Digital goal management training for cognitive impairment in cervical cancer survivors-a randomized comparison study

Cognitive impairment (CI) is a common late effect after cancer treatment, for which effective interventions are lacking. Goal management training (GMT) is a validated cognitive training protocol reported to improve cognition, including executive functioning. The purpose of this study was to examine the feasibility and acceptability of digital GMT in cervical cancer survivors (CCS) experiencing CI and compare it to computerized cognitive training (CCT).

Thirty-five CCS with significant subjective CI were randomized in a 1:1 ratio between digital GMT (N = 18) and CCT (N = 17). The primary endpoint was attendance, and participants attending ≥ 80% of the sessions were categorized as completers. Acceptability was evaluated post-intervention using the Client Satisfaction Questionnaire-8 (CSQ-8). Secondary outcomes included self-reported and performance-based cognitive functioning.

The completion rate in both groups was 88%. Participants in both groups reported high levels of satisfaction (CSQ-8; GMT: M = 25.2, SD 3.7, range 18-31, and CCT: M = 24.6, SD 3.1, range 19-30). Exploratory analyses showed improvements in both groups over time in attention and memory as well as self-reported cognitive functioning.

Digital GMT is feasible with a high level of compliance and satisfaction in CCS. Preliminary efficacy data shows promising cognitive improvement over time, and the results are comparable to CCT and warrant further investigation in a larger-scale trial.

If deemed effective in a larger study, digital cognitive training, such as GMT, is a low-cost, low-staff intensive intervention that is easily implemented and available to cancer survivors experiencing CI.