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Symposium

LGBTQIA+

Moving Toward Equitable Implementation of Behavioral Interventions for LGBTQ Populations

2 - (SYM 2) FOCUS on Us: Using LGBTQ Community Feedback to Adapt a Cancer Caregiving Intervention

Thursday, June 25, 2026
9:57 AM - 10:18 AM PDT
Location: Golden Gate C2, B2 Level
Keywords: L / G / B / T, Health Psychology, Couples / Close Relationships
Abstract Body

LGBTQ cancer patients and their caregivers experience disparities in cancer-related health outcomes, including health-related quality of life (QOL). Evidence-based psychoeducational and behavioral interventions to improve QOL often do not address LGBTQ-specific needs, limiting their real-world reach. Using the ADAPT-ITT framework, community stakeholders identified improving LGBTQ cancer patient/caregiver QOL as a priority and identified the dyadic FOCUS program as their preferred intervention. FOCUS was originally a nurse-led psychoeducational and behavioral intervention conducted over 5 in-person and phone-based sessions with both patients and caregivers together. We conducted 10 “theater test” focus groups with LGBTQ cancer survivors and caregivers (N = 52) to obtain suggestions for adapting the FOCUS program and enhancing its reach to LGBTQ survivors and caretakers. During the focus groups, participants were shown existing FOCUS materials and asked to provide feedback based on their personal experiences with cancer. We transcribed and coded focus group data and synthesized participants’ feedback. Participants suggested several adaptations of the FOCUS program content to better address LGBTQ cancer-related needs, including: acknowledging patients’ “chosen family”; providing information about legal issues to support unmarried partners; recognizing the impact of minority stress on psychological distress; discussing how to find LGBTQ resources, support, and health information when providers cannot answer LGBTQ-specific questions; and empowering to advocate for oneself in the face of non-affirming care. Transgender and nonbinary participants in particular recommended providing information on gender affirming care during cancer treatment and recognizing the potential impact of treatment on body image and gender identity. Participants also suggested modifications to the intervention format, including time for the patient and the caregiver to meet with the interventionist separately, delivering the intervention virtually over Zoom to improve accessibility, and having an LGBTQ or allied interventionist lead the sessions. Overall, participants endorsed the FOCUS program as a potentially efficacious intervention and provided specific modifications to meet the needs of LGBTQ cancer survivors and caregivers. Culturally-specific adaptations are not only important for establishing intervention effectiveness but also in ensuring future implementation efforts reach patients who need the most support.