Mokuau, N., Braun, K.L., Wong, L.K., Higuchi, P., & Gotay, C.C. (2008). Development of a family intervention for Native Hawaiian women with cancer: A pilot study. Social Work, 53, 9–19.

To determine the feasibility and impact of providing a family-oriented intervention incorporating Hawaiian values on native Hawaiian women with cancer

Recruited patients were randomly assigned to an intervention or control group. The intervention group received sessions of informational and emotional support that incorporated prayer (often done by an elder), participant and staff disclosure of genealogies to affirm spiritual origins, and use of other cultural value items, such as graphics incorporating Hawaiian themes, plant fiber bags for program materials, and sharing of food. Sessions were focused on providing information on cancer basics and understanding of treatment and side effects, as well as information seeking and communication. Sessions included one or two patient-selected family members together. The intervention group had six sessions provided in a variety of locations, including homes, business offices, and libraries. Control group patients received two visits from the research team over three months and were provided with educational brochures and opportunity for having questions answered. Interventions were provided by master’s-prepared social workers.

• The sample included 12 participants.
• Mean age of patients was 55 years (intervention group range was 25–76 years; control group range was 48–84 years).
• Mean age of family members was 54 years.
• Patients were 100% female, and family members were 50% male.
• Patients had a variety of cancer types, including breast, ovarian, throat, uterine, lung, and lymphoma.
• Family members were primarily spouses and adult children.

Hawaii

A randomized prospective trial design was used.

• Cancer knowledge assessment (author developed)
• 12-item self-efficacy scale (author developed) (α = 0.91)
• Family Crisis-Oriented Personal Evaluation Scale (F-COPES)
• Brief Symptom Inventory (BSI)

In the intervention group, women showed significant improvement in F-COPES and decrease in BSI scores (p < 0.05). Family members also reported significant increase in self efficacy (p < 0.01) and F-COPES scores (p < 0.01). Women in the control group did not show change on any indicators, and their family members showed significantly poorer F-COPES total scores (p < 0.05).

Provision of a culturally relevant support intervention appeared to have a positive effect on Hawaiian patients and family members coping with cancer.

• The sample was small, with less than 30 participants.
• No specific diagnostic or symptom information was provided. Differences in these between groups can be expected to have substantial influence on outcomes of interest in this study.
• No demographic information was provided.
• No information regarding the stage of disease or phase of care was provided, another set of items that can be expected to influence outcomes.
• There was no appropriate attentional control, as control subjects received much less intervention time and content than the intervention group.

This study points to the need to consider provision of supportive interventions that are designed according to specific cultural values of participants. This particular study has a number of methodologic and reporting issues that limit the usefulness of findings.