Background: Chinese-Australian immigrants with cancer face myriad psychosocial challenges and unmet needs. A self-management resource (WeCope) was developed to empower patients and caregivers to address these challenges. However, conducting cancer research with immigrant populations can be time and resource intensive, and establishing intervention and study methods feasibility is crucial. This mixed methods study aimed to explore the feasibility (intervention usage, practicality, and barriers and facilitators for applying self-management suggestions from WeCope) and acceptability (relevance and usefulness) of WeCope as an intervention among Chinese-Australian immigrants.
Methods: Adult patients (age ≥18 years) diagnosed with cancer in the past year; immigrated to Australia from a country with Mandarin/Cantonese as their spoken language; able to read Traditional/Simplified Chinese and speak Mandarin/Cantonese; were recruited via local district hospitals from May 2021 to April 2022. Patients were asked to complete a baseline questionnaire (T0), use the WeCope intervention (six booklets and an audio guide) for two months, and complete a post-intervention (T1) questionnaire. Semi-structured telephone interviews exploring engagement with WeCope and its impact were conducted with a sub-set of participants in their preferred language. Follow-up interviews were conducted a month later evaluating continued usage. Transcripts were thematically analysed.
Results: Fifty-eight patients were identified as potentially eligible; 14 (38%) enrolled in the study. Five were lost to follow-up and one excluded due to ineligibility resulting in eight participants. Four of eight participants underwent an interview, with two interviewed again. Themes were generated regarding intervention use (individual needs guided WeCope use, technological limitations impede engagement), acceptability (validating their experience; booklets offer general guidance), and practicality (optimising their situation, being prepared, returning to normality). Engagement with WeCope varied: 4/5 participants read less than half of the booklets; 3/5 rated at least one booklet as relevant; 3/5 listened to less than half of the audio guide. Themes identified barriers to applying self-management suggestions from WeCope (uncertainty and unanswered questions; system barriers hinder support seeking); and facilitators (healthcare system as a conduit for knowledge and support; coming together as one community).
Conclusion: While WeCope was perceived as acceptable, feasibility of the intervention was limited. Lingering uncertainty and lengthy waiting times contributed to immigrants’ reluctance to engage with recommended support services. It is therefore vital to consider the practicality of interventions for Chinese-Australian immigrants with a need for greater support from clinicians to facilitate self-management. The importance of social support should also be considered.