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Marshall CA, Curran MA, Trejo J, Gonzalez AA, Armin J, Hamann HA, Badger TA, Garcia FAR. The Evolution of Un Abrazo Para La Familia: Implications for Survivors of Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1075-1080. [PMID: 32239477 DOI: 10.1007/s13187-020-01737-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Un Abrazo Para La Familia™ (Abrazo) is a 3-h modular preventive intervention designed for low-income caregivers who are co-survivors of cancer. Here we (1) consider the benefit to survivors of cancer, that is, the care recipients who participate in Abrazo; (2) summarize the literature specific to research outreach to low-income, underserved populations when they are faced with cancer; and (3) describe current steps being taken in Southern Arizona to reach these populations via Abrazo. Specific to considering the benefit to care recipients, we analyzed care recipient data derived from three existing cohorts of Abrazo participants. Analyses of the combined cohorts of these data demonstrate that Abrazo is effective with care recipients given statistically significant higher cancer knowledge and self-efficacy scores, pre- vs. post-intervention. We can now report benefit to care recipients who participate in Abrazo. This allows us, with confidence, to expand research recruitment efforts to include care recipients as part of the Abrazo intervention in our efforts to serve low-income, underserved populations when faced with cancer.
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Affiliation(s)
- Catherine A Marshall
- Department of Disability and Psychoeducational Studies, The University of Arizona, Tucson, AZ, USA.
| | - Melissa A Curran
- Department of Family Studies and Human Development, Tucson, AZ, USA
| | - Juanita Trejo
- Un Abrazo Para La Familia, The University of Arizona, Tucson, AZ, USA
- Department of Psychology, The University of Arizona, Tucson, AZ, USA
| | - Alma A Gonzalez
- Department of Disability and Psychoeducational Studies, The University of Arizona, Tucson, AZ, USA
- Un Abrazo Para La Familia, The University of Arizona, Tucson, AZ, USA
| | - Julie Armin
- Department of Family and Community Medicine, The University of Arizona, Tucson, AZ, USA
| | - Heidi A Hamann
- Department of Psychology, The University of Arizona, Tucson, AZ, USA
| | - Terry A Badger
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, The University of Arizona, Tucson, AZ, USA
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Marshall CA, Curran MA, Brownmiller G, Solarte A, Armin J, Hamann HA, Crist JD, Niemelä M, Badger TA, Weihs KL. Oregon's Familias en Acción replicates benefits for underserved cancer co-survivors through Un Abrazo Para la Familia. Psychooncology 2018; 27:2405-2411. [PMID: 30047167 DOI: 10.1002/pon.4841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/12/2018] [Accepted: 07/15/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Our goal in this study was to determine if we could replicate initial findings when providing the intervention, Un Abrazo Para La Familia ("Abrazo"). Abrazo is a community-focused psychoeducational preventive intervention addressing the cancer information and coping needs of low-income, underserved family members of cancer survivors, developed and first implemented in Tucson, Arizona. METHODS We used a preintervention and postintervention evaluation design to assess the effectiveness of replicating the Abrazo intervention with underserved Hispanic/Latino family members facing cancer as co-survivors. We describe lessons learned in an expansion of Abrazo from one region of the United States to another. RESULTS Portland promotoras demonstrated that when the Abrazo intervention is provided via a culturally congruent, accessible format, the significant gains in cancer knowledge and self-efficacy reported by underserved co-survivors can be replicated. This is important because Oregon represents a US region different from Abrazo's origins in the Southwest. CONCLUSION Our replication study provides a useful roadmap for others focusing on the psychosocial needs of Hispanic/Latino cosurviving family members of cancer. A manualized 12-hour training program based on the initial discovery and efficacy work was developed to train promotoras as a part of this study. The manual provides a clear protocol for others to replicate our intervention and evaluation procedures. Abrazo may be particularly important for family-centered care if the family does not have the cancer knowledge or self-confidence needed to fully participate.
