Developing a national implementation strategy to accelerate uptake of evidence-based family caregiver support in U.S. cancer centers

J Nicholas Odom; Heather M Young; Katherine Sterba; Timothy S Sannes; Susan Reinhard; Chandylen L Nightingale; Diane Meier; Tamryn F Gray; Betty Ferrell; Maria E Fernandez; Heidi Donovan; Kayleigh Curry; Erin R Currie; Tara Bryant; Marie A Bakitas; Allison J Applebaum

doi:10.1002/pon.6221

Developing a national implementation strategy to accelerate uptake of evidence-based family caregiver support in U.S. cancer centers

Psychooncology. 2024 Jan;33(1):e6221. doi: 10.1002/pon.6221. Epub 2023 Sep 25.

Authors

J Nicholas Odom^{1

2

3}, Heather M Young⁴, Katherine Sterba⁵, Timothy S Sannes⁶, Susan Reinhard⁷, Chandylen L Nightingale⁸, Diane Meier⁹, Tamryn F Gray¹⁰, Betty Ferrell¹¹, Maria E Fernandez¹², Heidi Donovan¹³, Kayleigh Curry¹, Erin R Currie¹, Tara Bryant¹⁴, Marie A Bakitas^{1

2

3}, Allison J Applebaum¹⁵

Affiliations

¹ School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA.
² Division of Geriatrics, Gerontology, and Palliative Care, UAB Department of Medicine, Birmingham, Alabama, USA.
³ UAB Center for Palliative and Supportive Care, Birmingham, Alabama, USA.
⁴ Betty Irene Moore School of Nursing, University of California, Davis, Davis, California, USA.
⁵ Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
⁶ UMass Memorial Cancer Center, Worcester, Massachusetts, USA.
⁷ AARP Public Policy Institute, Washington, District of Columbia, USA.
⁸ Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
⁹ Mount Sinai Medical Center, New York, New York, USA.
¹⁰ Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
¹¹ City of Hope, Duarte, California, USA.
¹² Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA.
¹³ Schools of Nursing and Medicine, and the National Rehabilitation Research & Training Center on Family Support, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
¹⁴ Viva Health, Inc., Birmingham, Alabama, USA.
¹⁵ Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Abstract

Objective: Characterize key factors and training needs of U.S. cancer centers in implementing family caregiver support services.

Methods: Sequential explanatory mixed methods design consisting of: (1) a national survey of clinicians and administrators from Commission-on-Cancer-accredited cancer centers (N = 238) on factors and training needed for establishing new caregiver programs and (2) qualitative interviews with a subsample of survey respondents (N = 30) to elicit feedback on survey findings and the outline of an implementation strategy to facilitate implementation of evidence-based family caregiver support (the Caregiver Support Accelerator). Survey data was tabulated using descriptive statistics and transcribed interviews were analyzed using thematic analysis.

Results: Top factors for developing new caregiver programs were that the program be: consistent with the cancer center's mission and strategic plan (87%), supported by clinic leadership (86.5%) and providers and staff (85.7%), and low cost or cost effective (84.9%). Top training needs were how to: train staff to implement programs (72.3%), obtain program materials (63.0%), and evaluate program outcomes (62.6%). Only 3.8% reported that no training was needed. Qualitative interviews yielded four main themes: (1) gaining leadership, clinician, and staff buy-in and support is essential; (2) cost and clinician burden are major factors to program implementation; (3) training should help with adapting and marketing programs to local context and culture; and (4) the Accelerator strategy is comprehensive and would benefit from key organizational partnerships and policy standards.

Conclusion: Findings will be used to inform and refine the Accelerator implementation strategy to facilitate the adoption and growth of evidence-based cancer caregiver support in U.S. cancer centers.

Keywords: cancer; dissemination; family caregiving; implementation.

MeSH terms

Ambulatory Care Facilities
Caregivers*
Health Services
Humans
Neoplasms* / therapy

Grants and funding

P30 CA008748/CA/NCI NIH HHS/United States