Adapting a preparatory skills-building program for carers of people with cancer through co-design: The iCanSupport Project.

Introduction: Health services rely upon carers to provide care for a loved one with cancer, yet carers often feel ill-prepared for this role. Despite a multitude of programs to support carer mental health, programs that help carers feel better equipped to support a person with cancer are lacking. This study aimed to address this need by adapting an evidence-based intervention to be suitable for carers of people with cancer. Methods: The study used an exploratory, qualitative design consisting of experienced-based co-design and an in-depth stakeholder engagement strategy. An existing evidence-based program to promote resilience in the context of providing care was adapted for relevance to carers for people with cancer via two co-design workshops with carers and health professionals (n=8). The resulting prototype program was refined based on stakeholder consultations with staff and consumer members of cancer and carers support organisations across Australia (n=16). Transcripts of the workshops, meetings and written feedback from carers were thematically analysed. Results: Major program developments were guided by three themes which emerged in the co-design workshops: “creating value for carers”, “multiple contributors to carer distress”, and “the need for flexible implementation”. Analysis of the stakeholder consultation data showed that the themes of: “diversity in carer journeys” and “creating impact for carers” were key to further tailoring the program for applicability to practice. An adapted program called “iCanSupport” resulted from the process, with key adaptations being more relevant case study scenarios for carers, and greater flexibility in the process of accessing and engaging with the intervention to accommodate a range of carer circumstances. Conclusion: Programs to build skills for becoming a carer for someone with cancer are absent, yet desired by carers. Using co-design provided a user-centric approach to make adaptations to an existing evidence-based program. Program evaluation is required to determine the effectiveness of the co-designed approach for improving carer preparedness among a range of cohorts.