Implementation of a Psychoeducational Program for Cancer Survivors and Family Caregivers at a Cancer Support Community Affiliate: A Pilot Effectiveness Study.
BACKGROUND
Psychoeducational interventions, tested for efficacy in randomized clinical trials, are seldom implemented in clinical practice where cancer survivors and their family caregivers can benefit from them.


OBJECTIVE
This study examined the effectiveness of the FOCUS Program on cancer survivors' and their family caregivers' outcomes when implemented at a Cancer Support Community (CSC) affiliate by agency social workers. Study aims were to (1) test effects of the program on survivor and caregiver outcomes as a unit and (2) determine program feasibility in terms of enrollment, retention, intervention fidelity, and satisfaction.


METHODS
A preintervention and postintervention pilot effectiveness study was conducted with 34 cancer survivor-caregiver dyads (ie, pairs). The FOCUS Program, originally delivered by nurses in dyads' homes, was modified to a small-group format and delivered by CSC social workers. The primary outcome was quality of life (QOL). Intermediary outcomes were benefits of illness/caregiving, communication, support, and self-efficacy. Analyses included repeated-measures analysis of variance.


RESULTS
Dyads had significant improvements in total QOL; physical, emotional, and functional QOL; benefits of illness; and self-efficacy. Effect sizes were similar to prior randomized clinical trial findings. Although dyads were difficult to recruit (enrollment, 60%), both retention (92%) and intervention fidelity (94%) were high.


CONCLUSIONS
It was possible to implement the FOCUS Program at a CSC affiliate by agency staff, obtain positive intervention effects, and maintain intervention fidelity.


CONCLUSIONS
Researchers and clinicians need to collaborate to implement more evidence-based interventions in practice settings for cancer survivors and their family caregivers.
Author Affiliations: Cancer Support Community of Greater Ann Arbor, Michigan (Ms Dockham); School of Nursing, University of Michigan, Ann Arbor (Ms Schafenacker and Drs Ronis, Titler, and Northouse); School of Nursing, Loyola University, Chicago, Illinois (Dr Yoon); and School of Public Health, Yale University, New Haven, Connecticut (Dr Kershaw).
Bonnie
B
Dockham
Ann
A
Schafenacker
Hyojin
H
Yoon
David L
DL
Ronis
Trace
T
Kershaw
Marita
M
Titler
Laurel
L
Northouse
D000328:Adult; D000368:Aged; D017028:Caregivers / Q000193:education* / Q000523:psychology*; D003153:Community Health Services / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010353:Patient Education as Topic; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D011788:Quality of Life; D012944:Social Support; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data