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This summary is machine-generated.

This study piloted a stepped-care approach for cancer self-management support, finding a 3-step intervention beneficial for patients and caregivers. Further testing is warranted for this dyadic support model.

Keywords:
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Area of Science:

  • Oncology
  • Behavioral Science
  • Clinical Trials

Background:

  • Self-directed interventions offer cost-effective cancer patient and caregiver support.
  • Barriers can hinder adherence and efficacy of these interventions.
  • Optimizing delivery is key for patient and caregiver self-management.

Purpose of the Study:

  • To pilot a Sequential Multiple Assignment Randomized Trial (SMART).
  • To develop a time-varying dyadic self-management intervention using a stepped-care approach.
  • To optimize the delivery of the Coping-Together intervention for cancer patients and caregivers.

Main Methods:

  • 48 cancer patient-caregiver dyads were randomized.
  • Stage 1: Coping-Together (workbook/booklets) vs. Coping-Together + telephone guidance.
  • Stage 2: Re-randomization for non-responders to continue or step-up intervention.

Main Results:

  • Feasible and acceptable: low refusal/attrition rates, high booklet helpfulness.
  • Telephone guidance improved adherence; self-directed format showed greater benefit in Stage 1.
  • Stepped-up participants in Stage 2 showed benefits, particularly patients.

Conclusions:

  • A 3-step dyadic self-management support approach shows promise.
  • The stepped-care model warrants further investigation.
  • Optimized intervention delivery can enhance patient and caregiver outcomes.