Cancer Support Program Research Articles

Effect of an oncology care management program on ED visits in a rural Medicaid population.

175 Background: Optum’s Cancer Support Program (CSP) provides care management to members with cancer diagnoses facing healthcare barriers. CSP nurses educate members on symptom management, palliative care and advance care planning, address psychosocial needs and close gaps in care. Improving health equity and outcomes is a program priority. In 2023, Optum analyzed outpatient claims for 24,221 Medicaid members with cancer and found that rural members visit emergency departments (ED) 31% more than urban members. As part of a CSP quality and outcomes assessment, we aimed to understand CSP’s impact on ED utilization within a high-risk rural Medicaid population. Methods: Beginning 1/1/23, Medicaid members in rural zip codes with an active cancer diagnosis were stratified as high- or low-risk based on diagnosis and clinical factors. High-risk members were invited to participate in CSP and receive individualized telephonic care management. 2023 outpatient medical claims were evaluated, and rural ED visit rates were compared for high-risk CSP participants and non-participants for approximately 4 months (average CSP engagement) after CSP enrollment or identification (non-participants). Population demographics were tested via a Mood's median test; ED visits per thousand members per year (PTMPY)—engaged, non-engaged, and difference in means—was tested via a 10,000-iteration bootstrap. Results: The study population included 421 members stratified as high-risk. Of those, 38% (161) enrolled in CSP. Reasons for non-enrollment included inability to reach the member (61%) and member refused (39%). There were no statistically significant differences between the groups’ demographic composition (all variables had p ≥ 0.05). Under a 10,000-iteration bootstrap, there were 2,696 ED visits PTMPY, 80% CI [2,258, 3,150] in the participant group and 3,427 ED visits PTMPY, 80% CI [2,904, 3,974] in the non-participant group. The difference in means between the groups was 730 ED visits PTMPY, 80% CI [52, 1,421]. Conclusions: Rural Medicaid members enrolled in CSP experienced lower ED visit rates, suggesting that care management may be effective at reducing ED utilization within rural populations that lack access to wraparound oncology services. Limitations of this study include small sample size and potential enrollment bias. Further analysis is underway to increase the study sample size and identify other factors that may be impacted by care management, thereby improving healthcare equity.

Geriatric assessment-guided interventions for older adults with multiple myeloma: A feasibility and acceptability study

IntroductionGeriatric assessment (GA)-guided supportive care programs have been successful in improving treatment outcomes for older adults with solid-organ cancers. This study aimed to evaluate the feasibility of a GA-guided supportive care program among older adults treated for multiple myeloma (MM). Materials and MethodsThe study utilized an existing registry of adults with plasma cell disorders at the University of North Carolina. Patients with MM, aged 60 or older, and having a GA-identified deficit in one or more problem area were offered referrals to supportive care resources during routine visits. Problem areas included physical function deficits, polypharmacy, and anxiety or depression. Patients with physical function deficits were offered referral to physical therapy (PT), those with polypharmacy to an Oncology Clinical Pharmacist Practitioner (CPP), and those with mental health symptoms to the Comprehensive Cancer Support Program (CCSP). ResultsOf the 58 individuals identified as having at least one deficit on the GA, PT was the most commonly identified relevant resource (79%), followed by CPP visits (57%). Among individuals that were offered referral(s) to at least one new supportive care resource, the acceptance rate was 50%. Referral acceptance rates were highest among those recommended for a CPP visit (55% of those approached) and lowest for CCSP (0%). DiscussionThe study examined the feasibility and acceptability of a referral program for supportive care resources among older adults with MM who have deficits on GA. The most commonly identified deficit was physical functioning, followed by polypharmacy and mental health. The study found that physical interventions and referrals to CPPs were the most accepted interventions. However, the low proportion of patients who accepted physical therapy referrals indicates the need for tailored and more personalized approaches. Further research is needed to explore the feasibility and impact of supportive care referral programs for older adults with MM.

