|1R34CA283408-01 Interpret this number
|University Of Rochester
|Adapting the Focus Program for Sexual and Gender Minority (SGM) Cancer Patients and Caregivers
The goal of this project is to adapt the empirically-validated FOCUS intervention and test its feasibility and
acceptability among sexual and gender minority (SGM) cancer patients and their caregivers. SGM cancer
patients face unaddressed challenges that adversely impact their quality of life (QOL), including minority stress,
or the chronic stress engendered by living with a stigmatized SGM identity. Furthermore, caregivers of SGM
patients are often not acknowledged in healthcare systems primarily designed to serve heterosexual/cisgender
(H/C) patients; resources for caregivers of H/C patients often do not address their needs; SGM patients may be
more likely to rely on SGM friends or ex-partners as caregivers; and these diverse SGM caregivers may be
affected by minority stress in cancer care settings. Psychoeducational interventions are needed to address these
disparities and improve the QOL of SGM cancer patients and their caregivers together. The FOCUS intervention
uses both psychoeducation and problem solving to improve QOL, coping, and self-efficacy in cancer patients
and their caregivers, and has been shown to be efficacious in three prior clinical trials. However, as noted by our
SGM community partners, the LGBT Cancer Action Council (CAC), its content has not been tailored to SGM
relationships. Consequently, we propose to adapt the evidence-based FOCUS Program for SGM cancer
patients and their caregivers (Aim 1). In collaboration with the LGBT CAC and guided by the transtheoretical
SGM-affirmative adaptation model and ADAPT-ITT framework, we will conduct 6 focus groups with ≥24 SGM
cancer patients and their ≥24 caregivers to “theater test” FOCUS and elicit qualitative feedback about adaptation.
We will also elicit feedback from our panel of 5 topic experts in SGM research, and create a manualized, adapted
intervention called FOCUS-SGM. We will then assess the feasibility and acceptability and explore potential
outcomes of the adapted FOCUS-SGM intervention in a two-arm pilot trial (Aim 2). We will randomize 80
SGM cancer patients and their caregivers (total N≥160) to either FOCUS-SGM or a waitlist control. Assessment
of patients and caregivers will occur at baseline, post-intervention, and at a 3-month follow-up (~6 months
after baseline). We hypothesize that it will be feasible to recruit a sample of SGM cancer patients and caregivers
through clinic, community, and online approaches; at least 80% of SGM patients and caregivers will be highly
satisfied with the content and delivery of FOCUS-SGM; 75% will complete 3 or more FOCUS-SGM sessions;
and 75% will complete post-intervention and 3-month follow-up assessments. We will also explore whether
potential outcome measures (QOL, coping, self-efficacy to manage cancer, relationship communication, and
minority stress) are responsive to the effect of FOCUS-SGM versus control. This grant represents a critical step
in preparing our team to conduct a definitive trial of FOCUS-SGM, responds to community and NCI priorities,
and has potential to address QOL disparities in SGM populations.
Satisfaction with care, general health, and mental health among sexual and gender minority cancer survivors: Results of the OUT National Cancer Survey.
, Gada U.
, Lyerly R.
, Scout N.F.N.
Cancer, 2023-12-20; , .