Pilot-Testing a Survivorship Needs Assessment Planning Tool for Head and Neck Cancer Survivors and Caregivers

Abstract

Abstract The purpose of this study was to develop and pilot-test a tablet-based survivorship needs assessment planning (SNAP) tool to assess head and neck cancer (HNC) survivor and caregiver needs after treatment and generate tailored care plans. We recruited survivors completing treatment <24 months ago, and their caregivers. Participants completed baseline surveys, a clinic session with SNAP assessments (symptoms, unmet needs, behaviors) and care plan delivery, and 6-week follow-up surveys. We tracked intervention delivery/acceptability and used paired t-tests to explore changes in psychosocial factors over time. We enrolled 25 survivors (65% male, mean age = 63, 65% stage IVA) and their caregivers (73% female, mean age = 56, 77% partners). The average time to complete SNAP assessments was 11 and 6 minutes for survivors and caregivers, respectively. Algorithm-driven care plans included messages (mean = 19), educational materials (mean = 13) and referrals (mean = 4.5). Top referrals included Behavioral Medicine, Nutrition and Physical Therapy (84, 77 and 65% flagged, respectively). In those declining referrals, main reasons included being overwhelmed, seeing local provider or lacking interest. Participants rated SNAP favorably with >80% reporting high comfort using tablets and navigating questions. Dyads strongly agreed that care plans were helpful emotionally (>75%) and provided practical information (>73%). After the session, both survivors and caregivers reported significantly fewer unmet needs (7.7 versus 2.9, P = 0.001 survivors; 7.0 versus 4.1, P = 0.02, caregivers) and higher survivorship preparedness (4.9 versus 5.2 in both, P = 0.02 and P = 0.03). While depression, symptom distress and symptom management abilities were stable in survivors, caregivers had significantly lower depression (P = 0.01) and symptom distress (P = 0.03), and higher ratings of perceived patient symptom management abilities (P = 0.004) at follow-up. Open-ended responses highlighted that SNAP visits helped pull together complex medical information and made families feel supported. Participants desired more information about cancer stage and caregivers preferred earlier intervention. Results support the feasibility of implementing SNAP in the HNC clinic and highlighted needed modifications for system improvement.