Tailored support for preparing employees with cancer to return to work: Recognition and gaining new insights in an open atmosphere.

A considerable number of cancer survivors face difficulties in returning to work (RTW). More insight is needed on how to support employees shortly after cancer treatment and help them make the transition back to work. To gain an in-depth understanding of how and under what circumstances a Cancer & Work Support (CWS) program, which assists sick-listed employees with cancer in preparing their RTW, works. A qualitative design was used, inspired by Grounded Theory and Realist Evaluation components. Semi-structured interviews were conducted with RTW professionals (N = 8) and employees with cancer (N = 14). Interview themes covered experiences with CWS, active elements, and impeding and facilitating factors. Interviews were transcribed and analyzed by multiple researchers for contextual factors, active mechanisms, and the outcomes experienced. Respondents experienced the support as human centered, identifying two characteristics: 'Involvement' ('how' the support was offered), and 'Approach' ('what' was offered). Four themes were perceived as important active elements: 1) open connection and communication, 2) recognition and attention, 3) guiding awareness and reflection, and 4) providing strategies for coping with the situation. Variation in the experiences and RTW outcomes, appeared to be related to the personal, medical and environmental context. Both professionals and employees really appreciated the CWS because it contributed to RTW after cancer. This research shows that not only 'what' RTW professionals do, but also 'how' they do it, is important for meaningful RTW support. A good relationship in an open and understanding atmosphere can contribute to the receptiveness (of employees) for cancer support.

Effect of an oncology care management program on unplanned hospital admissions in a commercially insured population.

1547 Background: Despite advances in cancer outcomes, costs of cancer care continue to rise. Acute care utilization contributes significantly to these costs. The Cancer Support Program’s (CSP) care management services focus on providing education on symptom management, palliative care and advance care planning, addressing psychosocial needs and closing gaps in care in members with cancer who are at high risk for unplanned hospital admissions (UHA). Methods: Beginning 1/1/22, commercially insured members with an active cancer diagnosis were clinically stratified as high or low risk for UHA. All high-risk members were invited to participate in the CSP program. Individuals who agreed to participate received individualized telephonic care management support. Medical claims from 1/1/22 through 9/30/22 were evaluated, and rates of UHA were compared between participants and non-participants within the identified high-risk population for an average period of 4 months after identification (the period equivalent to the average enrollment period of participants). Results: The study population included 3,113 members who stratified as high risk. Of those, 36% were enrolled in the program. Reasons for non-enrollment include inability to reach (72%), member refused (27%) and bad contact information (1%). There were no statistically significant differences between the two groups’ demographic composition except for age (the enrolled group had slightly more in the 51-64 age group [63% vs. 59%; p < 0.001] and slightly fewer in the > 65 age group (9% vs. 15%; p < 0.001]). There were 358 UHA in the participating group and 737 UHA in the non-participating group. When normalized, there were 1,179 UHA per thousand members per year (PTMPY), 99% CI [1,171 UHA, 1,184 UHA] (bootstrap) in the participating group and 1,526 UHA PTMPY, 99% CI [1,523 UHA, 1,535 UHA] (bootstrap) in the non-participating group. Conclusions: Early results show lower UHA rates for members who participated in the care management program, suggesting the program is effective in reducing acute care utilization within the high-risk population. Limitations of this study include potential enrollment bias, changes in risk status from clinical or social factors, and the potential for human error or inconsistency in the risk stratification process. Further study is underway to validate these results.

Geriatric-assessment-guided interventions for older adults with multiple myeloma: A feasibility study.

