Process evaluation of the Cancer Home-Life Intervention: What can we learn from it for future intervention studies?

Karen la Cour*, Lisa Gregersen Oestergaard, Åse Brandt, Sara Marie Hebsgaard Offersen, Line Lindahl-Jacobsen, Malcolm Cutchin, Marc Sampedro Pilegaard

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: The Cancer Home-Life Intervention showed no significant effects, and examination of the processes affecting or inhibiting outcomes is relevant. Aim: To evaluate the Cancer Home-Life Intervention for its processes of implementation, mechanisms of impact and contextual factors. Design: Process evaluation conducted alongside the randomised controlled trial, using quantitative and qualitative methods (ClinicalTrials.gov NCT02356627). The Cancer Home-Life Intervention is a tailored, occupational therapy–based programme. Setting/participants: This study took place in participants’ homes and at hospital. A total of 113 home-dwelling adults (⩾18 years) with advanced cancer who had received the Cancer Home-Life Intervention were included, together with five intervention-therapists. Results: All 113 participants (100%) received a first home visit; 32 participants (26%) received a second visit; and 4 participants (3%) received a third visit. Median number of delivered intervention components were 3 (interquartile range: 2; 4). Identified barriers for effect included unclear decision process for intervention dosage; participants’ low expectations; participants’ lack of energy; and insufficient time to adopt new strategies. The trial design constituted a barrier as the intervention could only be provided within a specific short period of time and not when relevant. Intervention components working to solve practical everyday problems, enhance enjoyment and increase a sense of safety were perceived as useful. Conclusion: Future interventions can benefit from inclusion criteria closely related to the intervention focus and clear procedures for when to continue, follow-up and terminate intervention. Decisions about dose and timing may benefit from learning theory by taking into account the time and practice needed to acquire new skills.

Original languageEnglish
JournalPalliative Medicine
Volume34
Issue number10
Pages (from-to)1425-1435
ISSN0269-2163
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Activities of daily living
  • health care
  • independent living
  • neoplasms
  • occupational therapy
  • process assessment

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