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Affiliation(s)
- Catherine A Marshall
- Department of Disability and Psychoeducational Studies, The University of Arizona, Tucson, AZ, USA
| | - Melissa A Curran
- Department of Family Studies and Human Development, The University of Arizona, Tucson, AZ, USA
| | | | | | - Julie Armin
- Department of Family & Community Medicine, The University of Arizona, Tucson, AZ, USA
| | - Heidi A Hamann
- Departments of Psychology and Family & Community Medicine, The University of Arizona, Tucson, AZ, USA
| | - Janice D Crist
- College of Nursing, The University of Arizona, Tucson, AZ, USA
| | - Mika Niemelä
- Department of Psychiatry, Oulu University Hospital and Center for Life Course Health, Research, University of Oulu, Oulu, Finland
| | - Terry A Badger
- College of Nursing and Department of Psychiatry, The University of Arizona, Tucson, AZ, USA
| | - Karen L Weihs
- Department of Psychiatry, The University of Arizona, Tucson, AZ, USA
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Niemelä M, Marshall CA, Kroll T, Curran M, Koerner SS, Räsänen S, García F. Family-Focused Preventive Interventions With Cancer Cosurvivors: A Call to Action. Am J Public Health 2016; 106:1381-7. [PMID: 27196647 DOI: 10.2105/ajph.2016.303178] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Health promotion and preventive action in the context of public health interventions for highly prevalent, long-term conditions such as cancer are rarely geared toward the family as a whole. Yet family members, as cancer cosurvivors, must manage their own substantial stress and multiple caregiving responsibilities and often constitute a critical nexus between individual patients and clinicians. We drew on 2 examples of cancer cosurvivorship from 2 different health service contexts, the United States and Finland. A systemic approach in public health is needed to support family members who not only have to confront the meaning of long-term conditions such as cancer but also may have to manage concurrent social life challenges and stressors such as economic hardship.
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Affiliation(s)
- Mika Niemelä
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Catherine A Marshall
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Thilo Kroll
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Melissa Curran
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Susan Silverberg Koerner
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Sami Räsänen
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Francisco García
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
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Marshall CA, Curran MA, Koerner SS, Kroll T, Hickman AC, García F. Un Abrazo Para La Familia: an evidenced-based rehabilitation approach in providing cancer education to low-SES Hispanic co-survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:626-33. [PMID: 24347436 PMCID: PMC4062619 DOI: 10.1007/s13187-013-0593-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We discuss Un Abrazo Para La Familia as an effective, rehabilitation-informed evidence-based model of education, information-sharing, and skill teaching for use with low-income Hispanic co-survivors of cancer. Over 2 years, 120 co-survivors participated in the intervention. The majority of participants (96 %) were women and all but one reported being Hispanic. Both in years 1 and 2, we followed the same pre- and post-intervention evaluation design. Based on pre- and post-intervention assessments of cancer-related knowledge and self-efficacy, the percentage of questions answered correctly about cancer significantly increased for co-survivors. Self-efficacy significantly increased as well. Using item analysis, we explored skill teaching as a mechanism for the effective delivery of Un Abrazo and recommend the use of promotoras in providing the intervention. Of the 12 cancer knowledge items resulting in statistically significant increases of cancer knowledge, 5 were taught via interactive skill teaching. Given the projected rise in the incidence of cancer in Hispanic populations, coupled with the fact that people from low-income backgrounds face unique challenges in cancer prevention and management, implications of the Un Abrazo model for future research and policy regarding cancer and families are considered.
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Affiliation(s)
| | - Melissa A. Curran
- Family Studies and Human Development University of Arizona 650 N. Park McClelland Park Tucson, AZ 85721-0078
| | - Susan Silverberg Koerner
- Department of Human & Community Development University of Illinois at Urbana-Champaign 226 Bevier Hall, M/C 180 Urbana, IL 61801
| | - Thilo Kroll
- Co-Director Social Dimensions of Health Institute (SDHI) University of Dundee and St Andrews School of Nursing & Midwifery University of Dundee
| | - Amy C. Hickman
- Rhetoric and Composition Department of English University of Arizona, Tucson, AZ 85721
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