12065 Background: Multiple myeloma (MM) is disproportionately a disease of older adults, and aging-related impairments are common in this population. Geriatric assessment (GA) guided supportive care programs have been linked to improved treatment outcomes among older adults with solid-organ cancers. We sought to evaluate the feasibility of a GA-guided supportive care program among older adults treated for MM. Methods: We leveraged an existing registry of adults with plasma cell disorders at the University of North Carolina. Registry participants meeting inclusion criteria were offered referrals to supportive care resources by their MM provider during routine visits in 2021-2022. Inclusion criteria were diagnosis of MM, age ≥60, and presence of ≥1 selected problem areas (physical function, polypharmacy, mental health) on the GA. Function deficits were defined as self-report of requiring assistance with ≥1 instrumental activities of daily living or recent fall(s), polypharmacy as ≥10 daily medications, and anxiety/depression on the Mental Health Index 13. Individuals with physical function deficits were offered referral to physical therapy (PT). Those with polypharmacy were offered referral to an oncology Clinical Pharmacist Practitioner (CPP) for comprehensive medication reconciliation and evaluation for de-prescribing. Patients with mental health symptoms were offered referral to our center’s Comprehensive Cancer Support Program (CCSP). Results: 59 individuals were identified as having at least one deficit on the GA (Table). Of these, 14 were already utilizing all relevant resources, leaving 45 individuals eligible for a new resource. Among these, 16 accepted a referral to at least one resource. An additional 16 were approached and declined all offered referrals. For the remaining 13 screened individuals, providers were prompted regarding a referral recommendation prior to the patient’s visit, but a referral was not offered during the visit. Physical therapy was the most commonly identified relevant resource (n = 46), followed by CPP visits (n = 33). Referral acceptance rates were highest among those recommended for a pharmacy visit (55% of those approached) and lowest for CCSP (0%). Conclusions: Given the prevalence of polypharmacy or physical function deficits and acceptance rates for related interventions, future interventions focusing on collaboration with CPPs or physical therapists appear feasible in this setting. Methods to direct patients to supportive care resources that do not rely on provider recommendations during the limited window of clinic visits may also be beneficial. Clinical trial information: NCT04999085 . [Table: see text]

Abstract 53: Implementing Equitable Cancer Support Program: Lessons From Cervical Cancer Chemotherapy Access Program (C3AP)

Abstract Purpose: There is an inverse relationship between diagnosis to initiation of treatment interval and outcome of cancer treatment. A significant number of diagnosed cervical cancer patients don’t receive timely treatment in low resource settings. The Cervical Cancer Chemotherapy Access Program (C3AP) is one of End Cervical Cancer Nigeria Initiative’s interventions to IMProve Access to Cervical Cancer Treatment (IMPACT) in low resource settings. This report provides documentary evidence of the evolution of the implementation of the C3AP and highlights best practices that can be scaled up. Methods: The C3AP was conceptualized to increase the proportion of diagnosed cervical cancer patients that receive timely treatment by exploring adjuvant and neoadjuvant role of chemotherapy in the management of cervical cancer patients in settings where access to radiotherapy services can not be guaranteed. We instituted Plan Do Study and Act (PDSA) quality improvement cycle for the C3AP and used RE-AIM framework to study the implementation processes to be acted upon as part of the PDSA quality improvement process towards improving reach of the program. Results: The C3AP supported treatment of only 4 patients over the reporting period of 5months. Poor referral to the program is a major hurdle the program is battling. Only 2(17%) of the 12 confirmed cases of cervical cancer diagnosed in the facility within the 5month study period were able to access chemoradiation, suggesting a missed opportunity for 6/10(60%) that couldn’t afford chemoradiation. The program evolved over a PDSA cycle to eliminate social eligibility in the criteria to access the support thereby able to shorten application -support interval to same day with potential positive impact on prognosis. Conclusion: Providing equitable support for indigent cancer patients should be beyond the emotion to help humanity. We recommend the use of structured quality improvement for all programs providing support to indigent cancer patients to ensure implementation fidelity. Citation Format: Qudus Lawal, Kasimu Umar Adoke, Jummai Jimeta Tuko, Aminu Magashi Garba, Ishak K. Lawal. Implementing Equitable Cancer Support Program: Lessons From Cervical Cancer Chemotherapy Access Program (C3AP) [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 53.

