{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:14:21Z","timestamp":1768954461631,"version":"3.49.0"},"reference-count":46,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["05-K08CA279242-02"],"award-info":[{"award-number":["05-K08CA279242-02"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U54CA163071"],"award-info":[{"award-number":["U54CA163071"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U01CA290613"],"award-info":[{"award-number":["U01CA290613"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["U54MD007579"],"award-info":[{"award-number":["U54MD007579"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH137857"],"award-info":[{"award-number":["R01MH137857"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Practical training and recruitment strategies are critical for the sustainable implementation of psychosocial interventions. However, few studies have examined how to prepare community partners and doctoral students to support culturally adapted psycho-oncology interventions. This pre-pilot study aims first to evaluate two distinct training programs and recruitment procedures, and second to explore preliminary pre-post outcomes of the Caregiver-Patients Support to Cope with Advanced Cancer (CASA) intervention, using the Consolidated Framework for Implementation Research (CFIR). Three clinical psychology graduate students received CASA training, and two community partners completed Recruitment training. We present descriptive pre- and post-assessments, along with qualitative feedback, for both training and institutional (Puerto Rico Biobank) and community-based recruitment outcomes. A related-samples nonparametric analysis examined pre- and post-CASA intervention signals. Results indicated knowledge gains among doctoral students (pre-test M = 3.3; post-test M = 9.3) and community partners (pre-test M = 4.5; post-test M = 9.5). Preliminary outcomes revealed significant improvements in spiritual well-being (Z = \u22122.618, p = 0.009) and quality of life (Z = \u22122.957, p = 0.003) and a reduction in depressive (Z = \u22122.764, p = 0.006), anxiety (Z = \u22122.667, p = 0.008), and distress (Z = \u22122.195, p = 0.028) symptoms following CASA. Of 26 recruited dyads, institutional referrals enrolled 16 dyads (61.5%), while community partners referred 10 dyads with a 90.9% success rate. Findings support the feasibility of both training and CASA exploratory outcomes suggest meaningful psychosocial benefits for Latino dyads coping with advanced cancer. Combining institutional infrastructure with community engagement may enhance sustainability and equitable access to psycho-oncology care.<\/jats:p>","DOI":"10.3390\/ijerph23010116","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:23:56Z","timestamp":1768811036000},"page":"116","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Training and Recruitment to Implement the CASA Psychosocial Intervention in Cancer Care"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0745-7703","authenticated-orcid":false,"given":"Normarie","family":"Torres-Blasco","sequence":"first","affiliation":[{"name":"School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico"},{"name":"Ponce Medical School Foundation Inc., Ponce Research Institute, Ponce 00716, Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7189-7658","authenticated-orcid":false,"given":"Stephanie D.","family":"Torres-Marrero","sequence":"additional","affiliation":[{"name":"School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico"},{"name":"Ponce Medical School Foundation Inc., Ponce Research Institute, Ponce 00716, Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2974-1606","authenticated-orcid":false,"given":"Ninoshka","family":"Rivera-Torres","sequence":"additional","affiliation":[{"name":"School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico"},{"name":"Ponce Medical School Foundation Inc., Ponce Research Institute, Ponce 00716, Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Cort\u00e9s-Cort\u00e9s","sequence":"additional","affiliation":[{"name":"School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico"},{"name":"Ponce Medical School Foundation Inc., Ponce Research Institute, Ponce 00716, Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"P\u00e9rez-De Santiago","sequence":"additional","affiliation":[{"name":"School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico"},{"name":"Ponce Medical School Foundation Inc., Ponce Research Institute, Ponce 00716, Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s10865-017-9892-5","article-title":"Cancer-Related Loneliness Mediates the Relationships between Social Constraints and Symptoms among Cancer Patients","volume":"41","author":"Adams","year":"2018","journal-title":"J. Behav. