinical benefits and underscore mindfulness as a transferable skill supporting wellbeing in daily life. Our findings support a person‑centred model of digital mindfulness delivery, demonstrating that participants engaged most strongly with features that felt flexible, relevant, and emotionally supportive rather than prescriptive. This analysis provides practical guidance for the design of low‑burden, scalable digital interventions for cancer populations, suggesting that prioritising acceptability, simplicity, and autonomy may enhance satisfaction engagement and sustainability. In conclusion, these findings provide a strong foundation for future trials and implementation research aimed at scaling person-centred digital mindfulness interventions as an accessible component of holistic cancer survivorship care. Given the high female participation in our study, future research should examine engagement preferences with MindOnLine among men, diverse cancer populations and care settings, to inform wider implementation and integration into supportive cancer care pathways. Declarations Author contributions All authors contributed to the study conception and design. Data analysis was performed by LR, and NW. The first draft of the manuscript was written by LR and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Ethics approval and consent to participate Ethics approval was obtained from the Peter MacCallum Cancer Centre (20-53) and Deakin University (2020-284). Informed consent was obtained from all individual participants included in the study. Competing interests The authors have no relevant financial or non-financial interests to disclose. Funding This study was funded by the National Health and Medical Research Council (NHMRC) Partnership Grant ID APP1179317, with partner cash contributions from the Department of Health, Victoria, Epworth HealthCare and Western Health. The funder supported the cost of undertaking the project. Acknowledgment We acknowledge each of our partners, Breast Cancer Network of Australia, Barwon Health, Prostate Cancer Foundation of Australia, Peter MacCallum Cancer Centre, Western Health, Smiling Mind, Epworth HealthCare, and the Victorian State Government Department of Health, for their support of this project. We also acknowledge and thank the cancer survivors taking part in this study. Australian New Zealand Clinical Trials Registry: ANZCTR: 12620000645954 References IHME, Global Burden of Disease ( 2024 ) – with major processing by Our World in Data. “Number of people with cancer” [dataset]. IHME, Global Burden of Disease, “Global Burden of Disease - Prevalence and Incidence” [original data]. Retrieved September 11, 2025 from https://archive.ourworldindata.org/20250909-093708/grapher/number-of-people-with-cancer.html (archived on September 9, 2025). 2024. Australian Institute of Health, Welfare, Cancer data in Australia . 2024, AIHW: Canberra. Simard, S., et al., Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies . Journal of Cancer Survivorship, 2013. 7(3): p. 300–322. Mendoza, L.S.M., et al., Health, psychosocial and cognitive factors associated with anxiety symptoms . Current Psychology, 2024. 43(26): p. 22376–22388. Salafia, C., et al., Perceived negative consequences of cancer and psychological distress in survivors: the moderating role of social support . Journal of Cancer Survivorship, 2025. 19(1): p. 12–20. Fodor, L.A., D. Todea, and I.R. Podina, Core Fear of Cancer recurrence symptoms in Cancer Survivors: a network approach . Current Psychology, 2023. 42(28): p. 24795–24810. Chan, R.J., et al., Effectiveness and implementation of models of cancer survivorship care: an overview of systematic reviews . J Cancer Surviv, 2023. 17(1): p. 197–221. Semenenko, E., et al., Review of psychological interventions in patients with cancer . Support Care Cancer, 2023. 31(4): p. 210. Dong, M., et al., Effects of Psychological Intervention Based on Digital Health Technology on Psychological Outcomes in Cancer Survivors: Systematic Review and Meta-Analysis . Psycho-Oncology, 2025. 34(5): p. e70166. Lin, L.Y., et al., Effects of Mindfulness-Based Therapy for Cancer Patients: A Systematic Review and Meta-analysis . J Clin Psychol Med Settings, 2022. 29(2): p. 432–445. Zheng, Y., et al., The Effects of Non-Mindfulness Practices and Human Support on Depression, Mental Well-Being, and Mindfulness in Digital Mindfulness-Based Interventions: A Four-Armed Randomized Dismantling Trial . Mindfulness, 2025. 16(4): p. 833–845. Livingston, P.M., et al., Efficacy of an online mindfulness program (MindOnLine) to reduce fear of recurrence in people living with, and beyond breast, prostate or colorectal cancer: a randomized controlled trial . eClinicalMedicine, 2025. 86. Russell, L., et al., A pilot randomised controlled trial of an online mindfulness-based program for people diagnosed with melanoma . Supportive care in cancer, 2019. 27(7): p. 2735–2746. Winter, N., et al., Engagement Strategies to Improve Adherence and Retention in Web-Based Mindfulness Programs: Systematic Review . J Med Internet Res, 2022. 24(1): p. e30026. Boucher, E.M. and J.S. Raiker, Engagement and retention in digital mental health interventions: a narrative review . BMC Digital Health, 2024. 2(1): p. 52. Perski, O., et al., Conceptualising engagement with digital behaviour change interventions: a systematic review using principles from critical interpretive synthesis . Translational behavioral medicine, 2017. 7(2): p. 254–267. Crane, R.S., et al., What defines mindfulness-based programs? The warp and the weft . Psychological medicine, 2017. 47(6): p. 990–999. Livingston, P.M., et al., Efficacy and cost-effectiveness of an online mindfulness program (MindOnLine) to reduce fear of recurrence among people with cancer: study protocol for a randomised controlled trial . BMJ Open, 2022. 12(1): p. e057212. Braun, V. and V. Clarke, Using thematic analysis in psychology . Qualitative research in psychology, 2006. 3(2): p. 77–101. Bryda, G. and D. Sadowski. From words to themes: AI-powered qualitative data coding and analysis . in World conference on qualitative research . 2024. Springer. Morgan, D.L., Exploring the use of artificial intelligence for qualitative data analysis: The case of ChatGPT . International journal of qualitative methods, 2023. 22: p. 16094069231211248. Bergerot, C.D., et al., Feasibility and acceptability of a mindfulness app-based intervention among patients with metastatic renal cell carcinoma: a multinational study . The Oncologist, 2025. 30(1). Xu, L., A. Guan, and Y. Huang, Effects of online mindfulness-based interventions on mental and physical health outcomes in cancer patients: A systematic review and meta-analysis of randomized controlled trials . Medicine, 2025. 104(12): p. e41870. Baydoun, M., et al., Mindfulness-Based Interventions in Cancer Survivors: A Systematic Review of Participants’ Adherence to Home Practice . Patient Preference and Adherence, 2021. 15(null): p. 1225–1242. Abraham, C. and S. Michie, A taxonomy of behavior change techniques used in interventions . Health psychology, 2008. 27(3): p. 379. Bradbury, K., et al., Developing a digital intervention for cancer survivors: an evidence-, theory-and person-based approach . NPJ digital medicine, 2019. 2(1): p. 85. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 06 Apr, 2026 Editor assigned by journal 06 Apr, 2026 Submission checks completed at journal 02 Mar, 2026 First submitted to journal 25 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8972358","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":618424458,"identity":"d7cc0d2d-2f0f-49af-80c7-e07408bdc34d","order_by":0,"name":"Lahiru Russell","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7klEQVRIiWNgGAWjYBACPigtw8feYMDAcEACxDHAq4UNSvOw8RwgWYtEAkgLAzFaeJ9J/vhjw8Mm+Xjjgx9nLPIY2Ju3STDUHMajhd1MmrctjYdNOq3YsOeGRDEDz7EyCYZj+LSwsUkzNhwGaskxk+D5IJHYIAFkMLDh1wJ02H+gw86Y//wD0iL/BqjlH34tEjxsB4De5zFj5rkBsoXHTIKxDY8WZjZma962ZGAgpxVLy5yRSGwDMiwS+9JxauFnb2O8+eOPnRw/++GNH98cq0vsBzJufPhmjVMLAzOmU4EgAbeGUTAKRsEoGAVEAAC4DkMpHIw2xgAAAABJRU5ErkJggg==","orcid":"","institution":"Deakin University","correspondingAuthor":true,"prefix":"","firstName":"Lahiru","middleName":"","lastName":"Russell","suffix":""},{"id":618424459,"identity":"2bea7856-dcd4-41e7-a187-da9f67bc9787","order_by":1,"name":"Natalie Winter","email":"","orcid":"","institution":"Deakin University","correspondingAuthor":false,"prefix":"","firstName":"Natalie","middleName":"","lastName":"Winter","suffix":""},{"id":618424460,"identity":"83a166b0-234d-4de2-a84b-92d490959833","order_by":2,"name":"Liliana Orellana","email":"","orcid":"","institution":"Deakin University","correspondingAuthor":false,"prefix":"","firstName":"Liliana","middleName":"","lastName":"Orellana","suffix":""},{"id":618424461,"identity":"14c37038-cffa-4b11-a82c-164dfce95cf0","order_by":3,"name":"Victoria White","email":"","orcid":"","institution":"Deakin University","correspondingAuthor":false,"prefix":"","firstName":"Victoria","middleName":"","lastName":"White","suffix":""},{"id":618424462,"identity":"bb180e04-1131-4233-84b4-58004deb8303","order_by":4,"name":"Patricia M Livingston","email":"","orcid":"","institution":"Deakin University","correspondingAuthor":false,"prefix":"","firstName":"Patricia","middleName":"M","lastName":"Livingston","suffix":""}],"badges":[],"createdAt":"2026-02-26 02:23:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8972358/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8972358/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106726643,"identity":"1280e8bd-bbf7-4bb0-9db4-2621b7c5a1d4","added_by":"auto","created_at":"2026-04-12 18:36:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1535856,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8972358/v1/3afff009-9256-4d85-b87b-5dcfb56a3c16.