Abstract B025: The Ronnie Lippin Cancer Support and Navigation Program: Serving cancer patients in culturally and language specific ways

Abstract Background: Twenty three percent of adults in Los Angeles County report difficulty in accessing medical care. This is particularly troubling when faced with cancer. Approximately 1 in 3 Latinos will face cancer in their lifetime. Yet they have the highest number of uninsured of any group. There is a lack of culturally and linguistically sensitive support for these patients confronted with a cancer diagnosis. This contributes to increasing health disparities because of lack of compliance with treatment, failure to follow up with care, lack of transportation which contribute to cancer disparity. The Ronnie Lippin Cancer Support and Navigation program at USC provides linguistic and culturally sensitive public health education and cancer information and customized evidence-based research and resources to cancer patients and caregivers living in Los Angeles County. Methods: During 2019-2021 we provided health education, cancer information and resources, patient navigation and liaison services to cancer patients in Los Angeles County. Services included explaining medical lingo using easy to understand terminology in Spanish and English. We connected patients to support groups, mental health services, nutrition, and physical activity programs and provided health and wellness related information. Also resources for wigs, housing, and welfare assistance. We helped to answer frequently asked questions about cancer treatment and accompanied patients to major medical appointments in person or remotely during the pandemic. We reminded patients of their appointments and next steps. The program provided Spanish/English bilingual services and identified resources in Korean, Mandarin and Tagalog, to meet patient needs. Results: We provided services to 383 individuals between 2019-2021. Of these, the majority were females, with most ranging between 40-64 years of age. Although the majority where of Hispanic/Latino descent, we also serviced African Americans and Asian populations. Individuals served were categorized in four groups for services: previvors (individual at risk for cancer who have genetic predispositions and are taking prophylactic actions to reduce their risk or are undergoing cancer screening tests) and survivors, in active treatment at all stages, and survivors no longer in treatment. Those in end of life or hospice care were the fourth group. Cancer types varied from lung, breast, prostate, brain, cervical, liver, uterine, testicular, and colorectal among other. Patients mostly spoke Spanish and had language challenges. Patient navigators helped patients understand treatment instructions, provided health information to support health and mental health wellness. Conclusion: The program proved to be very effective at serving patients. However, more support is needed in Mandarin for Chinese community. Marketing and outreach strategies need focus on males, Asians and African Americans to increase participation. Printed educational materials and online resources are needed in Mandarin and Korean. We provide recommendations and lessons learned. Citation Format: Ghecemy Lopez, Elena Nieves, Rosa Barahona, Lourdes A. Baezconde-Garbanati. The Ronnie Lippin Cancer Support and Navigation Program: Serving cancer patients in culturally and language specific ways [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B025.

Abstract P3-17-01: Metastatic breast cancer caregiver participation in a psychoeducational cancer support program: Results from the frankly speaking about cancer: Metastatic breast cancer evidence-based educational workshops

