Objectives/purpose
Cancer carers experience high levels of distress and caregiving strain, yet pathways to identify and manage their psychosocial needs remain limited. We developed and are evaluating the CarersCanADAPT Pathway, an online distress screening and stepped care model for Australian cancer carers. Positioned adjacent to cancer services, the Pathway connects carers to community, government, and online resources. We report on the first 8 months of the CarersCanADAPT study.
Sample and setting
Australian family/friend carers of an adult previously diagnosed with cancer were recruited via social media, advocacy groups, and hospital clinics.
Procedures
After consent and baseline measures, participants accessed an online portal to complete screening using the Distress Thermometer (DT) and 6-item Supportive Care Needs Survey – Partners & Carers. Those scoring ≥4 on the DT completed the GAD-7 and PHQ-9. Based on distress levels, carers were allocated to one of four steps: Step 1 (low distress, Cancer Council resources), Step 2 (non-psychological distress, Cancer Council and Government resources), Step 3 (mild-moderate symptoms of anxiety/depression, online CBT), or Step 4 (severe anxiety/depression, referral to GP/psychologist).
Results:
Between Nov 2024 and May 2025, 110 carers completed screening. Most were female (85%), spouses (71%), and caring for someone with advanced cancer (60%). Mean DT was 5/10. Over half (58%) reported symptoms consistent with anxiety or depression and were allocated to Steps 3 or 4. Common unmet needs included emotional support for themselves (69%), managing caregiving’s impact on work and activities (48%), and accessing carer-relevant information (47%). Implementation outcomes of the Pathway are being concurrently evaluated.
Conclusion and clinical implications
This interim reporting demonstrates the feasibility and early utility of an online screening and stepped care pathway for carers. The model addresses key health system barriers and shows promise for scalable, community-linked psychosocial support. Future integration with oncology services will be discussed.