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"MindOnLine, a self-guided online mindfulness program supporting people living with cancer: Participant satisfaction analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe survival rates of people living with cancer have improved due to screening programs, earlier interventions, and advancements in treatment. As of 2022, approximately 53.5\u0026nbsp;million people worldwide were living within five years of a cancer diagnosis [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In Australia, over one million individuals are living with a history of cancer, a figure expected to increase due to population growth and ageing [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. While this trend reflects substantial progress in oncology, it also underscores the pressing need for effective and sustainable survivorship care. Many people living with cancer experience long-term physical symptoms, psychological distress, and fear of recurrence, all of which can impact their quality of life and recovery [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Addressing these challenges requires the development and implementation of psychosocial supportive care programs that are not only evidence-based but also scalable and accessible to people with limited access to health services.\u003c/p\u003e \u003cp\u003eThere is a growing body of evidence demonstrating that digital health offers accessible and cost-effective means of delivering psychosocial support technologies in cancer survivorship care [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Interventions particularly targeting mental health have shown reduction in symptoms of depression, anxiety, and distress among cancer survivors [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Among these, mind-body interventions, such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) have gained considerable attention. A recent meta-analysis provided evidence to support the efficacy of mindfulness-based programs in improving quality of life and alleviating symptoms such as pain, fatigue, and emotional distress in cancer populations [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Furthermore, digital adaptations of these programs have demonstrated comparable benefits in the general population, with recent trials indicating that self-guided online mindfulness interventions can reduce depression and enhance emotional regulation [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. These findings were observed in cancer populations in a few studies [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite these promising outcomes, challenges remain in the implementation and uptake of online mindfulness programs. User engagement, adherence, and satisfaction are often suboptimal when programs are not tailored to individual needs, preferences, or life contexts, fail to resonate with end users, undermining motivation to engage or continue [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In addition, assessing user engagement with digital interventions encompasses both objective usage metrics such as frequency, duration, and depth of interaction, and subjective experiential dimensions, including attention, interest, and emotional response [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Understanding the user experience is critical for intervention improvement, and to ensure that its design and are acceptable to users.\u003c/p\u003e \u003cp\u003e \u003cem\u003eMindOnLine\u003c/em\u003e, a self-guided online mindfulness program was developed drawing on mindfulness‑based stress reduction principles, using an established framework for mindfulness‑based programs [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], and an iterative process of pilot testing and user feedback. The original program, a 6‑week online intervention for people with melanoma was tested in a randomised controlled pilot study [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Participants\u0026rsquo; feedback highlighted the value of extending the program to enhance sustainability of practice, leading to a 9‑week program with greater flexibility of access and usage for cancer survivors. In our recent randomised controlled trial, we demonstrated that a 9‑week \u003cem\u003eMindOnLine\u003c/em\u003e program significantly reduced fear of cancer recurrence (FCR), anxiety, and depression among cancer survivors [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The current paper presents feedback from participants about their satisfaction with, and perceptions of, \u003cem\u003eMindOnLine\u003c/em\u003e. By exploring the user experience, this study aimed to provide deeper insights into the strategies through which digital mindfulness interventions may support psychological wellbeing in cancer survivorship.\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003eInformation about the study design and recruitment process are detailed elsewhere [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In brief, a randomised controlled trial was conducted between October 2020 and June 2023 to evaluate the effectiveness and cost-effectiveness of \u003cem\u003eMindOnLine\u003c/em\u003e for people diagnosed with breast, bowel and prostate cancer experiencing FCR. The program incorporated educational content, formal and informal mindfulness practices. Each week introduced a new topic (e.g., stress reduction, emotional regulation, self-compassion) via short videos that lasted between 1\u0026ndash;9 minutes, and guided meditation audios ranging from 1\u0026ndash;10 minutes each. Participants were encouraged to engage in daily practice and apply mindfulness in everyday activities. Engagement and adherence strategies included twice-daily email reminders with meditation links, goal setting and progress tracking features, reflective journaling prompts, and on-demand access to all program materials.\u003c/p\u003e \u003cp\u003ePeople who were aged 18 or older living in Australia who had completed treatment for Stage I\u0026ndash;III breast, prostate, or colorectal cancer within the past five years, had internet access, and reported clinically significant FCR on the Fear of Cancer Recurrence Inventory (FCRI), with a severity score\u0026thinsp;\u0026ge;\u0026thinsp;13, were eligible to participate.\u003c/p\u003e \u003cp\u003e Participants were recruited using a range of platforms, including targeted paid social media advertisements with Facebook and Instagram (Meta), community and peak national consumer advocacy networks, as well as through health services, cancer registries and oncologists involved in the project. Satisfaction assessments were conducted at 9 weeks, and 9 months [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. All procedures performed in this study were conducted in accordance with the ethical standards of the institutional research committee and with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study.\u003c/p\u003e \u003cp\u003eThe current paper reports on participants\u0026rsquo; satisfaction with \u003cem\u003eMindOnLine\u003c/em\u003e on completion of the 9-weeks intervention period.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cp\u003e\u003cem\u003eProgram satisfaction\u003c/em\u003e was assessed using 10 statements relating to the program\u0026rsquo;s look and feel (e.g. \u0026ldquo;I thought the program was easy to use\u0026rdquo;), and eight statements relating to its ability to help participants understand and cope with their emotions (e.g., \u0026ldquo;the program helped decrease my anxiety\u0026rdquo;). All18 statements were rated using a 5-point Likert scale (1\u0026thinsp;=\u0026thinsp;strongly disagree to 5\u0026thinsp;=\u0026thinsp;strongly agree). Responses were categorised in three levels (strongly disagree/disagree, neutral, strongly agree/agree). The neutral responses were retained as a distinct category, reflecting ambivalence on program satisfaction. The statements are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cem\u003eHelpfulness\u003c/em\u003e of each weekly session (nine items) and engagement features of the program (six items) were measured on a 6-point scale, \u0026ldquo;N/A did not use this feature\u0026rdquo; (0), and very unhelpful (1) to very helpful (5). Responses were transformed in a 3-point scale (Did not use this feature, very unhelpful/unhelpful/neutral, very helpful/helpful,). The neutral responses were grouped with unhelpful responses, as both reflect insufficient perceived utility to support engagement and inform program design decisions. The list of items is reported in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cem\u003eOverall helpfulness of the program\u003c/em\u003e was assessed across three domains:1) encouraging people to practice mindfulness, 2) manage difficulties, and 3) intention to maintain the practice. Responses were collected on a 4-point Likert scale. For domains 1 and 2, response options were: 1-Not helpful, 2-Quite helpful, 3-Very helpful, or 4-Unsure. For domain 3, options included: 1-Not at all, 2-Every now and then, 3-Quite often, or 4-Unsure.\u003c/p\u003e \u003cp\u003eFour open-ended questions explored 1) perceived helpfulness of \u003cem\u003eMindOnLine\u003c/em\u003e program overall in encouraging mindfulness practice; 2) usefulness of the program to help manage difficulties/ challenges; 3) likelihood of continued use of the \u003cem\u003eMindOnLine\u003c/em\u003e program; and 4) additional information participants would have liked.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eAnalysis\u003c/h3\u003e\n\u003cp\u003eDescriptive statistics were used to report the characteristics of participants in the intervention group.\u003c/p\u003e \u003cp\u003e Thematic analysis was applied to examine participants\u0026rsquo; responses to the four open-ended questions. Following Braun and Clarke\u0026rsquo;s (2006) framework [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], responses were first reviewed by a researcher for clarity and relevance. Only clearly articulated sentences were retained, while brief or ambiguous responses (e.g., \u0026ldquo;no,\u0026rdquo; \u0026ldquo;n/a,\u0026rdquo; \u0026ldquo;helpful\u0026rdquo;) were excluded to ensure analytical depth. Given the overlap in content across the four open-ended questions, all responses were consolidated to provide a holistic understanding of participants\u0026rsquo; experiences. The data were analysed in parallel by a researcher (LR) and Microsoft Copilot\u0026copy; an AI-powered assistant integrated into Microsoft 365. Copilot was used to generate initial categories based on recurring topics, following a generative coding approach similar to that described by Bryda and Sadowski (2024)[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], where large language models were employed to inductively identify patterns in qualitative data.