Thompson Tess, Lero Christi M, Levitan Julia, Bradley Cory D, James Aimee S, Heiden-Rootes Katie, Sargent Emani, Johnson LaShaune P
University of North Carolina at Chapel Hill, School of Social Work, Chapel Hill, NC, USA.
Washington University in St. Louis, Brown School of Social Work, St. Louis, MO, USA.
Cancer Control. 2024 Jan-Dec;31:10732748241305583. doi: 10.1177/10732748241305583.
Breast cancer patients and their informal caregivers often report unmet psychosocial, relational, and physical health needs. Dyadic interventions may improve patient and caregiver outcomes, but few have been integrated into clinical care or designed for Black breast cancer patients and their female caregivers. We used the Health Equity Implementation Framework to design for dissemination by identifying facilitators and barriers to implementing a dyadic survivorship intervention delivered via video teleconferencing (e.g., Zoom).
We conducted semi-structured interviews with a purposive sample of 18 collaborators with roles at a comprehensive cancer center and community organizations to understand facilitators and barriers to implementing a dyadic intervention for Black breast cancer patients and their caregivers. We used rapid qualitative analysis (templated summaries synthesized in matrices) to conduct a directed content analysis. We identified patterns in responses to interview guide questions and developed cross-cutting themes.
Collaborators' roles fell into four domains: patient-facing mental health (33%), patient-facing physical health (28%), research/administration (28%), and cancer-focused community groups (11%). Participants were supportive of a dyadic intervention for Black women with breast cancer and female caregivers. Collaborators noted that psychosocial care at the cancer center was already being delivered via Zoom and saw benefits to including caregivers. Overarching themes include and
Application of these findings can help address the challenges of implementing a dyadic survivorship intervention for Black women with breast cancer and their caregivers in clinical settings. Expanding models such as the Health Equity Implementation Framework to include caregivers may help focus dissemination and implementation efforts on both members of a dyad and improve outcomes for both.
乳腺癌患者及其非正式护理人员经常报告心理社会、人际关系和身体健康需求未得到满足。二元干预可能会改善患者和护理人员的结局，但很少有干预措施被纳入临床护理或专门为黑人乳腺癌患者及其女性护理人员设计。我们使用健康公平实施框架，通过识别实施通过视频电话会议（如Zoom）提供的二元生存干预的促进因素和障碍来进行传播设计。
我们对18名在综合癌症中心和社区组织担任不同角色的合作者进行了半结构化访谈，以了解对黑人乳腺癌患者及其护理人员实施二元干预的促进因素和障碍。我们使用快速定性分析（在矩阵中综合模板化总结）进行定向内容分析。我们确定了对访谈指南问题的回答模式，并制定了贯穿各领域的主题。
合作者的角色分为四个领域：面向患者的心理健康（33%）、面向患者的身体健康（28%）、研究/管理（28%）和专注于癌症的社区团体（11%）。参与者支持对患有乳腺癌的黑人女性及其女性护理人员进行二元干预。合作者指出，癌症中心的心理社会护理已经通过Zoom提供，并且认为纳入护理人员有好处。总体主题包括……
应用这些研究结果有助于应对在临床环境中对患有乳腺癌的黑人女性及其护理人员实施二元生存干预的挑战。扩展诸如健康公平实施框架等模式以纳入护理人员，可能有助于将传播和实施工作重点放在二元组的两个成员身上，并改善双方的结局。
