Strand Two

This strand is employing a staged approach to the design of interventions, based on accurate understanding of need, followed by testing of components, exploratory trials to estimate efficacy and recruitment and only then larger appropriately powered multi-centre trials, to test the efficacy of the complete intervention. The the work of the collaborative members will be coordinated to 'build' interventions that can then be evaluated and rapidly tested in multi-centre trials, using the collaborative as a platform for this. Initial work will be on interventions for emotional distress, where our focus is on delivery of care by non-specialist staff especially oncologists and nurses. Our specific aims are to:

• a) Develop and rigorously evaluate complex interventions for patient's problems.
• b) Develop complex interventions for other problems, initially building on our existing expertise in managing fatigue and breathlessness then moving on to address others.
• c) Study how these interventions can be effective for patients within the context of primary care and hospices including studying the coordination and planning of care.

Current Research

• Literature review undertaken and consensus meeting (including users) on interventions for distress and depression held.
• Current treatments trials of management of distress and depression completed and the implications of their findings explored.
• Studies to address issues arising have been planned and funding for these sought

Future Research

Development work on new interventions for depression and emotional stress commences. This will include pilot studies of elements of intervention to address specific questions including:-

• how the intervention will relate to primary care:
• the oncologist’s role in acting on screening information and what form that information takes (link with strand 1)
• the oncologist’s role in acting on screening information and what form that information takes (link with strand 1)
• Develop training in interpretation and response to screening measures with strand 3)