\u003c/p\u003e \u003cp\u003eTo ensure rigor, the categories generated by Copilot were compared with those identified by the researcher. This comparative process examined theme overlap (categories present in both analyses), divergence (unique categories identified by either Copilot or the researcher), and terminology (differences in naming or framing of similar concepts). This approach aligns with the methodology used by Morgan (2023)[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], who demonstrated the value of comparing AI-generated themes with human-coded ones to assess consistency and interpretive depth.\u003c/p\u003e \u003cp\u003eEach category was cross-referenced with the original dataset to confirm accuracy and contextual integrity. Categories were then grouped into broader themes, which were refined with the input from a second researcher (NW) to reduce redundancy and enhance clarity. This iterative process ensured that both human and AI contributions were critically evaluated, supporting a transparent and triangulated analysis. In the presentation of results below, each theme is supported by participants quotes and their respective study ID.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 434 participants with stage I\u0026ndash;III breast, prostate, or colorectal cancer were recruited and randomly assigned to either the intervention or waitlist group. Of the 233 participants allocated to the intervention, 167 (72%) provided responses to satisfaction, helpfulness, or future intention to use \u003cem\u003eMindOnline\u003c/em\u003e. Demographic and clinical characteristics of this group are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Demographic and clinical characteristics pf participants (n\u0026thinsp;=\u0026thinsp;167)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDemographics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003eClinical Characteristics\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCancer type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBreast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e59.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProstate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e23.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBowel\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e17.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYears since treatment finished\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;60 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026le;1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;60 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026gt;1 to \u0026le;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e47.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReceived surgery (n\u0026thinsp;=\u0026thinsp;166)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried or de facto relationship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e89.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReceived chemotherapy (n\u0026thinsp;=\u0026thinsp;166)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompleted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e56.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot completed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e43.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReceived radiotherapy (n\u0026thinsp;=\u0026thinsp;166)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e59.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking part time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e40.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking full time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArea of residence\u003csup\u003e\u0026sect;\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReceived hormonal therapy (n\u0026thinsp;=\u0026thinsp;166)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMetropolitan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e63.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-metropolitan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e36.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMindfulness experience\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eNegative impact of COVID19 on mental wellbeing\u003c/b\u003e\u003csup\u003e\u003cb\u003e(a)\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e59.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMediation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e17.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMindfulness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eProgram satisfaction\u003c/h3\u003e\n\u003cp\u003eThe majority of participants reported they \u0026lsquo;liked the look and feel aspects\u0026rsquo; of the program, and most (91.0%) found the program \u0026lsquo;easy to use\u0026rsquo; and would \u0026lsquo;recommend it to a friend in a similar situation\u0026rsquo; (82.6%) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). About half (41.3%-58.7%) reported that the program helped understanding and coping with their emotions, with larger proportions reporting to feel more in \u0026lsquo;control of their thoughts or worries\u0026rsquo; (58.7%), \u0026lsquo;decreased their anxiety\u0026rsquo; (54.2%), and helped them to \u0026lsquo;think more positively about their situation\u0026rsquo; (51.5%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eProgram satisfaction\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;167\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree/Disagree\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStrongly agree/Agree\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLook and feel aspects\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. I liked using this program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (16.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e125 (74.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. I found it easy to login and log out of my account\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11 (6.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e151 (90.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. I thought this program was easy to use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e152 (91.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. I felt very confident using this program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (13.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e140 (83.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5. I enjoyed learning about mindfulness through this program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (6.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (16.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130 (77.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6. It is likely that I will continue to practice mindfulness in the future\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (15.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e129 (77.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7. I would recommend this program to friends in a similar situation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (6.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18 (10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e138 (82.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8. I found the exercises easy to do\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30 (18.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130 (77.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9. The exercises kept me engaged with the program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (11.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (22.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e110 (65.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10. I liked the look of the weekly sessions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47 (28.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e107 (64.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUnderstanding and coping with emotions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11. The program helped me feel more in control of my thoughts or worries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56 (33.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e98 (58.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12. The program helped me cope better with any worries I have about cancer returning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70 (41.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81 (48.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13. The program helped me to understand my cancer worries better\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78 (46.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73 (43.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14. The program helped decrease my anxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (8.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e62 (37.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e90 (54.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15. The program helped reduce my worries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69 (41.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78 (46.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16. The program helped me feel more hopeful\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85 (50.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69 (41.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e17. The program helped me to think more positively about my situation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69 (41.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86 (51.