Abstract Background: Education about metastatic breast cancer can help caregivers by providing tools to deal with the psychosocial effects of the disease. This analysis explores metastatic breast cancer caregivers’ experiences related to participation in Cancer Support Community’s national evidence-based educational program, Frankly Speaking About Cancer: Metastatic Breast Cancer. This comprehensive psychosocial education program, created for people diagnosed with metastatic breast cancer and their caregivers, provides information about current treatments, side-effect management, and social and emotional challenges of an advanced breast cancer diagnosis. Methods: Caregivers who attended 67 workshops across the country between 2014 and 2019 completed program evaluations and provided self-reported data on factors including pre- and post-workshop knowledge, workshop satisfaction, confidence levels, and intentions for patient-provider communication post-workshop. In total, 305 caregivers of patients with metastatic breast cancer attending in-person Frankly Speaking About Cancer: Metastatic Breast Cancer workshops nationwide completed a survey assessing their experiences and learnings as a result of the educational workshops. Descriptive analyses and pre-and post-workshop comparisons were conducted to assess workshop outcomes. Results: Caregivers were predominantly White (79%) and female (75%) and averaged 64.2 years old (s.d.=12.5). 75% strongly identified as caregivers and 69% were strongly involved in coordinating the patient’s care (rated a ‘4’ or ‘5’ on a 5-point scale for both). Most participants in the caregiving capacity (87%) reported experiencing emotional distress due to their loved one’s cancer. The workshop was well-received, with 92% recommending the workshop to others facing similar issues. Most caregivers (77%) reported gaining a “high or very high” level of knowledge about metastatic breast cancer, which was a significant increase compared with pre-workshop levels (42%; χ²= 13.4, p <.05). Caregivers were likely to report that they gained confidence to participate in treatment decision-making with their loved one’s health care team (79%) and to ask questions about side effects of metastatic breast cancer and its treatment (82%) as a result of participating in the workshop. Lastly, 92% of caregivers reported that because of the workshops, they felt better prepared to emotionally cope with their metastatic breast cancer caregiving experience. Discussion: Results suggest that comprehensive information and supportive services are highly relevant in meeting the psychosocial needs of cancer caregivers. Increased understanding of informational and emotional support service utilization can inform provision of services and programs addressing the emotional and informational needs of caregivers. Citation Format: Claire Saxton, Kirstin Fearnley, Maria B. Gonzalo, Cynthia Schwartz. Metastatic breast cancer caregiver participation in a psychoeducational cancer support program: Results from the frankly speaking about cancer: Metastatic breast cancer evidence-based educational workshops [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-17-01.

Lessons from a Customer Discovery Study: a Technology-Based Cancer Support Program for Asian American Breast Cancer Survivors.

A culturally tailored technology-based cancer support program was recently developed and tested among Asian American breast cancer survivors. To explore future opportunities to sustain the program, the research team participated in the SPeeding Research-tested INTervention (SPRINT) program sponsored by the National Cancer Institute. The purpose of this discussion paper is to share the lessons that the research team gained from a customer discovery study through the SPRINT program. During the SPRINT program, a total of 73 stakeholders were recruited through a snowball sampling across the globe. Semi-structured interviews were conducted for customer discovery through WebEX, phone calls, and in-person visits (50 in-person interviews, 4 phone interviews, and 19 WebEx interviews). All the interviews were recorded using audio-taping or writing memos. Also, the research team wrote memos on the issues/concerns related to the project during the interview process. Then, the transcripts and memos were analyzed using a content analysis to provide evidence for the lessons. The themes reflecting the lessons from the customer discovery study included (a) "who are the stakeholders"; (b) "depending on stakeholders"; (c) "what works or not"; (d) "personal versus family responsibilities"; and (e) "depending on countries' situations." These lessons could provide directions for future development and implementation of technology-based cancer support programs for Asian American breast cancer survivors.

Virtual psychosocial services for the adult population in a large community oncology practice.

283 Background: Psychological and social supports are essential to address the emotional impact of cancer. The Covid-19 pandemic exacerbated emotional distress for patients with cancer and impeded many of the traditional service delivery models for supportive services. An increase in patient reported distress from routine distress screenings highlighted the need to transition to virtual Social Work (SW) services. Methods: Patients were referred to virtual SW services three ways: self-referral, distress screenings, and clinic staff. A virtual support group registration site was created to increase awareness which was promoted by our marketing team. Three different SW facilitated virtual support groups were offered: Stronger Together, Empower Your Recovery: A Program for Healing and Growth for Living Beyond Cancer©*, and Paving the Way for Your Journey: A Cancer Support Program (PTW). Of note, the PTW six-week psychoeducation support group curriculum was developed by six employed SW facilitators. Groups included closed and open formats with scheduled frequencies. In addition to virtual support groups, standard social support including, psychosocial assessments, Advance Care Planning, virtual counseling visits were offered virtually with patients via the VSee telemedicine platform. Results: Social Work referrals increased by 154% from 949 in 2019 to 2413 in 2020 due to positive distress screening. From March 2020-21, 14,948 patients received SW services which was an increase from 10,208 seen from March 2019-20. Of these, 372 received virtual psychosocial telemedicine services from March 2020-21. There were 4092 unique webpage views to the support group information and registration website. Total number of all virtual registrants in the 3 groups from May 2020 to February 2021 was 326. Conclusions: The COVID19 pandemic required us to use, technology and virtual tools to ensure continued patient access to psychosocial services and expand access to support groups, in addition to the in-person SW services that remained. Limitations of virtual support groups and telemedicine included lack of internet access felt to be from socioeconomic barriers. Further research is needed to evaluate the benefits of providing structured psychoeducational virtual support groups to patients with cancer. Virtual counseling and support groups may continue to benefit patients with cancer.

