Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Ecological Validation of the FORT (Fear Of Recurrence Therapy) Program: Adapting the Patient Workbook from Mexican to European Spanish for Breast Cancer Survivors in Spain (126477)

Tania Estapé 1 , Lizette C Gálvez 2 , Nuria Gondón 3 , Christine Maheu 4 , Sophie Lebel 5 , Yolanda Andreu 6 , Jordi Estapé 1
  1. FEFOC Fundacio, Barcelona, BARCELONA, Spain
  2. Posgrado de la Facultad de Psicología,, Universidad Nacional Autónoma de México,, Mexico City, Mexico
  3. Clinical and Health Psychology, Fundació Hospital de lÈsperit Sant,, Santa Coloma de Gramenet, Catalonia, Spain
  4. School of Nursing, McGill University, Montreal, Canada
  5. School of Psychology, University of Otawa, Otawa,, Canada.
  6. Personality, Assessment and Psychologycal Treatment, Psyhcology Faculty, Valencia University, Valencia, Spain

Objectives/Purpose:
Fear of cancer recurrence (FCR) is a common and distressing psychological issue among survivors. The FORT (Fear of Recurrence Therapy) program offers an evidence-based group intervention for FCR. While validated in Mexican Spanish, cultural and linguistic differences may limit its effectiveness in European Spanish populations. This study assesses the ecological validity of the FORT Patient Workbook from both professional and patient perspectives in Spain.

Sample and Setting:
The sample included three psycho-oncologists and three breast cancer survivors in Spain. The setting was non-clinical and exploratory, aimed at qualitative evaluation of materials for future clinical implementation.

Procedures:
Participants independently reviewed the translated Patient Workbook. Evaluation followed Bernal’s eight dimensions of ecological validity. Professionals and patients provided qualitative feedback and rated agreement levels. Inter-rater reliability was calculated using the Kappa index.

Results:
High agreement (Kappa = 0.8–1.0) was observed across most dimensions. Both professionals and patients identified mismatches in terminology (e.g., recurrencia vs recaída) and suggested minor linguistic and contextual changes. Concerns were raised regarding the group therapy format and cultural appropriateness of some exercises (e.g., worst-case scenario visualisation). Lower agreement on the “context” dimension (Kappa = 0.6) reflected challenges in addressing age diversity and socioeconomic variation.

Conclusion and Clinical Implications:
The FORT program is appropriate for Spanish-speaking breast cancer survivors in Spain with minor modifications. Tailoring language, therapeutic format, and contextual relevance enhances its acceptability and effectiveness. These adaptations are essential for broader implementation across diverse Spanish-speaking populations.