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18. The program helped me to think more positively about the future\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (6.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77 (46.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79 (47.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eHelpfulness of weekly sessions and program features\u003c/h3\u003e\n\u003cp\u003eThe majority of participants indicated that week 1 and 2 of the program were most helpful, and between one quarter and one third of participants indicated that they did not use sessions 5 through 9. Around two thirds of participants found the daily reminders (67%) and the weekly mindfulness exercises (63%) helpful (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). However, nearly two-thirds did not use the journalling option (63.3%), 56.6% did not use the goal setting feature and around a quarter of participants did not find the progress monitoring feature (24.2%) or the goal setting feature (25.3%) helpful.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Helpfulness of weekly sessions and program features\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDid not use this feature\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVery unhelpful/ Unhelpful\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVery helpful /Helpful\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek 1 Introduction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11 (6.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22 (13.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e133 (80.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek 2 Reducing stress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (7.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24 (14.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e128 (77.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek 3 Relating to emotions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (13.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34 (20.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e108 (65.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek 4 Self-compassion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34 (20.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e100 (60.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek 5 Communicating mindfully\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (18.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e95 (57.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek 6 Living mindfully\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26 (15.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e97 (59.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek 7 Reducing worry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54 (33.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29 (17.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e80 (49.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek 8 Reducing worries mindfully\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43 (26.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (18.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e90 (54.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek 9 Maintaining a mindfulness practice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53 (32.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37 (22.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e74 (45.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGuided meditation library\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54 (33.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29 (17.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e80 (49.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaily reminders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (12.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e111 (67.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe weekly mindfulness exercises\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (17.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e104 (63.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProgress monitoring feature\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71 (43.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40 (24.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e54 (32.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJournaling option\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e105 (63.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30 (18.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGoals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94 (56.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42 (25.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30 (18.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eOverall helpfulness of the program in encouraging to practice mindfulness, manage difficulties, and maintain the practice\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe majority (126/166, 75.9%) found the program quite or very helpful in encouraging mindfulness practice. Two-thirds (108/165, 65.5%) found it helpful in managing difficulties, though around 20% (36/165, 21.8%) were unsure. Most (120/166,72.7%) expressed intention to continue mindfulness practice either quite often or occasionally (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Overall helpfulness of the program\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMindOnLine was helpful in\u0026hellip;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNot helpful\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eQuite helpful\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVery helpful\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eUnsure\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026hellip;encouraging to practice mindfulness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17(10.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55(33.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71(42.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23(13.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026hellip;manage difficulties\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(12.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66(40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42(25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e36(21.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eNot at all\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eEvery now and then\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eQuite often\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eUnsure\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntention to maintain the practice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20(12.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48(29.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e72(43.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25(15.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eOpen-ended questions\u003c/h2\u003e \u003cp\u003eOf the 167 respondents, 106 (63.5%) provided responses to at least one open-ended question. Similar to the data in Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, most respondents were female (n\u0026thinsp;=\u0026thinsp;79, 74.5%), over 60 years (61, 57.5%), married or in a de facto relationship (74/106, 69.8%), had completed a university degree (60, 56.6%), and were living in a metropolitan area (75, 70.8%). The majority had a breast cancer diagnosis (63, 59.4%) with prostate and bowel cancer equally represented (22, 20.8%, and 21, 19.8%, respectively).\u003c/p\u003e \u003cp\u003eA total of 267 open ended responses were included in the analysis. The thematic analysis showed four overarching themes that capture the experiences of individuals engaging with \u003cem\u003eMindOnLine\u003c/em\u003e during and beyond their cancer journey. These four themes and their sub-themes are described in the sections below, and Table \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e provides additional information.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eTheme 1: Transformative during and beyond cancer\u003c/h3\u003e\n\u003cp\u003eIn this theme participants describe the program as emotionally supportive, particularly during the post-treatment phase when feelings of isolation were common. This theme consisted of four sub-themes that encompasses the benefits of the program during and beyond cancer with practices learnt integrated into other areas of daily living.\u003c/p\u003e\n\u003ch3\u003eSub-theme 1.1 – Supportive and inclusive\u003c/h3\u003e\n\u003cp\u003eThis sub-theme illustrates how participants reported that \u003cem\u003eMindOnLine\u003c/em\u003e provided a sense of care, support, and inclusion following cancer treatment, helping to reduce feelings of isolation. For example:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eIt made me feel someone cared. End of cancer treatment leaves me feeling discarded and irrelevant and utterly alone with no help or care from anyone.\u003c/em\u003e\u0026rdquo; \u0026mdash; (Female, 68 yrs, Breast cancer)\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 1.2 \u0026ndash; Leads to lifestyle changes\u003c/h2\u003e \u003cp\u003e \u003cem\u003eMindOnLine\u003c/em\u003e also facilitated meaningful lifestyle changes, with participants reporting increased mindfulness and integration of practices into daily routines:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI am now meditating about twice a week with a goal for every day\u0026hellip; I am living more mindfully already.\u003c/em\u003e\u0026rdquo; \u0026mdash; (Female, 50 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI learnt to use these skills [body scan, breathing and sound meditations] when I swim\u0026hellip; this process gave me tools that I have been able to implement directly into my life.