# A Culturally Congruent Psychosocial Intervention for Latino Caregivers of Children with Cancer: Formative Evaluation and Preliminary Efficacy

## TL;DR

A community-developed psychosocial program for Latino families of children with cancer improved emotional well-being and health literacy, and was well-received by participants.

## Contribution

The study introduces a culturally congruent, community co-developed intervention for Spanish-speaking Latino caregivers of children with cancer.

## Key findings

- Health literacy doubled from pre- to post-intervention and remained high at 3 months.
- Emotional distress decreased significantly and was sustained at 3 months post-intervention.
- Participants reported high satisfaction with the intervention.

## Abstract

What are the main findings?

A community co-developed intervention to address quality of life in Spanish-speaking families impacted by childhood cancer was feasible, evidenced by high consent and adherence rates, and well-liked and well-received by families.

The community co-developed intervention was associated with increases in emotional well-being, improvements in health literacy, and high satisfaction ratings.

What are the implication of the main findings?

Effectively engaging with community members can result in a culturally congruent intervention that is well-received and relevant for Spanish-speaking families impacted by childhood cancer.

The Corazones intervention was well-received and associated with improvements in quality of life outcomes for Latino families and can serve as a model for engaging community to address cancer health disparities.

Background: Parents of children with cancer experience significant psychological distress that is associated with poorer health outcomes. A recent review of caregiver interventions illustrated none targeting Latino parents of children with cancer and a significant need for culturally congruent intervention approaches. Aims: Following our first paper in this issue describing the development of a community co-developed intervention to address psychosocial outcomes in Spanish-speaking Latino families impacted by childhood cancer, this second paper describes the formative evaluation and exploratory analysis of preliminary efficacy in a single-arm pre–post trial. Methods: A total of 32 Spanish-speaking Latino parents/caregivers of children with cancer received the 12-session intervention targeting health literacy, culturally congruent care, and caregiver well-being. Quantitative measures of health literacy and emotional well-being were collected at baseline, post-intervention, and 3 months post-intervention and mixed methods formative evaluation data were collected immediately post-intervention. Results: Mixed methods formative evaluation showed that the intervention was useful, helpful, and relevant. Exploratory preliminary efficacy data using a non-parametric Friedman test showed that health literacy doubled from pre- (33%) to post-intervention (67%) and was sustained at 3 months (X2(2) = 12.52, p = 0.002; Cohen’s d = 0.65). Repeated measures ANOVA showed that emotional distress decreased significantly from baseline to immediately post-intervention with sustained treatment effects at 3 months post-intervention (F(2,62) = 4.37, p = 0.046; Cohen’s d = 0.42). Satisfaction scores were well above treatment acceptability (M = 39.13, SD = 2.80). Conclusions: Implementation of a community co-developed intervention with the goal of achieving cultural congruency was feasible, likeable, and relevant for Spanish-speaking Latino parents and caregivers of children undergoing treatment for cancer. Moreover, the exploratory analysis showed the intervention was associated with improvements in health literacy and emotional well-being and high levels of treatment satisfaction.