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.genhosppsych.2025.02.023","article-title":"Existential Distress in Advanced Cancer: A Cohort Study","volume":"94","author":"Philipp","year":"2025","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10880-024-10011-x","article-title":"A Systematic Review of Trajectories ofClinically Relevant Distress Amongst Adults with Cancer: Course and Predictors","volume":"32","author":"Curran","year":"2025","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s12955-025-02357-z","article-title":"Psychosocial Factors Associated with Quality of Life in Cancer Patients Undergoing Treatment: An Umbrella Review","volume":"23","author":"Marzorati","year":"2025","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e70068","DOI":"10.1002\/pon.70068","article-title":"Psychosocial Correlates of Death Anxiety in Advanced Cancer: A Scoping Review","volume":"34","author":"Brown","year":"2025","journal-title":"Psychooncology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1207\/S15324796ABM2401_06","article-title":"Measuring Spiritual Well-Being in People with Cancer: The Functional Assessment of Chronic Illness Therapy\u2014Spiritual Well-Being Scale (FACIT-Sp)","volume":"24","author":"Peterman","year":"2002","journal-title":"Ann. Behav. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1177\/0898010119895368","article-title":"Critical Literature Review on the Definition Clarity of the Concept of Faith, Religion, and Spirituality","volume":"38","author":"Southard","year":"2020","journal-title":"J. Holist. Nurs."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1002\/pon.6038","article-title":"Spiritual Well-Being, Distress and Quality of Life in Hispanic Women Diagnosed with Cancer Undergoing Treatment with Chemotherapy","volume":"31","author":"Barata","year":"2022","journal-title":"Psychooncology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1007\/s10943-020-01147-9","article-title":"Spiritual Well-Being, Depression, and Quality of Life Among Latina Breast Cancer Survivors","volume":"60","author":"Gany","year":"2021","journal-title":"J. Relig. Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3231","DOI":"10.1002\/cncr.31539","article-title":"Individual Meaning-Centered Psychotherapy for the Treatment of Psychological and Existential Distress: A Randomized Controlled Trial in Patients with Advanced Cancer","volume":"124","author":"Breitbart","year":"2018","journal-title":"Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Breitbart, W.S., Butow, P.N., Jacobsen, P.B., Lam, W.W.T., Lazenby, M., and Loscalzo, M.J. (2021). Meaning-Centered Psychotherapy. Psycho-Oncology, Oxford University Press. [4th ed.].","DOI":"10.1093\/med\/9780190097653.001.0001"},{"key":"ref_12","first-page":"23","article-title":"Meaning-Centered Psychotherapy and Cancer: Finding Meaning in the Face of Suffering","volume":"37","author":"Lichtenthal","year":"2020","journal-title":"Psychiatr. Times"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1007\/s11920-014-0488-2","article-title":"Meaning-Centered Psychotherapy: A Form of Psychotherapy for Patients with Cancer","volume":"16","author":"Meier","year":"2014","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_14","first-page":"227","article-title":"Eficacia de La Psicoterapia Centrada En El Sentido En Pacientes Adultos Con C\u00e1ncer Avanzado: Revisi\u00f3n Sistem\u00e1tica y Meta-An\u00e1lisis","volume":"18","author":"Dietrich","year":"2021","journal-title":"Psychooncology"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Torres-Blasco, N., Costas-Mu\u00f1iz, R., Rosario, L., Porter, L., Su\u00e1rez, K., Pe\u00f1a-Vargas, C., Toro-Morales, Y., Shen, M., Breitbart, W., and Castro-Figueroa, E.M. (2022). Psychosocial Intervention Cultural Adaptation for Latinx Patients and Caregivers Coping with Advanced Cancer. Healthcare, 10.","DOI":"10.3390\/healthcare10071243"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e045487","DOI":"10.1136\/bmjopen-2020-045487","article-title":"Cultural Adaptation of Meaning-Centered Psychotherapy for Latino Families: A Protocol","volume":"12","author":"Zamore","year":"2022","journal-title":"BMJ Open"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Torres-Blasco, N., Torres Marrero, S., De Lahongrais-Lamboy, A., Rivera-Torres, N., Rosario-Ramos, L., and Arg\u00fcelles-Berrios, C. (BMC Health Serv. Res., 2025). A Feasibility Study Using the RE-AIM Framework: Healthcare Providers\u2019 and Community Partners\u2019 Perceptions of a Psychosocial Intervention for Latino Patient\u2013Caregiver Dyads Coping with Advanced Cancer, BMC Health Serv. Res., in press.","DOI":"10.1186\/s12913-025-13794-3"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S104","DOI":"10.2105\/AJPH.2025.308029","article-title":"Community Engagement: A Foundation for Health Equity and Resilience","volume":"115","author":"Michener","year":"2025","journal-title":"Am. J. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Moore, R., Callaghan-Koru, J., Vincenzo, J.L., Patton, S.K., Spear, M.J., Riklon, S., Alik, E., Padilla Ramos, A., Takamaru, S., and McElfish, P.A. (2024). External Relationships as Implementation Determinants in Community-Engaged, Equity-Focused COVID-19 Vaccination Events. Front. Health Serv., 4.","DOI":"10.3389\/frhs.2024.1338622"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/s43058-023-00483-7","article-title":"ISCCCE Partnership Implementation of Evidence-Based Primary Cancer Prevention Interventions in MA Community Health Centers: An Explanatory Sequential Mixed Methods Study","volume":"4","author":"Lee","year":"2023","journal-title":"Implement. Sci. Commun."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s11414-021-09767-z","article-title":"Engaging the Community to Effectively Plan and Implement Community-Based Mental Health Programs","volume":"49","author":"McNeish","year":"2022","journal-title":"J. Behav. Health Serv. Res."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Wienert, J., and Zeeb, H. (2021). Implementing Health Apps for Digital Public Health\u2014An Implementation Science Approach Adopting the Consolidated Framework for Implementation Research. Front. Public Health, 9.","DOI":"10.3389\/fpubh.2021.610237"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering Implementation of Health Services Research Findings into Practice: A Consolidated Framework for Advancing Implementation Science","volume":"4","author":"Damschroder","year":"2009","journal-title":"Implement. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"68","DOI":"10.12788\/jcso.0321","article-title":"Distress Management in Cancer Patients in Puerto Rico","volume":"15","year":"2017","journal-title":"J. Community Support. Oncol."},{"key":"ref_25","unstructured":"(2025, November 04). 45 CFR Part 46\u2014Protection of Human Subjects, Available online: https:\/\/www.ecfr.gov\/current\/title-45\/part-46."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.amepre.2021.04.005","article-title":"Methods-Motivational Interviewing Approach for Enhanced Retention and Attendance","volume":"61","author":"Brown","year":"2021","journal-title":"Am. J. Prev. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1177\/0739986320926524","article-title":"Psychometric Analysis and Factor Structure of the Spanish Version of the Eight-Item Patient Health Questionnaire in a General Sample of Puerto Rican Adults","volume":"42","year":"2020","journal-title":"Hisp. J. Behav. Sci."},{"key":"ref_28","first-page":"116","article-title":"Impacto Y Viabilidad De Una Intervenci\u00f3n Con Activaci\u00f3n Conductual Mediante Actividad F\u00edsica Para Sobrevivientes De C\u00e1ncer De Mama","volume":"28","author":"Bernal","year":"2017","journal-title":"Rev. Puertorrique\u00f1a Psicol."},{"key":"ref_29","unstructured":"National Comprehensive Cancer Network (2024). NCCN Guidelines Versi\u00f3n 2. 2024 Instrumento de Malestar Emocional, National Comprehensive Cancer Network."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1200\/JCO.1993.11.3.570","article-title":"The Functional Assessment of Cancer Therapy Scale: Development and Validation of the General Measure","volume":"11","author":"Cella","year":"1993","journal-title":"J. Clin. Oncol."},{"key":"ref_31","unstructured":"(2025, August 25). PR BioBank. PSM-MCC Website. Available online: https:\/\/www.phsu-moffitt.org\/PR-Biobank?lang=sp."},{"key":"ref_32","unstructured":"Corder, G.W., and Foreman, D.I. (2014). Nonparametric Statistics: A Step-by-Step Approach, John Wiley & Sons, Inc.. [2nd ed.]."