Feasibility, acceptability, and experienced benefits of kind acts and gratitude letter interventions among collectivist and individualist culture cancer patients and caregivers: A pilot study.

PURPOSE: Cancer is a leading cause of death regardless of cultural background, leading to physical and role changes post-diagnosis, diminishing quality of life. The objective of this randomized pilot study was to evaluate the feasibility, acceptability, and potential efficacy of two positive activity interventions conducted by cancer patients from collectivist and individualist cultures.

METHODS

Thirty-six collectivist or individualist cancer patients undergoing systemic therapy who could identify a caregiver were randomized and engaged in either: (1) contributions to caregiver, (2) gratitude letters to caregiver, or (3) control activities once per week for 3 weeks. Consent, retention, and adherence rates were calculated to assess feasibility; semi-structured interviews were conducted to assess program satisfaction and perceived benefits of the interventions.

RESULTS

The patients' Mage = 49 years, 90 % were married/in a relationship, and all had breast or prostate cancer; collectivists were primarily comprised of Latinos (77.8 %), and individualists, Whites (92.3 %). Feasibility was demonstrated with a 21 % modified consent rate, a 76 % retention rate, and a 75 % adherence rate. Thirteen patient and caregiver interviews were conducted: The contribution activity increased competence and connectedness for collectivists and competence and autonomy for individualists. The gratitude letter helped collectivists express emotions to caregivers and reappraise thoughts and individualists to acknowledge caregiver contributions and their need for help.

CONCLUSIONS

This pilot study demonstrated feasibility, acceptability, and potential efficacy of two positive activity interventions among collectivist and individualist cancer patients. To examine the well-being effect sizes, mechanisms, and appropriate dissemination, future research with larger sample sizes is recommended. This study was registered on ClinicalTrials.gov with ID# NCT04810052.