There are over 10 million cancer survivors whose needs for psychosocial care are not being met. Although some supportive-educative programs exist, they are expensive to deliver and do not address communication problems of patients and their family caregivers. To address the needs of the growing number of cancer survivors, given a decreasing pool of health care providers, there is an immediate need for new methods of delivering evidence-based programs of care. The proposed R21 will be used to develop an individually tailored, interactive, web-based intervention for cancer patients (lung, colorectal, breast, prostate) and their family caregivers that will lead to better patient-caregiver communication, more dyadic support, higher self-efficacy, and increased perceived benefits of the illness experience;and to less emotional distress. This intervention is based on an efficacious, family-based program of care (the FOCUS Program) that has been tested previously in three large randomized clinical trials with positive outcomes for patients and their caregivers. In this R21 we will translate the primarily face-to-face, family-based program to an internet-based version.
The Specific Aims are:
Aim 1. To develop an individually-tailored, interactive, web-based and email-based, Family Involvement Module. The three-session module will be completed jointly by patients and caregivers to increase patients'and caregivers'effective communication, dyadic support, self-efficacy, perceived benefits of the illness, and to decrease their emotional distress. For Sub Aim 1.1, we will conduct formative testing while developing the module during month 03 using qualitative data obtained from four focus groups (N=16 patient-caregiver dyads). For Sub Aim 1.2, we will conduct usability testing of the near final module in month 10 with data obtained from qualitative interviews with patients and caregivers (N=5 dyads) as they complete web-based task assignments using a """"""""think aloud"""""""" protocol while they navigate the module.
Aim 2. To conduct a Phase II study with cancer patients and their family caregiver (N=40 dyads) using baseline (Time 1) and two-month follow-up (Time 2) assessments. Between Times 1 and 2, all participants jointly will complete the web-based Family Involvement Module. For Sub Aim 2.1, we will determine the feasibility of delivering the web-based module measured by indicators of web engagement obtained from paradata which are automatically recorded by the website, and with a process evaluation completed by study participants. For Sub Aim 2.2, we will conduct a preliminary assessment of the magnitude of intervention effects on patients'and caregivers'levels of effective communication, dyadic support, self-efficacy, perceived benefits of the illness and emotional distress from Time 1 to Time 2. Data will be obtained from two large cancer centers using established instruments, and analyzed with descriptive statistics and paired t-tests. Findings from this R21 will provide data that are essential to test this innovative, tailored, interactive web-based intervention with a larger sample in a R01.
There are over 10 million cancer survivors whose needs for psychosocial care are not being met. This study will translate an established program of care for cancer patients and their family caregivers to a tailored, web- based intervention. This innovative intervention has the potential to provide psychosocial care to a vast number of cancer patients and caregivers at a lower cost.
| Northouse, Laurel; Schafenacker, Ann; Barr, Kathryn L C et al. (2014) A tailored Web-based psychoeducational intervention for cancer patients and their family caregivers. Cancer Nurs 37:321-30 |
| Zulman, Donna M; Schafenacker, Ann; Barr, Kathryn L C et al. (2012) Adapting an in-person patient-caregiver communication intervention to a tailored web-based format. Psychooncology 21:336-41 |