Going virtual: increased uptake of gynecologic cancer support services post-COVID-19

Going virtual: increased uptake of gynecologic cancer support services post-COVID-19

An online group for young women with breast cancer: sparking online engagement

ABSTRACT Younger women diagnosed with breast cancer express more psycho-emotional concerns than older women because younger women are facing problems with fertility, disruption to their young families, disruption to their careers, and lower libido during a time of higher sexual activity. Support groups create a place for younger women diagnosed with breast cancer to give and receive mutual aid. To meet the needs of younger women with breast cancer, an online support group was created by the Adelphi NY Statewide Breast Cancer Hotline and Support Program. A SPARC grant from the International Association of Social Work with Groups (IASWG) helped the program reduce technology barriers to the online group, and help the program promote the group to community partners. The author, in the role of the support group facilitator, created a comfortable and confidential group space by embracing the needs of the clients, including the need for a flexible virtual meeting space. The ongoing facilitation of the online group impacted the support services provided by the Adelphi NY Statewide Breast Cancer Hotline and Support Program, encouraging additional psychoeducational groups to be developed, and contributing to expanding online group services to meet the specific needs of all program clients when the program was forced to transition to online services due to the COVID-19 crisis striking the local community.

A multi‐centre randomized controlled trial of mobile gynaecological cancer support program for patients with gynaecological cancer undergoing chemotherapy: Study protocol

Patients with gynaecological cancer often experience high levels of uncertainty in illness during chemotherapy and report unmet supportive care needs. Mobile applications (apps) are increasing being used as an easily accessible alternative to support these patients, but a lack of rigorous trials have been conducted to explore their effectiveness. Based on Mishel's uncertainty in illness theory, the Mobile Gynaecological Cancer Support (MGCS) program is an app-based program that includes four modules: 1) weekly topics, 2) emotional care, 3) discussion centre and 4) health consultation. The aim of this study is to assess the effectiveness of MGCS for Chinese patients with gynaecological cancer receiving chemotherapy in respect of reducing uncertainty in illness and symptom distress and improving quality of life and social support. A multi-centre randomized controlled trial will be used. One hundred and sixty-eight patients with gynaecological cancer commencing chemotherapy will be recruited from three university affiliated hospitals and assigned to the control or intervention group with block randomization. The control group will only receive routine care. The intervention group will access the MGCS program for 24weeks and receive routine care. Health outcomes will be evaluated at baseline, 12weeks, and 24weeks. Repeated measures multivariate analysis of covariance (intention-to-treat) will be used to assess the effectiveness of MGCS. This is the first trial to explore the effectiveness of an app-based program for patients with gynaecological cancer using a robust and rigorous study design in China. If effective, this trial will provide evidence for an app-based program to support these patients. The knowledge gained can be applied to develop other culturally appropriate app-based programs for cancer groups worldwide, and provide evidence for health policymakers to allocate more resources and train staff for e-health. ChiCTR2000033678 (Chinese Clinical Trial Registry Registered 08 June, 2020).

