Two in five Canadians can expect to be diagnosed with cancer. Despite detection and treatment improvements, a cancer diagnosis still exposes patients to a wide range of complex physical and psychosocial challenges. With increased reliance on outpatient treatments and decreased health care resources, the responsibility for the day-to-day management of these challenges falls principally on patients and their family caregivers. Family caregivers have become central to providing the support patients need during the illness. In fact, cancer is the second most common condition in Canada requiring assistance from caregivers. Caregivers' support reduces the demand on the healthcare system and helps patients adjust to the disease. However, caregivers often receive little formal training, resulting in high burden.
Since both patients and caregivers are affected by the disease and need help to tackle cancer challenges, much attention has been paid to the development of coping skills and self-management interventions delivered jointly to patients and caregivers (dyadic interventions). High-quality dyadic interventions greatly benefit patients' and caregivers' health and well-being. Some dyadic interventions have been more effective than patient-only interventions, which shows how much patients' outcomes depend on well-prepared family caregivers.
But three challenges remain. First, most dyadic interventions are time- and people-intensive, making them too costly for the health system's limited resources. This calls for more sustainable and accessible delivery methods. Second, most intervention studies exclude patients and caregivers from culturally and linguistically diverse backgrounds, despite evidence that they have worse health and well-being outcomes than non-diverse groups. Third, evaluating cancer self-management interventions requires measures that are sound. However, the use of multiple measures to assess the same outcome and lack of testing of some measures used with caregivers threatens the extent to which intervention effects are appropriately captured.
The proposed research program addresses each of these challenges through six inter-related studies.