\u003c/em\u003e\u0026rdquo; \u0026mdash; (Female, 58 yrs, Breast cancer)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 1.3 \u0026ndash; Outside of the cancer experience\u003c/h2\u003e \u003cp\u003eBeyond the cancer context, participants found that their experience with \u003cem\u003eMindOnLine\u003c/em\u003e provided benefits for broader life challenges:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI found the program very enjoyable and useful and helpful not just in relation to cancer but in all aspects of my life\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 61 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eThe skills I have learnt\u0026hellip; assisted me with some family challenges unrelated to my own diagnosis.\u003c/em\u003e\u0026rdquo; \u0026mdash; (Female, 58 yrs, Breast cancer)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 1.4 \u0026ndash; Developing new skills\u003c/h2\u003e \u003cp\u003e Participants also described acquiring new skills, such as self-compassion and emotional regulation, helped them to manage their emotions:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eKnowing it was ok to get distracted and bring yourself back without being hard on myself has encouraged me to continue\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 65 yrs, Bowel cancer)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003e[It] helped me with self-compassion as I feel I am thinking of how others are coping with me having cancer and disregarding my own feelings\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 70 yrs, Bowel cancer)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eTheme 2: Empowering through mindfulness practice\u003c/h2\u003e \u003cp\u003eIn this theme, participants described \u003cem\u003eMindOnLine\u003c/em\u003e as supporting the continuation of mindfulness practice beyond the intervention period. This theme comprises four sub‑themes reflecting how the program reinforced existing skills and motivated ongoing engagement with mindfulness strategies in everyday life.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 2.1 \u0026ndash; Reinforcing existing practice\u003c/h2\u003e \u003cp\u003e \u003cem\u003eMindOnLine\u003c/em\u003e reinforced existing mindfulness practices and inspired continued engagement and learning. One participant noted:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003e[The program] helped me consolidate the work I've done previously on mindset\u0026hellip; techniques I have used in the past\u0026hellip; were explained further\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 47 yrs, Breast cancer)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 2.2 \u0026ndash; Inspired to continue this practice\u003c/h2\u003e \u003cp\u003eOthers expressed motivation to continue using the program materials beyond the 9-week intervention period:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI have saved the MindOnLine emails and plan to use them\u0026hellip;\u003c/em\u003e\u0026rdquo; \u0026mdash; (Female, 55 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI have kept info [from MindOnLine] to use at a later date\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 58 yrs, Breast cancer)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 2.3 \u0026ndash; Encouraged to engage with similar programs\u003c/h2\u003e \u003cp\u003eDue to positive experiences when using \u003cem\u003eMindOnLine\u003c/em\u003e, several participants showed interest in exploring similar programs or resources after the end of the study:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI have joined a meditation group\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 63 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eIt encouraged me to download an overnight mindfulness app, which I use nightly now\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 67 yrs, Breast cancer)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 2.4 \u0026ndash; Motivated to further learn on the topic\u003c/h2\u003e \u003cp\u003eSimilarly, people reported that \u003cem\u003eMindOnLine\u003c/em\u003e sparked their interest in undertaking further learning about mindfulness practice:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eSome suggestions for courses or reading or information for further research either during the program or for after the program [would be useful]\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 60 yrs, Breast cancer)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eTheme 3: Individualised and practical program experience\u003c/h2\u003e \u003cp\u003eIn this theme, participants reflected on their experiences of specific program components and delivery features. This theme comprises three sub‑themes that capture varied responses to the meditations, weekly thematic content, and reminder prompts, highlighting the importance of flexibility and tailoring to individual preferences to support engagement.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 3.1 \u0026ndash; Meditations\u003c/h2\u003e \u003cp\u003eFeedback highlighted the importance of tailoring the program to individual preferences. Some found that they had a positive experience with the meditations and that they were calming:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI did find the sessions calming\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 57 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003eContrastingly, others found aspects of the guided meditations challenging:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI found the guided meditation very hard to listen to\u0026hellip; instructions at indiscriminate times\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 56 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI had difficulty with some of the shorter guided meditations\u0026hellip; I would have preferred more gaps between the instructions\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 63 yrs, Breast cancer)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 3.2 \u0026ndash; Weekly themes\u003c/h2\u003e \u003cp\u003eWeekly themes were generally appreciated:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI enjoyed making the time to watch the weekly videos which were informative\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 47 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003eHowever, some participants found repetition or focus on negative experiences disengaging:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eWeeks 2 and 3\u0026hellip; turned me off the program \u0026mdash; the thought of thinking of a negative experience, twice a day for a fortnight just struck me as an unnecessary pain\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 51 yrs, Breast cancer)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 3.2 \u0026ndash; Reminders\u003c/h2\u003e \u003cp\u003eReminders were helpful for habit formation:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eDaily reminders were helpful, particularly in early weeks to develop habit of setting aside time\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 68 yrs, Bowel cancer)\u003c/p\u003e \u003cp\u003eYet, others found them intrusive:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eTwice daily reminders to meditate\u0026hellip; extremely annoying and frustrating\u0026hellip; turned me off the program completely\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 66 yrs, Breast cancer)\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eTheme 4: Integration into daily life amid competing demands\u003c/h2\u003e \u003cp\u003eIn this theme, participants describe how the structure of \u003cem\u003eMindOnLine\u003c/em\u003e supported regular mindfulness practice, alongside challenges related to competing health, work, and caregiving demands. This theme comprises two sub‑themes capturing sustained engagement through structured and relevant support and tensions arising from conflicting priorities.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eSub-theme 4.1 \u0026ndash; Structured support for sustained practice\u003c/h2\u003e \u003cp\u003eParticipants reported that \u003cem\u003eMindOnLine\u0026rsquo;s\u003c/em\u003e structured format supported regular mindfulness practice and sustained engagement, while also identifying a need for content tailored to work‑related contexts to better support practice during everyday role transitions.:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eIt was good for scheduling of time to undertake the practice\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 65 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eI love this program because it helps to keep me engaged in regular meditation practice\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 66 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;\u0026hellip; a session targeting returning to work to help with mindfulness in work situations [would be helpful].\u0026rdquo;\u003c/em\u003e \u0026mdash; (Female, 56 yrs, Breast cancer)\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eSub-theme 4.2 \u0026ndash; Conflicting priorities\u003c/h2\u003e \u003cp\u003eOthers struggled due to competing priorities noting that aspects of timing and intensity could be confronting and may benefit from greater flexibility or longer program duration:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eWork and family absorbed all of my time\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Male, 60 yrs, Bowel cancer)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eMy husband also cancer patient\u0026hellip; My difficulties are compounded by being his carer\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Female, 68 yrs, Breast cancer)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eUnfortunately, my brother in the USA was terminally sick\u0026hellip; I lost momentum\u003c/em\u003e.\u0026rdquo; \u0026mdash; (Male, 67 yrs, Prostate cancer)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMindonline Experience Thematic Analysis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThemes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSub-themes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eQuotes\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"16\" rowspan=\"17\"\u003e \u003cp\u003e1. Transformative during and beyond cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e1.1 Supportive and inclusive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026rdquo; It made me feel someone cared. End of cancer treatment leaves me feeling discarded and irrelevant and utterly alone with no help or care from anyone\u0026rdquo; \u0026mdash; BMF821\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"It has been of great help and support, thank you for allowing me to be part of the trial group.