Feasibility of an Online Shared Reading Intervention in Survivors of Gynecological Cancer: Protocol for a...

Gynecological cancers pose significant physical, psychological, and social challenges for those affected. Although psychosocial interventions are components of holistic cancer care, access can be limited by specialized practitioner expertise, wait times, gender-biased care, and accessibility constraints. These barriers highlight a recognized need for alternative, timely, and nonclinical approaches that can complement existing services and relieve system pressures.

The primary study aim is to evaluate the feasibility and acceptability of an online shared reading program as a novel, adjunctive psychosocial intervention for people affected by gynecological cancers. The secondary aim is to explore the intervention's preliminary individual-level outcomes on psychological distress, well-being, and quality of life.

This mixed methods feasibility study uses a multiple-baseline single-case design informed by a realist evaluation theoretical framework. Up to 10 participants aged 18 years or older with a primary diagnosis of gynecological cancer will be recruited internationally. The intervention consists of 6 weekly 1-hour literature reading group sessions delivered via Microsoft Teams. Three baseline assessments at -2 weeks, -1 week, and week 0 will establish outcome stability prior to the intervention, followed by midintervention (week 3) and postintervention (week 6) assessments. Outcome measures include the Short Warwick-Edinburgh Mental Wellbeing Scale, the Kessler Psychological Distress Scale, the WHOQOL-BREF social domain subscale, and 2 global quality of life items from the EORTC QLQ-C30. Individual-level change within these measures will be examined using the reliable change index at a threshold of 1.96 or higher, presented as modified Brinley plots. Feasibility will be assessed and summarized descriptively using recruitment and retention rates, session attendance and completion rates, and reasons for dropout. Acceptability will be examined through semistructured interviews of up to 30 minutes conducted by an independent researcher after the intervention. Interview data will be analyzed using reflexive thematic analysis to explore participants' intervention experience and perceived mechanisms of change.

This feasibility study was funded in October 2022 as part of a PhD scholarship. Recruitment began in November 2025 and continued until March 2026. At the time of manuscript submission in January 2026, a total of 6 people had registered their interest, of whom 2 met the eligibility criteria. The data analysis plan was formulated but not implemented, with the intervention set to begin in May 2026. Findings are expected to be submitted for publication in November 2026.

Potential implications include that the digital, low-intensity, group-based online shared reading format may offer a novel psychosocial support alternative to survivors of gynecological cancer who may be otherwise excluded due to residing in geographically remote areas, financial constraints, or reluctance to engage with formal psychological therapy. If feasible and acceptable, the intervention may contribute to equitable cancer care provision and inform the design of future implementation studies in digital oncology services.