Development and Assessment of an Integrated Patient Information, Education and Support Program in Head and Neck Cancer - Comprehensive Head and Neck Cancer Education and Support (CHANCES) Program

Interrelated factors at the patient, provider, and information levels can have a detrimental impact on patient understanding of health information and subsequent health outcomes. We developed a comprehensive, multiformat education program for patients with head and neck cancer (HNC) and healthcare professionals (HCP) involved in their care. Aims: To establish a HNC information platform accessible and acceptable to HCP and patients incorporating continuous quality improvement and new evidence as it emerges. A multi-stage development and revision process was undertaken. Stage 1: Cross-sectional stakeholder information needs survey. Stage 2: Content development: Multidisciplinary expert panel (n=20) developed content using an iterative review process. Stage 3: Multiplatform resource build; Stage 4. Usability testing; Stage 5. User acceptability testing. In a cross sectional survey of HCP perceptions of HNC resources 112 /648 (17%) clinicians responded with 85% using written information as their primary mode of patient education. They indicated need for improved information on pain management, risk factors, survivorship, and side effects. The majority (66%) indicated a preference for internet-based resources. A total of 596 patients responded to the survey of information needs, with most reported receiving sufficient information about disease process and treatment. Fewer reported information about psychosexual health (56%) or patient support groups (56%). Most patients wanted access informative via multiple modes of delivery. Information addressing 10 types of HNC from diagnosis through treatment to survivorship was developed, reviewed a minimum of three times each, and underwent assessment of readability before being finalized. Website was developed to present the information, animations, video vignettes, and downloadable information booklets. Usability assessment in 15/56 patients, 90% with high health literacy, indicate information presentation, order, and explanation of medical jargon was very clear (90%). Access to both written and electronic form as preferred by 33% of participants. Most patients (90%) felt prepared about their cancer diagnosis and treatment after reading the information resource. The CHANCES program is an evidence-based HNC information resource acceptable, accessible, and understandable to patients and to HCP. Longer-term evaluation is required to assess its impact on health outcomes and resource use.

Holistic Cancer Support Program in Rural Area

Holistic Cancer Support Program in Rural Area

Empowering Cancer Survivors to Become Mentors, and Leaders Through Various Workshops and Programs

Background and context: Friends of Cancer Patients UAE conducts various moral support programs for cancer patients, one of which is the “Color My World” program, which focuses on provide moral support to predominantly men and women, who have undergone, or are currently undergoing treatment of cancer. Aim: The aim is to empower cancer survivors to become leaders and mentors to other ladies/men currently undergoing treatment, and to establish a survivor led support program, as a result of these various programs and workshops. Strategy/Tactics: We believe that to for such a program to be a success, you need to understand your target group, their interests, as well as their backgrounds. A needs assessment needs to be conducted prior to the selection of workshops, whether through direct interviews with the patients, or internally by examining the different support programs available in the country, and what is available/not available. Program/Policy process: There are numerous workshops that take place throughout the year, and they are divided as follows: - There are workshops that focus on healthy living, and the importance of a healthy diet, which involves numerous cooking workshops, and educational sessions. - There are workshops that focus on skin care and make-up, where the ladies are taught how to take care of themselves by certified stylists and makeup artists. - Those who are interested in crochet and handicrafts, have the chance to take part in group workshops, or in focused 1 to 1 sessions. Outcomes: There are a number of positive outcomes that came about from our attempts to empower cancer survivors, the ones we believe are worth of being highlighted are: - A group of survivors are now leading, and running a cancer support program, that visits hospitals within the UAE, to visit those currently undergoing treatment, to provide support, and assist those still undergoing treatment in any way possible. - Many of the ladies, who attended previous workshops, will now start to lead similar workshops during hospital visits to children and women with cancer. What was learned: Cancer survivors must be the driving force in providing support to other cancer patients, and the existing model of the support groups can be linked with the educational workshops, to not only provide moral support, but also social support to the cancer patient.

Telephonic assesment of consumer satisfaction of telephonic case management of cancer patients.