\" - GGY079\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"If I continue, I\u0026rsquo;m sure it will have a greater [positive] impact on my anxiety\" \u0026mdash; AWL274\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"Having a program that reminding me that I was part of something specifically related to cancer treatment helped.\" \u0026mdash; IDI443\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1.2 Leads to lifestyle changes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I am now meditating about twice a week with a goal for every day. I often practise mindful pauses through the day and know I am living more mindfully already. Thanks very much, so very useful! Wish I had access to this YEARS ago!\" \u0026mdash; SER725\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I learnt to use these skills [body scan, breathing and sound meditations] when I swim, on the occasions when my sleep has been disrupted and other times I want to clear my mind. It has also been really useful in controlling my breathing when I run. ... this process gave me tools that I have been able to implement directly into my life.\" FCZ357\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"Really helpful - I learnt the skills and was able to use them throughout the day if necessary.\" \u0026mdash; RDA028\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e1.3 Outside of the cancer experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I found the program very enjoyable and useful and helpful not just in relation to cancer but in all aspects of my life\" \u0026mdash; GIU967\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"...I find the recordings soothing and it helps me focus it makes it easier to meditate and practice mindfulness and stop the anxiety and worrying thoughts spiralling in my head at night!\" \u0026mdash; GGY079\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"The skills I have learnt in this course have ... also assisted me with some family challenges unrelated to my own diagnosis but intrinsically linked to border closures with [COVID 19] and my elderly parents\u0026rsquo; situation.\" \u0026mdash; FCZ357\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"[MindOnLine] helped me notice thoughts especially negative ones and question their validity\" \u0026mdash; CWI505\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;The MindOnLine Program addresses my very real and troubling challenges and helps me look at them with more hope and a more optimistic view...I can be and am starting to be more compassionate and understanding of my feelings and thoughts, and that's a good feeling and reassuring.\" BZY556\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e1.4 Developing new skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;It is something I have not done before and was quite challenging to sit still however knowing it was ok to get distracted and bring yourself back without being hard on myself has encouraged me to continue with the practice and particular to give thanks\u0026rdquo; \u0026mdash; EHV312\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;I've never meditated before and didn\u0026rsquo;t understand how it worked. This program was excellent in explaining the practice.\u0026rdquo; - BAS170\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I found the use of breathing as an \"anchor\" quite profound, yet so simple. My mind jumps around a lot. To anchor it and re-focus on the task at hand was very helpful.\" \u0026mdash; PBR375\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;It is something I have not done before and was quite challenging to sit still however knowing it was ok to get distracted and bring yourself back without being hard on myself has encouraged me to continue with the practice and particular to give thanks\u0026rdquo; \u0026mdash; EHV312\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;[it] helped me with self-compassion as I feel I am thinking of how others are coping with me having cancer and disregarding my own feelings\u0026rdquo; \u0026mdash; JGE445\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"13\" rowspan=\"14\"\u003e \u003cp\u003e2. Empowering through mindfulness practice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.1 Reinforcing existing practice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"[the program] helped me consolidate the work I've done previously on mindset\u0026hellip; Many of the techniques I have used in the past (without really realising - they were just a way of coping!) were explained further in this program.\" UQE031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;It complemented the meditation app I was already using, good using a different approach.\u0026rdquo; \u0026mdash; CTK982\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;It encouraged me to reconnect with practices I loved.\u0026rdquo; \u0026mdash; MKH454\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e2.2 Inspired to continue this practice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I would always use it.\" \u0026mdash; BOT013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"Have done [mindfulness] before, happy to take it up again.\" - MQW283\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;I have kept info [from MindOnLine] to use at a later date.\u0026rdquo; \u0026mdash; PMT594\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I have saved the [MindOnLine] emails and plan to use them\u0026hellip;\" \u0026mdash; KXJ346\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e2.3 Encouraged to engage with similar programs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;I found some books on mindfulness and intend to continue learning.\u0026rdquo; \u0026mdash; JVR741\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026rdquo; It encouraged me to download an overnight mindfulness app, which I use nightly now.\u0026rdquo; \u0026mdash; OZL689\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;I have been enrolled in a local mindfulness program\u0026rdquo; \u0026mdash; PMT594\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I have joined a meditation group.\u0026rdquo; \u0026mdash; KZY260\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.4 Motivated to further learn on the topic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"Perhaps some guides for further reading or recommendations for continuing to develop and explore mindfulness\" \u0026mdash; KZY260\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;Perhaps some suggestions regarding where to from here. What further programs or materials might provide appropriate encouragement (e.g. links to reading material, websites, mindfulness apps).\u0026rdquo; \u0026mdash; BEA036\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"Some suggestions for courses or reading or information for further research either during the program or for after the program [would be useful]\" \u0026mdash; CWI505\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"17\" rowspan=\"18\"\u003e \u003cp\u003e3. Individualised and practical program experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003e3.1 Meditations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I did find the sessions calming\u0026rdquo; \u0026mdash; CDL581\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;I like the meditations, they are short, easy to access and enjoyable and I feel a lot better after doing them\u0026rdquo; \u0026mdash; GIU967\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003econtrast (meditations)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"I found the guided meditation very hard to listen to. I would have preferred that any instructions be given in at the beginning not at indiscriminate times throughout. - AEE024\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"I found several of the session had audio which actually disrupted the ability to become mindful\" \u0026mdash; UCA168\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"I had difficulty with some of the shorter guided meditations. I would have preferred more gaps between the instructions to allow me time to experience and settle in the practice.\" - KZY260\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"I found I got lost in the emotion a lot, some meditations caused tears\" \u0026mdash; OEA965\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSuggestion for improvement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"It would also be better if you did not use generic scripts (I have heard the ones you have used many times before). A selection of different voices to listen to would also be better.\" - AEE024\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"I have been exploring different guided meditations to find a pace that is slower\u0026hellip; I feel like I need more variation if I continue.\" - KZY260\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e3.2 Weekly themes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;A great program. I enjoyed making the time to watch the weekly video's which were informative.\u0026rdquo; - UQE031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003econtrast (weekly themes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"A week per session is too much\u0026hellip; and I found the instructions continuing throughout the meditations very distracting.\" \u0026mdash; AMU530\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"Weeks 2 and 3 with focus on a minor negative experience really turned me off the program - the thought of thinking of a negative experience, twice a day for a fortnight just struck me as an unnecessary pain.\" - IVT382\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"Rerunning the same session all week appeared totally pointless. I need variety to keep me interested.