Evaluating the efficacy of two body image online writing interventions against a neutral writing control in targeting positive body image and distress in female cancer survivors: a randomised controlled trial
Clinical Snapshot
PICO Framework
| P — Population | Adult female cancer survivors (N = 132) |
| I — Intervention | Two online writing interventions: Expand Your Horizon (EYH) and My Changed Body (MyCB) |
| C — Comparator | Neutral writing control condition |
| O — Outcomes | Body appreciation, body dissatisfaction, body functionality appreciation, self-compassion, and distress measured at baseline, immediately post-intervention, 1-week, and 2-week follow-up |
Bottom Line
This RCT demonstrates that the Expand Your Horizon online writing intervention can provide short-term improvements in body appreciation and reductions in body dissatisfaction among female cancer survivors, with statistically significant but modest effect sizes. While the intervention shows promise as a low-cost, accessible psychological support tool, several methodological limitations reduce confidence in the findings. The inability to blind participants, unclear randomisation procedures, and very short follow-up period (2 weeks) limit the strength of evidence. The clinical significance of the observed effect sizes in this vulnerable population requires further investigation. The intervention's online format makes it highly feasible for Australian healthcare settings and could complement existing survivorship care programs. However, longer-term studies with more robust methodology are needed before recommending widespread implementation. Clinicians should consider this as a potential adjunct to standard care while awaiting stronger evidence for sustained benefits.
Key Findings
P Value: p = .002 for both body appreciation and dissatisfaction outcomes
Effect Size: EYH vs control: body appreciation d = 0.31, body dissatisfaction d = -0.22
Primary Outcome: Body appreciation and body dissatisfaction immediately post-intervention
Nnt Or Sensitivity: Not calculable from available data; effect sizes suggest moderate clinical benefit
Confidence Interval: Not reported in abstract
Clinical Application
High feasibility - online delivery, minimal resource requirements, can be integrated into survivorship care programs Highly relevant to Australian cancer care; aligns with Cancer Australia survivorship guidelines and could complement existing psycho-oncology services through telehealth platforms Adult female cancer survivors experiencing body image concerns and psychological distress
Abstract
OBJECTIVE: This study evaluated the efficacy of two online writing interventions, Expand Your Horizon (EYH) and My Changed Body (MyCB), compared to control, in improving body image and distress in a cancer population, and investigated whether they target different mechanisms. METHODS: Adult female cancer survivors (N = 132) were randomised to EYH, MyCB, or a neutral writing control. Body appreciation, body dissatisfaction, body functionality appreciation, self-compassion and distress were measured at baseline, immediately post-intervention, 1-week, and 2-week follow-up. RESULTS: EYH participants demonstrated significantly higher body appreciation (p = .002, d = 0.31) and significantly lower body dissatisfaction (p = .002, d = -0.22) immediately post-intervention compared to control. The same pattern existed for MyCB participants but was not significant. No significant differences in proposed mechanisms-self-compassion or functionality appreciation-emerged between groups. Main effects of time emerged on body dissatisfaction, distress, and self-compassion at the 1-week and 2-week follow-ups, with all participants improving over time. CONCLUSION: The findings support the efficacy of EYH to improve state body appreciation and reduce body dissatisfaction in female cancer survivors. Further research is necessary to determine the optimal dose needed to produce sustained improvements in body image and distress.
References
- 1.Brkic, E., Prichard, I., & Beatty, L. (2026). Evaluating the efficacy of two body image online writing interventions against a neutral writing control in targeting positive body image and distress in female cancer survivors: a randomised controlled trial. Supportive Care in Cancer. https://doi.org/10.1002/cncr.28469
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