The development and evaluation of a web-based complex intervention: The caring for couples coping with colorectal cancer “4Cs: CRC” program

OBJECTIVE: This article aims to systematically present the completed process of developing and evaluating a web-based complex intervention called ‘Caring for Couples Coping with Colorectal Cancer “4Cs: CRC” program’; summarize the findings of this integrated supportive program; and provide valuable experience and suggestions for future interventions. METHODS: The integrated 4Cs: CRC program was guided by the Medical Research Council (MRC) framework, which has widely been used to develop and evaluate complex interventions. Three stages were completed for the program development, namely: (1) developing a complex intervention; (2) assessing feasibility; and (3) evaluating the complex intervention. RESULTS: Based on a series of interactive studies and a dyadic theoretical framework, the 4Cs: CRC program was developed into an integrated supportive six-week program that includes five weekly web-based interventions, as well as three biweekly face-to-face sessions. In particular, an online platform was designed to provide web-based interventions for couples facing colorectal cancer (CRC). Both the pilot study and qualitative process evaluation showed the program's preliminary feasibility, acceptability, and effectiveness. CONCLUSIONS: Under the guidance of the MRC framework, the 4Cs: CRC program was developed based on multiple interacting components. The program was initially proven to be feasible, acceptable, and effective at supporting CRC couples in mainland China, but requires further improvements according to the qualitative process evaluation results. More importantly, a full-scale randomized controlled trial is required to further explore the program's effectiveness in a wider population.