Abstract
Simple SummaryConducting a geriatric assessment represents the standard of care for the management of older adults with cancer. However, most studies of the geriatric assessment in oncology have included non-Hispanic white populations with high educational levels living in developed countries. In this study, we assessed the feasibility, reliability, and validity of two methods of administration (electronic touchscreen tablet and paper/pencil) of the Spanish language version of a self-administered geriatric assessment among older women with breast cancer in the United States. Our results show that implementing a self-administered geriatric assessment using either an electronic tablet or paper/pencil is feasible, reliable, and valid in Spanish-speaking older adults. However, in order to complete the geriatric assessment, participants with lower educational levels were more likely to need help and took significantly longer to do so. This study highlights the importance of tailoring assessments and questionnaires to the cultural, social, and educational level of older adults with cancer.We evaluated the feasibility, reliability, and validity of a Spanish-language self-administered geriatric assessment (GA) in older (age ≥ 65) Spanish-speaking women with breast cancer in the United States. Eligible participants (n = 181) were recruited and randomized. Feasibility was defined as the participant’s unassisted GA completion rate, completion time, and perception on ease of completion. Reliability and validity were assessed using Spearman’s correlation coefficients. Two-sided p < 0.05 was considered significant. Ninety-eight percent of participants (n = 177) completed the GA at least once. Median age was 70 years (range: 65–95) and 55% had ≤8th grade education. Forty-one percent (n = 73) were unable to complete the GA unassisted, median completion time was 28 min (range 8–90), and 77% (n = 136) rated the GA as “easy”/“very easy”. Patients with ≤8th grade education took longer to complete the GA (30 vs. 25 min, p = 0.0036) and needed more assistance (59% vs. 19%, p < 0.001) than those with ≥9th grade education. Test–retest reliability was high (≥0.82) for all domains except social activity (0.73). Validity among similar scales was found. The self-administered GA is a feasible, reliable, and valid tool for Spanish-speaking older women with breast cancer. Tailoring GA tools to the patients’ educational level is important when implementing tools in multicultural environments.
Highlights
Considerable global efforts have demonstrated the importance of incorporating the geriatric assessment (GA) as part of the routine care of older adults with cancer [1]
Most studies assessing the feasibility and reliability of the GA in oncology have included older adults with cancer living in high-income countries, who are more likely to have higher health literacy and educational levels, and data regarding its use in populations from developing countries and/or with lower educational levels is lacking
Tools for oncology was developed by the Cancer and Aging Research Group (CARG) [8,9], who demonstrated that its implementation in both paper/pencil and electronic touchscreen formats was feasible, reliable, and valid among English-speaking older adults in the US [10]
Summary
Considerable global efforts have demonstrated the importance of incorporating the geriatric assessment (GA) as part of the routine care of older adults with cancer [1]. Most studies assessing the feasibility and reliability of the GA in oncology have included older adults with cancer living in high-income countries, who are more likely to have higher health literacy and educational levels, and data regarding its use in populations from developing countries and/or with lower educational levels is lacking. While this is certainly relevant for the implementation of provider-administered GA tools, it is arguably even more so for self-administered assessments, which depend on the patient’s ability to understand and answer questions correctly [7]. One of the first self-administered GA tools for oncology was developed by the Cancer and Aging Research Group (CARG) [8,9], who demonstrated that its implementation in both paper/pencil and electronic touchscreen formats was feasible, reliable, and valid among English-speaking older adults in the US [10]
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