},{"key":"ref_33","first-page":"943","article-title":"Community Adaptation Strategies To Climate Change: Towards Sustainable Social Development","volume":"21","author":"Suhaeb","year":"2024","journal-title":"Migr. Lett."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Dushkova, D., and Ivlieva, O. (2024). Empowering Communities to Act for a Change: A Review of the Community Empowerment Programs towards Sustainability and Resilience. Sustainability, 16.","DOI":"10.3390\/su16198700"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Bern\u00e1dez, N., Gonz\u00e1lez-C\u00e9sar, M., Lores-Moreno, V., Moriconi, V., Gonz\u00e1lez-Moreno, J., and Cantero-Garc\u00eda, M. (2023). Terapia centrada en el sentido en pacientes oncol\u00f3gicos: Una revisi\u00f3n sistem\u00e1tica. Cuidar, 15\u201327.","DOI":"10.25145\/j.cuidar.2023.03.02"},{"key":"ref_36","first-page":"252","article-title":"Psicoterapia individual centrada en el significado en una paciente con c\u00e1ncer avanzado en cuidados paliativos: Reporte de caso","volume":"28","year":"2021","journal-title":"Med Paliat."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"102646","DOI":"10.1016\/j.ejon.2024.102646","article-title":"Impact of Spiritual Interventions in Individuals with Cancer: A Systematic Review and Meta-Analysis","volume":"71","author":"Izgu","year":"2024","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_38","first-page":"123","article-title":"The Role of Therapist Characteristics in Training Effects in Cognitive, Supportive-Expressive, and Drug Counseling Therapies for Cocaine Dependence","volume":"9","author":"Siqueland","year":"2000","journal-title":"J. Psychother. Pract. Res."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Zamiri, M., and Esmaeili, A. (2024). Strategies, Methods, and Supports for Developing Skills within Learning Communities: A Systematic Review of the Literature. Adm. Sci., 14.","DOI":"10.3390\/admsci14090231"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1093\/tbm\/ibz138","article-title":"Implementation of a Meaning-Centered Psychotherapy Training (MCPT) Program for Oncology Clinicians: A Qualitative Analysis of Facilitators and Barriers","volume":"11","author":"Polacek","year":"2021","journal-title":"Transl. Behav. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"106276","DOI":"10.1016\/j.nedt.2024.106276","article-title":"Real-World and Game-Based Learning to Enhance Decision-Making","volume":"140","year":"2024","journal-title":"Nurse Educ. Today"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1002\/cncr.23157","article-title":"Barriers to Recruiting Underrepresented Populations to Cancer Clinical Trials: A Systematic Review","volume":"112","author":"Ford","year":"2008","journal-title":"Cancer"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Guan, T., Cook, P., Xu, S., Ranzinger, L.H., Conklin, J.L., Alfahad, A.A.S., Ping, Y., Shieh, K., Barroso, S., and Villegas, N. (2023). Family-Based Psychosocial Interventions for Adult Latino Patients with Cancer and Their Caregivers: A Systematic Review. Front. Psychol., 14.","DOI":"10.3389\/fpsyg.2023.1052229"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"23333936211003557","DOI":"10.1177\/23333936211003557","article-title":"Four Kinds of Hard: An Understanding of Cancer and Death among Latino Community Leaders","volume":"8","author":"Larson","year":"2021","journal-title":"Glob. Qual. Nurs. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s12936-023-04474-w","article-title":"Stakeholder Perspectives on a Door-to-Door Intervention to Increase Community Engagement for Malaria Elimination in Zanzibar","volume":"22","author":"Abbas","year":"2023","journal-title":"Malar. J."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Sarpong, D.F., Liu, C.Y., Gordon, T.K., Sy, A., Mancera, B., Alhassan, M., and for the RCMI Community Engagement Consortium (2025). Engaging Communities and Empowering Research: Lessons from a Network of Community Engagement Cores. Int. J. Environ. Res. Public Health, 22.","DOI":"10.3390\/ijerph22111661"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/1\/116\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:24:18Z","timestamp":1768811058000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/1\/116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,17]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["ijerph23010116"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23010116","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,17]]}}}