Expanding the Support of Family Caregivers of Diverse Patients With Cancer and Diabetes

The AIM is a 4-item, 5-point Likert scale that measures intervention acceptability. The scale measures each statement from 1, "Completely disagree," to 5, "Completely agree." Scale items are averaged to produce a mean score. The AIM takes approximately 2 minutes to complete by caregivers.

The Coping Self-Efficacy Scale is a 26-item, 10-point ordinal scale that measures caregiver coping and self-efficacy ability. Subjects are asked to self-score their confidence in each prompt on a scale from 0 (Cannot do at all) to 10 (Certain I can do).

An overall CSES score is created by summing the item ratings (total score range, 0 - 260), with higher scores indicating greater perceived coping self-efficacy. Subjects must answer at least 80% of the scale items. For subjects missing an item or items, an individual's score for the missing item(s) is estimated by adding in their mean for the items that they answered for each item that they skipped, resulting in a "corrected sum." This measure will take approximately 7 - 10 minutes to complete by caregivers.

The Zarit Burden Assessment - Revised is a commonly used, 12-item self-report scale measuring caregiver burden. The Zarit Burden Assessment-Revised has excellent internal consistency (Cronbach's alpha typically ranges from 0.83 to 0.89) and test-retest reliability (typically around 0.71). The measure typically takes 5-10 minutes to completeby caregivers.

The Duke-UNC FSSQ is an 8-item, multidimensional scale measuring perceived social support. Response items are scored from 5 ("as much as I would like") to 1 ("much less than I would like"). The scores from all eight questions are summed for a total score range of 8 to 40, with higher scores indicating higher perceived support. The Duke-UNC FSSQ has demonstrated high reliability and convergent validity. This measure will take approximately 3-5 minutes to complete by caregivers.

The HADS is a 14-item, 4-point, self-report ordinal scale that measures depression and anxiety symptom severity. It is a well-validated and commonly used measure in both ill and healthy populations. It has two sub-scales, each with a total score range of 0 - 21, with higher scores suggesting more symptoms. Current research supports a threshold of 8 or higher as indicative of clinically significant depression or anxiety symptoms. The HADS takes approximately 3-5 minutes to complete by caregivers.

A subset of caregiver subjects will be asked to participate in a post-intervention, semi-structured, exit interview to further evaluate intervention acceptability.

The Karnovsky Performance Scale measures the functional status as it relates to cancer. The patient subject will self-report their current performance status by assessing a single item on an 8-point scale. The Karnovsky Scale takes approximately 2 minutes to complete.

The NCCN Distress Thermometer is a tool developed by the National Comprehensive Cancer Network (NCCN) to help healthcare providers assess and manage distress in cancer patients.

The single-item, 11-point NCCN Distress Thermometer asks subjects to rank their current level of distress on a scale from 0 (no distress) to 10 (extreme distress). This measure takes approximately 2 minutes to complete by patients.

The HADS is a 14-item, 4-point, self-report ordinal scale that measures depression and anxiety symptom severity. It is a well-validated and commonly used measure in both ill and healthy populations. It has two sub-scales, each with a total score range of 0 - 21, with higher scores suggesting more symptoms. Current research supports a threshold of 8 or higher as indicative of clinically significant depression or anxiety symptoms in patient participants. The HADS takes approximately 3-5 minutes to complete by patients.