The Development And Evaluation Of A WeChat-based Couples Coping Focused Supportive Intervention For Couples Coping With Colorectal Cancer As Dyads

Objective: To develop a WeChat-based supportive platform focusing on colorectal cancer(CRC)couples cope with cancer(Caring for CRC Couples Coping with Cancer,4Cs:CRC)as dyads;and then to develop a 4Cs:CRC supportive intervention using the WeChat-based platform;finally,to test the feasibility and preliminary efficacy of the WeChat-based 4Cs:CRC supportive intervention.Methods: Under the guide of the P-LLCF(a preliminary Live with Love Conceptual Framework),basing on the content of 4Cs(Caring for Couples Coping with Cancer)program and combining the previous qualitative research on CRC couples’ needs,we researched English and Chinese literature focused on Internet-based interventions and held an expert consultation meeting,in order to develop and refine the 4Cs:CRC WeChat-based supportive platform.Then using the WeChat-based supportive platform and following the experience of the previous 4Cs program to develop the 4Cs:CRC intervention.Finally,the feasibility and effectiveness of the WeChat-based 4Cs:CRC intervention was tested using a single-arm pre-post feasibility study design and quantitative and qualitative mixed-methods approach.Results:(1)The WeChat-based platform included six modules: Dyadic Learning Sessions,Healthy Information,Leisure Moment,Online Support,Sharing Circle and Personal Center(Me).The platform mainly provided couple-based dyadic guidance sessions,healthy education information,skill-building,and online communication support for CRC patients and their spousal caregivers.(2)The 4Cs:CRC intervention used an integrated approach combining WeChat-based and in-person delivery to support CRC couples,the WeChat-based platform provided online support contents throughout the intervention period(6 weeks).In addition,three face-to-face couple-based dyadic guidance sessions provided related skills helping couples cope with CRC together,and the contents of which were revised and improved based on the previous 4Cs program.(3)A total of 85 CRC couple dyads participated in the feasibility study,of which 69 dyads completed the intervention.The recruitment rate of the intervention was 72%,the overall completion rate of the intervention was 81.2%,and the average score of satisfaction items were 5.2-6.0(each item scores 1-7),which indicated the feasibility of the intervention.The overall effect sizes of the preliminary effect ranged from small to moderate for both CRC patients and their spousal caregivers(d=0.06-0.40).Quantitative results showed that the self-efficacy,cancer-related communication,dyadic coping,depression,and benefit-finding were improved for both patients and their partners.Furthermore,improvements in the mental component summary of SF-12 and caregiver burden were found for spousal caregivers,and positive improvements in CRC-specific QOL(quality of life)in symptom and functional domains for patients were observed.These preliminary findings verified the feasibility of this intervention.In addition,the results of the qualitative interview showed that participants’ good feedbacks on their feelings and experience of participating the program and using the WeChat-based platform,and they showed favorable comments on the program.Conclusions: In this study,we developed a WeChat-based supportive platform for CRC couples,constructed the WeChat-based 4Cs:CRC supportive intervention,and tested the feasibility and preliminary effectiveness of this intervention.Following further refinement based on the participants’ suggestions and comprehensive intervention evaluation,the optimal effect of the intervention may be examined in the future research,so that directing for the clinical application and promotion of the 4Cs:CRC intervention mode.