Dr. Morgan Leske

Post-doctoral Researcher

Flinders University

AUSTRALIA

Dr. Morgan Leske is a Registered Psychologist and Post-doctoral Researcher with a special interest in psycho-oncology and digital health. She completed her PhD at Flinders University, where she collaborated with Cancer Council SA to co-design an online healthy living intervention for post-treatment cancer survivors. Her research combines quantitative and qualitative methodologies, with a focus on person-centred approaches, to improve the accessibility and relevance of psychosocial support in cancer care.

Currently, she is involved in several research projects co-designing and evaluating online psychosocial interventions across the cancer care continuum, including for individuals recently diagnosed with cancer and women living with advanced breast cancer. She is particularly interested in how engagement in these interventions can be optimised with cancer-specific tailoring and human support to improve quality of life for people living with or beyond cancer. 

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Over 1.2 million Australians currently live with or beyond cancer; a figure estimated to grow due to increases in cancer incidence and survival. With this growth has come a parallel increase in survivorship burden, with one of the most significant concerns being mental health. Up to 52% of patients experience significantly elevated distress. While there is strong evidence for psychological interventions, such as Cognitive Behavioural Therapy and Mindfulness-based interventions, availability to the psycho-oncology workforce is limited. Digital health interventions have been proposed as a solution to improve access to psycho-social support. However, cancer survivors are a heterogenous population with different needs depending on sociodemographic (i.e., age, socio-economic status, etc) and clinical characteristics (i.e., cancer type, time since diagnosis, etc). This presentation will summarise the evolution of Finding My Way (FMW), an online self-guided psychotherapeutic intervention aimed at reducing cancer related distress and improving quality of life in the diagnosis and treatment phases of cancer survivorship. This program was initially implemented with newly diagnosed and curatively treated cancer survivors in both Australia and the UK, both within and outside a research trial. More recently, the program has been co-designed and evaluated with women with metastatic breast cancer (Finding My Way – Advanced; FMW-A) and used to provide the basis for an online intervention for post-treatment cancer survivors (Healthy Living after Cancer Online; HLaC Online). FMW has demonstrated efficacy in improving distress and quality of life and similar preliminary outcomes are available for FMW-A and HLaC Online in feasibility studies (note that efficacy outcomes for FMW-A will be available at the time of presentation). However, engagement in these interventions has been suboptimal. Across all the trials, on average, users will access three modules, regardless of whether there are 6 or 9 modules available. Usage is lower again when implemented in real world settings, with participants on average accessing 1.5/6 modules. Compellingly, however, results indicated that - despite having lower usage - participants achieved larger changes from baseline to post-program in distress. In addition, even when participants are encouraged to rearrange or self-tailor the modules accessed, they tend to access the modules in the order they have been presented. Participants who access more of the program also tend to be more well and have more cognitive capacity. While qualitative data from these trials have indicated that the content of these interventions is important and helpful, the time requirements and information overwhelm are often cited as reasons for disengagement. These collective findings lead to a key avenue for future research: Can we reduce the dose required for comparable outcomes to be achieved? Using archival data analysis from previous trials and co-design techniques, our team is designing a reduced-dose version of FMW while maintaining the core ingredients of the program.