Interventions for caregivers of cancer patients tend to reflect professionals' assumptions, and may not address caregivers' needs and interests. As a result, uptake of services is typically low, important issues are missed, and interventions often exclude many of those most in need. These problems are likely amplified when interventions designed for one sociocultural group are applied to another group. This project starts with an existing and tested intervention for caregivers of cancer patients from the broader population, and works to ensure its applicability and ease of use for a predominantly African American community by revising the content and methods of delivery based on input from caregivers in the West Philadelphia area. Our overarching goal is to ensure that the intervention is made acceptable, accessible, and responsive to the needs of low- and middle-income African Americans. We assume that the success of an intervention begins in its design, and that effectiveness in """"""""real world"""""""" settings is determined by both efficacy and acceptance by those who are the targets of an intervention. This acceptance depends on accommodating the needs of those to be served and on overcoming barriers to participation. Further, design of an intervention that meets the needs of a particular target population should directly involve representatives of that population. This project will progress through two distinct phases. In the first phase, caregivers will experience the existing intervention and participate in focus groups or in-home semi-structured interviews.
The specific aim of this phase is to develop culturally competent content in terms of the problems addressed and the solutions promoted in the intervention. The second phase incorporates the content refinements developed during the first phase into two alternative modes of delivery: community-based group intervention, and a combination of home-visit and telephone follow-ups. The experience of recipients choosing either of these interventions will again be assessed and results will used to further refine the intervention and its delivery. Beyond its specific aims, this project is intended to serve as a model strategy for the design and development of psychosocial interventions which have greater uptake and usefulness because they are responsive to the needs and preferences of potential consumers, and help overcome the barriers to participation that these individuals face.
