In Jordan, there are different types of hospitals that classified as military, public, private and specialized hospitals. Unfortunately, all of this hospitals provided healthcare services in different policies and guidelines except the public hospitals. There are 32 governmental and universities hospitals cover all cities, taking into account that there are at least one or two hospitals in each city.
Due to the type of sample and the population density, hospitals in Amman, in Al-Zarqa, and Irbid will be selected for this study. These hospitals are consider adequate to obtain the estimated sample size for this study.
A. In the first stage: a list for all governmental hospital was done. According to the following eligible criteria four hospital will be selected: first, provide service for breast cancer patient. Second one, following Jordanian ministry of health policy. These four hospitals will randomly allocated for intervention and control group.
B. In the second stage: all the eligible participant in the four hospitals will be identified and selected to participate in this study according to the inclusion and exclusion criteria to reduce the selection and consent bias.
Randomization will be taken by using random sequence number generation to randomize in level of hospitals by following consort 2010 guidelines. A list will be done for all eligible hospitals. The hospitals will be allocated equally to the intervention or control group (1:1). The four hospital will take sequentially number (1-4). An independent researcher (Jordanian external supervisor) who will be asked to carry out the randomization procedure. The odd number (1 and 3) will be taken as the intervention hospitals and the even numbers (2 and 4) will be taken as the control hospitals by using random sequence number generation.
After the completion of baseline collecting data, the researcher will check the questionnaire if completed by all recruited primary caregiver. The researcher will set number for the corresponding from (1 to 124). An independent researcher (external supervisor) who assigned for this study to avoid selection bias will provide a list of equal groups for all cluster. Each group contains 6-8 participants.
Allocation Concealment
The allocation concealment will be based on hospitals and individual level. The cluster allocation list will concealed from those involved in the research and place the numbers in sealed, opaque envelopes until the start of the intervention. Individual groups list for both arm of the study made by external supervisor will be concealed in sealed, opaque envelopes before one week of begging of the intervention each group will be contacted by hospital staff.
Implementation
The next step of randomization will be conducted by hospital administrator, someone who is not involved in all previous steps will open the sealed envelope and contact the four hospitals staff to inform the participants about their group time, and prepare them for first session.