The I-ONE trial: Integrative oncology education for patient navigators—A randomized pilot trial of web-based distance learning with or without small group retreat.

Abstract

171 Background: One of the major barriers to implementation of an integrative oncology (IO) approach is appropriately trained providers. This trial investigated the effectiveness of a mixed method educational program versus web based learning only for oncology patient navigators relative to knowledge and application of IO modalities. Methods: Patient navigators were randomized 1:1 to Web based education only (WEB) vs. WEB plus residential retreat (WEB+R). The trial was conducted as a randomized, two-group, pre-test/post-test design with 4 repeated measures. The primary study outcomes were knowledge and attitudinal beliefs about the perceived efficacy of IO approaches, as well as clinical and personal practices related to IO. Results: 24 patient navigators from varied educational backgrounds and practice settings were randomized to WEB vs. WEB+R. Referrals to complementary therapies increased by 104% immediately after training (p = .013) and by 77.4% 30 days out. (p = .013). There was a statistically significant increase in attitudinal beliefs about the perceived efficacy of IO approaches as measured by the Integrative Medicine Attitude Questionnaire (IMAQ) from baseline to posttest (p = .013). There were no significantly different values between randomized groups in any of the areas surveyed, however internal group pre and post test comparisons had multiple statistically significant improvements in the WEB + R group while there were no such changes in the WEB group, suggesting a trend toward increased educational efficacy for WEB + R that was likely the major driver of entire group educational improvements. Conclusions: Both Web based and Web based plus small group retreat programs were found to be effective in increasing clinical application and attitudinal beliefs about IO in patient navigators. There was a trend toward improved educational efficacy with WEB +R likely related to shared group and personal experience. As IO approaches become part of standard of care, mixed method online plus small group retreat programs would be useful for widespread dissemination of medical knowledge and increased clinical application of IO approaches.