Couples coping with cancer together: Successful implementation of a caregiver program as standard of care

OBJECTIVE: The couples coping with cancer together program (CCCT) is used to illustrate practical strategies to implement, evaluate, and grow a successful couples-based program in an NCI-designated CCC. CCCT is multimodal program utilizing psychoeducational, strategic, strengths-based, and problem-solving theoretical frameworks. CCCT integrates multiple intervention modalities, as the standard of care: patients/partners biopsychosocial screening, a standardized psychoeducational session, group intervention, and short-term couples counseling. METHODS: Implementation strategies included: (a) identifying Values-Benefits-Outcomes for key stakeholders, (b) recruiting an interdisciplinary team, (c) utilizing a concurrent development model (implementing program components in small iterations), (d) integrating program into existing institutional processes, and (e) collecting data and credibility. RESULTS: CCCT prospectively screened 1995 patients/partners simultaneously for biopsychosocial distress and 913 patient/partner completed program evaluations. Program satisfaction was extremely high: "I recommend this program, for other patients/partners (Patients 95.4% Partners 96.4%)." Ten of the 11 participating physicians anonymously surveyed responded and indicated 100% likely/very likely "to recommend the program to other physicians." CONCLUSIONS: Couples-based programs are underutilized and have been shown to be important for adjustment and increased longevity. Despite barriers in the healthcare environment, implementing couples-based programs into standard of care are feasible. These strategies may be applicable to develop supportive care programs in various health-care settings.