This study was a single-arm, prospective pilot trial of MyInspiration. In its current form, MyInspiration is a web-based digital tool designed to address patient spiritual needs by delivering content tailored to individual spiritual orientation. The current version of MyInspiration has patient resources across five domains: (1) written (e.g., sacred texts), (2) audio/visual (e.g., music/podcasts), (3) physical (e.g., submit requests for religious tools and foods), (4) communal (e.g., group worship), and (5) relational (e.g., request a chaplain or religious leader). MyInspiration offers a wide array of resources, some of which are general in nature (e.g., guided imagery, mindfulness), while others are customized based on the patient’s spiritual identity and specific needs. For instance, patients who identify as Hindu can indicate their religious preference during the onboarding or orientation process. Subsequently, if the patient expresses a desire for a religious text, the individual will receive the Vedas and the Upanishads—specific to their faith—rather than an exhaustive list of all religious texts. Additionally, every patient has access to the general resources available to all patients. Patients who do not specify a religious preference can explore all the resources offered by MyInspiration (Fig. 1).

a–d MyInspiration digital tool

Patients at The Ohio State University Comprehensive Cancer Center (OSUCCC) who were scheduled for future surgery as part of their treatment were recruited from August 1 through December 31, 2022. Eligible participants needed to be over 18 years of age and proficient in English. All recruited patients had access to a personal smart device to complete study activities. Recruitment for potential participants was carried out through three primary channels: (1) flyers, (2) MyChart, and (3) phone. Flyers were distributed to surgical oncology clinics to display for patients. The recruitment flyer contained information about the study and contact information for a member of the research team to receive additional information regarding the study. For recruitment through MyChart, honest brokers were utilized. Honest brokers are individuals who are not involved with the research study team; these “brokers” query patients who meet study eligibility and send individuals an approved recruitment email via MyChart inbox. Investigators only received patient information if the patient indicated interest in the study. Another method of recruitment involved research associates who pre-screened potential patients scheduled for appointments in the surgical oncology clinics prior to an appointment. If the patient appeared eligible, research staff members asked for physician approval to contact the patient. If the physician approved, research staff called the patient prior to the appointment and introduced the study.

For all three recruitment methods, participants who expressed interest to participate were contacted by research staff, screened for eligibility, and given the opportunity to ask any questions. If participants met eligibility criteria, they were provided with a consent form online via RedCap. After obtaining consent, patients received instructions to guide them through the process of accessing and utilizing MyInspiration, as well as completing all baseline measures. Participants were invited to take part in the study for a period of 30 days, which included any inpatient stays, if applicable. Efforts were made to schedule the surgical procedure in such a way that it fell within the middle of the study window, allowing patients to use MyInspiration both leading up to and following their surgical procedure. Upon successful completion of the 30-day follow-up survey, participants received online Amazon gift cards valued at $20 as compensation for their participation. This study protocol received approval from the Institutional Review Board at The Ohio State University (Protocol #2021C0010).

Individual patient (i.e., gender, relationship status, race, age) and disease-level (i.e., cancer type, stage, time since diagnosis) demographics were extracted from the electronic medical record at the conclusion of study activities. Feasibility and acceptability were assessed through recruitment and retention metrics (ratio of patients that consented and completed all assessments). Reasons why participants declined to enroll were also ascertained. Satisfaction was assessed with 5 Likert-style questions assessing patients’ user-experience with MyInspiration.

Patient spiritual well-being and finding meaning in their experience with cancer were measured at baseline and post-intervention. Spiritual well-being was assessed with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 item scale (FACIT-SP-12) [17]. The FACIT-SP-12 is the most frequently used measure of spiritual well-being amongst people with cancer and is part of the FACIT measurement system. Internal consistency was measured using Cronbach’s alpha and was deemed acceptable (> 0.70) for all subscales of the FACIT-Sp-12: α = 0.87 for faith (4-items), α = 0.88 for combined meaning/peace (8-items), α = 0.78 for meaning alone (4-items), α = 0.83 for peace alone (4-items), and α = 0.89 for Total FACIT-Sp-12 (12-items) [18, 19]. Responses on the FACIT-Sp-12 range from 0 (“not at all”) to 4 (“very much”). Subscale scores range from 0 to 16, while total scale score ranges from 0 to 48, with higher scores indicating better spiritual well-being [20]. The Impact of Cancer Scale (IOC) was developed to assess the influence of cancer on quality of life. The IOC has eight subscales. For the current study, “meaning of cancer” subscale was utilized, which examines personal growth related to the cancer experience (e.g., having had cancer turned into a reason to make changes in my life). The Likert-style response scale was the same as the FACIT-Sp-12. Subscale scores were averaged, with a possible range from 0 to 4 with higher scores being more positive. The IOC has published psychometric properties [21].

Descriptive statistics were used and presented as frequency (relative frequency: %) and mean (M, standard deviation: SD, range) for categorical and continuous data, respectively. It was determined prior to study activities that feasibility/acceptability > 75% was deemed acceptable. Paired t-tests were used to examine differences scores on baseline and exit assessments. All analyses were performed using SPSS v28 with significance established at α < 0.05.