80 Background: Feedback provided by customers/consumers has become an established means of assessing the quality of goods and services. The Optum division of UnitedHealth Group maintains two telephonic case management programs for cancer patients to support quality and cost effective care: Cancer Resource Services (CRS) and the Cancer Support Program (CSP). In each case, the purpose of the telephonic intervention is to provide support, education, and, when appropriate, steerage to one of our contracted Centers of Excellence (COEs). Methods: In this report, we provide satisfaction data collected during 2014 from surviving patients whose cases were closed or reached their 1-year anniversary in these case management programs. These telephonic surveys were conducted by a contracted third party. Results: For CRS, 363 members were contacted and surveys were completed; for CSP, 400 were contacted and completed. Average age was 61 (CRS) and 57 years (CSP). 61% were women. Sixty-two % of the CRS patients were treated at a COE as were 59% of the CSP patients. For CRS members, 90% experienced a positive health care experience (satisfied or very satisfied); for CSP, 94%. Quality of life was improved in 51% for CRS and 65% for CSP. For all four of these measures, there was a statistically significant (p < 0.05) improvement compared with the survey data from 2013. There was 96% overall satisfaction with the program for both CRS and CSP, while overall satisfaction with the nurse/case manager was 96% (CRS) and 98% (CSP). 96% (CRS) and 94% (CSP) are likely to recommend these services to others while 97% and 91% are likely to use these services again if needed. Positive comments outweighed suggestions for improvement. The most common suggestion for improvement was to expand the availability of these services. Conclusions: We conclude that our members with cancer are benefiting from the experience of telephonic case management by our experienced oncology nurse/case managers who are, in turn, assisted by our associated staff of social workers and medical directors.

An evaluation report of the nurse navigator services for the breast cancer support program

Le projet d’amelioration de la qualite presente ici avait pour but d’evaluer l’efficacite des soins de soutien prodigues par les infirmieres pivots en cancer du sein (IPCS) aux patientes qui en sont atteintes et qui frequentent une clinique de sante du sein. Le processus d’evaluation a examine la satisfaction des patientes envers le programme des infirmieres pivots, qui vise a offrir aux patientes de l’information, du soutien emotionnel et de l’orientation tout au long de la trajectoire de soins. Les donnees ont ete recueillies grâce a un sondage constitue de questions de type « echelle de Likert » et de questions ouvertes. Le sondage a ete envoye par la poste aux patientes qui etaient passees a la clinique entre juillet 2011 et juillet 2013. Nous avons recu 154 reponses, ce qui represente un taux de reponse de 69 %. Plus de 90 % des participantes avaient compris l’information fournie par l’IPCS et etaient satisfaites des renseignements qu’elles avaient recus. Le soutien psychosocial offert par les services de counseling aux patientes et aux familles, a l’agence meme et dans la collectivite, comptait parmi les ressources les plus communement en demande. Parmi les recommandations formulees, mentionnons la prise de contact directement avec les patientes apres le premier rendez-vous a la clinique, puis au moins une fois apres le debut des traitements pour assurer la continuite et le soutien. Le role de l’IPCS etait considere comme tres utile et ayant une influence positive sur l’experience de la patiente.

An evaluation report of the nurse navigator services for the breast cancer support program

The purpose of this quality improvement project was to evaluate the effectiveness of breast cancer care support provided by breast cancer care navigators (BCCN) for women attending the breast health clinic (BHC). This evaluative process examined patients' satisfaction with the nurse navigator program that focused on addressing breast cancer patients' informational needs, emotional support, and guidance through the cancer trajectory. A survey approach using Likert-type scales and open-ended questions was utilized to gather data. Patients seen at the BHC between July 2011 and July 2013 were sent the surveys by mail. The 154 responses constituted a 69% response rate. More than 90% of participants understood the information provided by the BCCN and were satisfied with the information that had been received. Psychosocial support from patient/family counselling services at the agency and in the community were among the most common request for resources. Recommendations include contacting patients directly after their initial meeting at the clinic and at least once after their treatments began, to ensure continuity and support. BCCN role was identified as being valuable with a positive effect on patients' experience.

Abstract IA10: Challenges in addressing cancer health disparities in Native American communities

Abstract IA10: Challenges in addressing cancer health disparities in Native American communities