\" \u0026mdash; GJU012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e3.3 Reminders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"The reminders were helpful.\" \u0026mdash; FYK633\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"Daily reminders were helpful, particularly in early weeks to develop habit of setting aside time\" \u0026mdash; GAU831\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"Morning and evening routine very easy to follow and adhere to. Reminder emails very helpful.\" \u0026mdash; SIL673\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"Reminders were good, helped on busy days\" \u0026mdash; XJI868\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003econtrast (reminders)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"I received twice daily reminders to meditate which I found extremely annoying and frustrating... This turned me off the program completely and made me very annoyed so that after about three weeks, I gave up altogether... the constant reminders not only filled up my in-box but frustrated me no end.\" \u0026mdash; GWX345\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSuggestion for improvement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"Perhaps some reminders about these aspects of the program [weekly videos, goals settings, and progress monitoring] would have been beneficial.\u0026rdquo; \u0026mdash; MPV178\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"13\" rowspan=\"14\"\u003e \u003cp\u003e4. Integration into daily life amid competing demands\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e4.1 Structured support for sustained practice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;It was good for scheduling of time to undertake the practice\u0026rdquo; \u0026mdash; TJF596\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I love this program because it helps to keep me engaged in regular meditation practice\" \u0026mdash; ZLS243\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\" [I]...needed the discipline of your programme.\" \u0026mdash; MQW283\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;The MindOnLine program has been great for supporting me to practice regularly and feel the benefits of regular practice\u0026hellip;\" - KZY260\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"I found the style of MOL sometimes confronting especially last thing at night ....\" - CTK982\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"[I] can see some positives so would like longer than 9 weeks\u0026rdquo; \u0026mdash; CTK982\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;... a session targeting returning to work to help with mindfulness in work situations [would be helpful]. I find this a \u003cem\u003estruggle upon returning to work- dealing with the negative feelings of others and trying to cope with work strategies.\u0026rdquo; - WDB014\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e4.2 Conflicting priorities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;I wasn\u0026rsquo;t in the headspace to do the program because of other health issues.\u0026rdquo; - AXJ158\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;I found it difficult to make the time, especially in the morning when I started back at work.\u0026rdquo; - BAS170\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;My husband also cancer patient.... My difficulties are compounded by being his carer.\u0026rdquo; - BMF821\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;[The practice is] just hard to fit in with work and life at the moment...\u0026rdquo; - CSZ753\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\"Work and family absorbed all of my time.\u0026rdquo; - GVH9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;In the period of [the MindOnLine] course, I experienced several adversities happening to loved ones, and I had a Lymphocele aspiration so there was a lot going on.\u0026rdquo; - JVR741\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026ldquo;Unfortunately, my brother in the USA was terminally sick and I had to fly over 2 weeks after starting the program. He passed away less than a week after I arrived. I tried to continue but with so much to deal with I lost momentum.\u0026rdquo; - KMG472\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study evaluated participants\u0026rsquo; satisfaction with a 9-week mindfulness online program, \u003cem\u003eMindOnLine\u003c/em\u003e, by assessing its perceived helpfulness in supporting mindfulness practice and emotional coping, and intention for sustained engagement with the practice. Approximately 75% of participants found the program helpful in encouraging mindfulness and nearly two-thirds reported it helped them manage difficulties, with over 70% intending to continue the practice. Two-third of the participants responded to open-ended questions. Thematic analysis highlighted four key themes: the program was experienced as transformative, empowering participants to deepen or initiate mindfulness practice; it required a highly individualised and practical approach due to varied preferences; and while many successfully integrated it into daily life, others faced challenges due to competing demands. The findings suggest that \u003cem\u003eMindOnLine\u003c/em\u003e is a broadly acceptable and potentially impactful intervention for people living with breast, colorectal or prostate cancer, with further refinement needed to enhance personalisation and long-term engagement.\u003c/p\u003e \u003cp\u003eOur findings complement the evidence on \u003cem\u003eMindOnline\u003c/em\u003e\u0026rsquo;s effectiveness, which has demonstrated significant reductions in fear of cancer recurrence, anxiety, and depression among participants allocated to the intervention (\u003cem\u003eMindOnline\u003c/em\u003e) compared to a waitlist control group [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Together these observations indicate that participants\u0026rsquo; perceived helpfulness of the program in managing difficulties extends beyond measurable clinical improvements to influence daily functioning (theme 1 \u0026ndash; Transformative during and beyond cancer) and confidence to independently expand mindfulness practice over time (theme 2 \u0026ndash; Empowering through mindfulness practice). These findings also align with a growing body of evidence showing that most participants perceive digital mindfulness interventions as helpful for cultivating mindfulness and emotional coping. For example, a multinational study of patients with metastatic renal cell carcinoma receiving immunotherapy found that 75% achieved high adherence to a mindfulness app intervention and provided positive feedback on its usefulness, suggesting high perceived helpfulness in this population [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. A systematic review and meta‑analysis of 14 RCTS with 1316 participants found that online MBIs supported emotional coping in cancer patients by significantly reducing anxiety, stress, and fatigue while improving quality of life [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The findings suggest that digital MBIs can effectively cultivate mindfulness skills and support emotional wellbeing in cancer populations. Our study found participants valued mindfulness as a transferable skill helpful during cancer recovery and in everyday life. Combined with the clinical improvements, the felt and perceived benefits may motivate participants to maintain their mindfulness practice beyond the intervention period.\u003c/p\u003e \u003cp\u003eIn our study, 70% of participants reported intention to continue mindfulness practice beyond the intervention period. A systematic review of 21 studies with 1811 participants reported that cancer survivors completed, on average, approximately 60% of prescribed mindfulness home practice, with greater adherence associated with improved psychological outcomes, including reduced distress and fear of cancer recurrence [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. These findings are supported by the present study, in which participants described \u003cem\u003eMindOnLine\u003c/em\u003e as supporting sustained engagement and integration of mindfulness into daily life beyond the intervention period. Together, this suggests that program features promoting perceived usefulness, flexibility, and autonomy, rather than prescribed practice dose alone may be critical for fostering long‑term engagement with online mindfulness interventions.\u003c/p\u003e \u003cp\u003eAlthough journaling, goal setting, and progress tracking are established behaviour change techniques associated with sustained behaviour change [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], these features had limited uptake and perceived helpfulness within \u003cem\u003eMindOnLine\u003c/em\u003e. Evaluative goal‑setting and self‑monitoring tools may inadvertently undermine engagement when users experience difficulty or symptom fluctuation, particularly in cancer populations. For example, Bradbury and colleagues (2019)[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] enhanced a fully self-guided digital health intervention to promote physical activity, improve diet, and support mood management. The intervention was optimised through interviews with 96 cancer survivors and 31 focus groups with health service staff and cancer charity workers whose specific concerns were addressed in subsequent modification of the program leading to improved acceptability and feasibility of the intervention [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. One of these modifications related to goal setting. Interview findings suggested that participants risked disengaging if they failed to meet goals or experienced symptoms flare-ups. Consequently, goal setting was framed as flexible and adaptive to help prevent drop‑out following difficult periods. The authors recognised that evaluative goals such as quantifying progress (e.g. meditate 5min each day)[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] could foster feelings of failure and undermine engagement when participants experience challenges. Instead, they opted for a person-based adaptation that was more flexible and low-pressure compared to a classic measurable behaviour change technique. In our analysis, the contrast between low perceived usefulness of goal setting, journaling, and progress monitoring and high overall perceived helpfulness of MindOnLine suggests that sustained mindfulness engagement was driven primarily by experiential and contextual factors rather than self‑regulatory tools. Participants appeared to value the program\u0026rsquo;s flexibility, relevance, and emotional benefits, which may have supported intrinsic motivation and ongoing practice without reliance on evaluative behaviour change techniques.