Case Study: SAFAD
Adapting behavioral interventions without losing what makes it work.
Using cultural insight and behavioral science to redesign a cancer self-management intervention with South Asian survivors and caregivers.
Partners
Stanford Prevention Research Center
The Framily Lab
Community Wellness Collective
My Role
Co-Design Lead & Graduate Researcher
My CONTRIBUTIONS
Research design · Workshop facilitation · Generative activities · Qualitative synthesis · Intervention adaptation · Framework development
Challenge | Evidence-based doesn't always mean context-ready.
web-SUCCEED was an existing evidence-based cancer self-management intervention built around stress management, communication, action planning, and meaningful activity. Our challenge was not to build something new, but to understand how an intervention developed in one context could better support South Asian breast cancer survivors and their family caregivers.
Our early research showed that cultural adaptation needed to go beyond translation or representation. Family roles, stigma, disclosure, language, spirituality, and caregiving expectations shaped how participants experienced cancer and sought support.
The design question became: What should stay, what needed to adapt, and what was missing entirely?
web-SUCCEED Study Concept Model
Approach | I designed the research to surface differences, not force consensus.
Rather than asking participants what a “culturally adapted” intervention should look like, I designed activities that made underlying values and tensions visible. Survivors and caregivers mapped experiences across spectrums like Trust ↔ Fear, Everyone Knows ↔ Only for Myself, and Cancer/Caregiving ↔ Everyday Life, then moved from individual reflection into group ideation and prototype critique.
Some of our most important insights came from where perspectives differed. For sensitive activities, I separated survivors and caregivers so each group could speak freely before encountering the other group's perspectives. Instead of asking participants to resolve those differences, we used them to identify where the intervention needed flexibility.
The goal wasn't consensus. It was making difference visible enough to design for it.
Value Card Sorting
Survivors and caregivers received identical image sets and independently mapped what trust, privacy, caregiving, and everyday life meant to them.
Design | I translated cultural tensions into intervention decisions.
The research showed that cultural responsiveness could not be added as a layer of culturally relevant language or imagery. It needed to change the structure, content, and delivery of the intervention itself.
Survivors and caregivers wanted opportunities to come together around communication and planning, while more sensitive experiences—such as emotional processing, caregiver burden, intimacy, body image, and disclosure—could benefit from separate spaces. Participants also expanded the intervention beyond emotional coping to practical needs including healthcare navigation, transportation, food access, insurance, and trusted information.
We began translating these findings into an adapted model that could preserve web-SUCCEED's evidence-based foundation while creating flexibility around who participates together, what support is offered, and how that support is delivered.
Results | Community insight changed both the intervention and the way we approached adaptation.
Three community talks reached 120 participants, followed by an initial co-design workshop with five breast cancer survivors and five family caregivers.
More importantly, the process produced concrete directions for SAFAD: preserve the intervention's core behavioral strategies while adapting its language and delivery; create shared and separate spaces for survivors and caregivers; incorporate culturally relevant approaches to disclosure, coping, and family relationships; and expand support to include the practical realities surrounding cancer care.
The research process changed too. We added an Integration phase to the Generative Co-Design Framework, creating space for community partnership, relationship-building, and shared learning before asking people to participate in more vulnerable forms of co-design.
The result wasn't one culturally tailored version of an existing program. We identified what could remain universal—and designed flexibility around where people's values, relationships, and needs differed.
Next Step
Iterate with community — Continue co-design sessions and community presentations to refine the intervention and co-develop actionable resources with the Community Wellness Council at the Indian Community Center.