\u003c/p\u003e \u003cp\u003eThis study offers valuable insights into the experiences of people living with cancer engaging with a digital mindfulness program, combining quantitative and qualitative data to capture both perceived impact and lived experience. The thematic analysis highlighted the real-world relevance of the program. However, strong female representation limits generalisability among male users, and the smaller number of male participants precluded detailed exploration of gender differences. Additional research is needed to better understand how male participants engage with and experience the intervention. Additionally, the absence of long-term follow-up further constrains the scope of findings. Longitudinal designs are needed to assess sustained behavioural change and emotional outcomes beyond the intervention period.\u003c/p\u003e \u003cp\u003eThis mixed‑methods evaluation demonstrates that \u003cem\u003eMindOnLine\u003c/em\u003e is an acceptable and potentially impactful digital mindfulness intervention for people living with and beyond cancer. High levels of participant satisfaction, combined with perceived improvements in emotional coping and intentions to sustain practice, complement evidence of clinical benefits and underscore mindfulness as a transferable skill supporting wellbeing in daily life. Our findings support a person‑centred model of digital mindfulness delivery, demonstrating that participants engaged most strongly with features that felt flexible, relevant, and emotionally supportive rather than prescriptive. This analysis provides practical guidance for the design of low‑burden, scalable digital interventions for cancer populations, suggesting that prioritising acceptability, simplicity, and autonomy may enhance satisfaction engagement and sustainability.\u003c/p\u003e \u003cp\u003eIn conclusion, these findings provide a strong foundation for future trials and implementation research aimed at scaling person-centred digital mindfulness interventions as an accessible component of holistic cancer survivorship care. Given the high female participation in our study, future research should examine engagement preferences with \u003cem\u003eMindOnLine\u003c/em\u003e among men, diverse cancer populations and care settings, to inform wider implementation and integration into supportive cancer care pathways.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the study conception and design. Data analysis was performed by LR, and NW. The first draft of the manuscript was written by LR and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval was obtained from the Peter MacCallum Cancer Centre (20-53) and Deakin University (2020-284). Informed consent was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the National Health and Medical Research Council (NHMRC) Partnership Grant ID APP1179317, with partner cash contributions from the Department of Health, Victoria, Epworth HealthCare and Western Health. The funder supported the cost of undertaking the project.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe acknowledge each of our partners, Breast Cancer Network of Australia, Barwon Health, Prostate Cancer Foundation of Australia, Peter MacCallum Cancer Centre, Western Health, Smiling Mind, Epworth HealthCare, and the Victorian State Government Department of Health, for their support of this project. We also acknowledge and thank the cancer survivors taking part in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAustralian New Zealand Clinical Trials Registry:\u003c/strong\u003e ANZCTR: 12620000645954\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eIHME, \u003cem\u003eGlobal Burden of Disease (\u003c/em\u003e2024\u003cem\u003e) \u0026ndash; with major processing by Our World in Data. \u0026ldquo;Number of people with cancer\u0026rdquo; [dataset]. 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Springer.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMorgan, D.L., \u003cem\u003eExploring the use of artificial intelligence for qualitative data analysis: The case of ChatGPT\u003c/em\u003e. International journal of qualitative methods, 2023. 22: p. 16094069231211248.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBergerot, C.D., et al., \u003cem\u003eFeasibility and acceptability of a mindfulness app-based intervention among patients with metastatic renal cell carcinoma: a multinational study\u003c/em\u003e. The Oncologist, 2025. 30(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXu, L., A. Guan, and Y. Huang, \u003cem\u003eEffects of online mindfulness-based interventions on mental and physical health outcomes in cancer patients: A systematic review and meta-analysis of randomized controlled trials\u003c/em\u003e. Medicine, 2025. 104(12): p. e41870.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBaydoun, M., et al., \u003cem\u003eMindfulness-Based Interventions in Cancer Survivors: A Systematic Review of Participants\u0026rsquo; Adherence to Home Practice\u003c/em\u003e. Patient Preference and Adherence, 2021. 15(null): p. 1225\u0026ndash;1242.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbraham, C. and S. Michie, \u003cem\u003eA taxonomy of behavior change techniques used in interventions\u003c/em\u003e. Health psychology, 2008. 27(3): p. 379.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBradbury, K., et al., \u003cem\u003eDeveloping a digital intervention for cancer survivors: an evidence-, theory-and person-based approach\u003c/em\u003e. NPJ digital medicine, 2019. 2(1): p. 85.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"supportive-care-in-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jscc","sideBox":"Learn more about [Supportive Care in Cancer](https://www.springer.com/journal/520)","snPcode":"520","submissionUrl":"https://submission.nature.com/new-submission/520/3","title":"Supportive Care in Cancer","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8972358/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8972358/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study evaluated participant satisfaction with MindOnLine, a 9‑week self‑guided online mindfulness program designed to support psychological wellbeing among people living with and beyond breast, prostate, or colorectal cancer. It examined perceptions of usability, emotional coping support, and influence on ongoing mindfulness practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEmbedded within a larger randomised controlled trial, this survey‑based study collected quantitative and qualitative data from intervention‑group participants at program completion. Program satisfaction, session usefulness, and overall helpfulness were assessed using Likert‑scale measures across multiple domains, alongside four open‑ended questions exploring mindfulness practice, managing difficulties, future use, and desired content. Quantitative data were summarised descriptively. Open‑ended responses were analysed thematically using Braun and Clarke’s framework, with categories generated by human coders and Microsoft Copilot© compared to enhance analytical rigour.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf 233 intervention participants, 167 (72%) provided satisfaction data. Most reported that the program was easy to use (91%) and would recommend it to others (83%). Between 41% and 59% noted improved emotional understanding and coping, including decreased anxiety (54%) and increased control over thoughts (59%). Thematic analysis of 267 qualitative responses identified four overarching themes: (1) transformative benefits during and beyond cancer; (2) empowerment through sustained mindfulness practice; (3) individualised and practical program experiences; and (4) integration of mindfulness amid competing life demands.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMindOnLine was acceptable, empowering, and emotionally beneficial, with most participants intending to continue mindfulness practice. Findings highlight the value of flexible, person‑centred digital mindfulness interventions in cancer survivorship care and offer guidance for scalable implementation.\u003c/p\u003e","manuscriptTitle":"MindOnLine, a self-guided online mindfulness program supporting people living with cancer: Participant satisfaction analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-10 13:37:42","doi":"10.21203/rs.3.rs-8972358/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-04-06T18:56:03+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-06T18:53:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-03T01:48:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"Supportive Care in Cancer","date":"2026-02-26T02:16:33+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"supportive-care-in-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jscc","sideBox":"Learn more about [Supportive Care in Cancer](https://www.springer.com/journal/520)","snPcode":"520","submissionUrl":"https://submission.nature.com/new-submission/520/3","title":"Supportive Care in Cancer","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"593aab9c-61b7-4403-ab61-8e47748121e8","owner":[],"postedDate":"April 10th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-10T13:37:42+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-10 13:37:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8972358","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8972358","identity":"rs-8972358","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}