Background
Six multidisciplinary cancer centers were selected and funded by the Merck Foundation (2017‐2021) to collaborate in the Alliance to Advance Patient‐Centered Cancer Care (“Alliance”), an ...initiative to improve patient access, minimize health disparities, and enhance the quality of patient‐centered cancer care. These sites share their insights on implementation and expansion of their patient navigation efforts.
Methods
Patient navigation represents an evidence‐based health care intervention designed to enhance patient‐centered care and care coordination. Investigators at 6 National Cancer Institute‐designated cancer centers outline their approaches to reducing health care disparities and synthesize their efforts to ensure sustainability and successful transferability in the management of patients with cancer and their families in real‐world health care settings.
Results
Insights are outlined within the context of patient navigation program effectiveness and supported by examples from Alliance cancer center sites: 1) understand the patient populations, particularly underserved and high‐risk patients; 2) capitalize on the existing infrastructure and institutional commitment to support and sustain patient navigation; and 3) build capacity by mobilizing community support outside of the cancer center.
Conclusions
This process‐level article reflects the importance of collaboration and the usefulness of partnering with other cancer centers to share interdisciplinary insights while undergoing intervention development, implementation, and expansion. These collective insights may be useful to staff at other cancer centers that look to implement, enhance, or evaluate the effectiveness of their patient navigation interventions.
The Alliance to Advance Patient‐Centered Cancer Care shares 3 insights for cancer care centers looking to implement effective patient navigation programs. These insights include: 1) understanding the cancer center's catchment area, 2) capitalizing on the existing infrastructure, and 3) mobilizing community support.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Abstract Background To examine the validity of screening and case-finding tools used in the identification of depression as defined by an ICD10/DSM-IV criterion standard. Methods We identified 63 ...studies involving 19 tools (in 33 publications) designed to help clinicians identify depression in cancer settings. We used a standardized rating system. We excluded 11 tools without at least two independent studies, leaving 8 tools for comparison. Results Across all cancer stages there were 56 diagnostic validity studies (n = 10,009). For case-finding, one stem question, two stem questions and the BDI-II all had level 2 evidence (2a, 2b and 2c respectively) and given their better acceptability we gave the stem questions a grade B recommendation. For screening, two stem questions had level 1b evidence (with high acceptability) and the BDI-II had level 2c evidence. For every 100 people screened in advanced cancer, the two questions would accurately detect 18 cases, while missing only 1 and correctly reassure 74 with 7 falsely identified. For every 100 people screened in non-palliative settings the BDI-II would accurately detect 17 cases, missing 2 and correctly re-assure 70, with 11 falsely identified as cases. The main cautions are the reliance on DSM-IV definitions of major depression, the large number of small studies and the paucity of data for many tools in specific settings. Conclusions Although no single tool could be offered unqualified support, several tools are likely to improve upon unassisted clinical recognition. In clinical practice, all tools should form part of an integrated approach involving further follow-up, clinical assessment and evidence based therapy.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The aim of this study was to determine the effect of problem-solving education on self-efficacy and distress in informal caregivers of allogeneic hematopoietic stem cell transplantation patients. ...Patient/caregiver teams attended three 1-hour problem-solving education sessions to help cope with problems during hematopoietic stem cell transplantation. Primary measures included the Cancer Self-Efficacy Scale–transplant and Brief Symptom Inventory–18. Active caregivers reported improvements in self-efficacy (p < 0.05) and distress (p < 0.01) post-problem-solving education; caregiver responders also reported better health outcomes such as fatigue. The effect of problem-solving education on self-efficacy and distress in hematopoietic stem cell transplantation caregivers supports its inclusion in future interventions to meet the multifaceted needs of this population.
Full text
Available for:
NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
Over the past ten years, the concept of psychosocial screening has received a great deal of attention. Guidelines, recommendations, and standards have been developed to encourage or require that all ...patients be screened for their distress at the time of diagnosis or when patients commence care in a cancer center for the first time. However, the concept of psychosocial screening has long history in the cancer literature.
Full text
Available for:
BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
To provide an overview of issues and challenges associated with integrating development of survivorship care plan processes with electronic medical records (EMRs).
Published peer-reviewed literature.
...Evidence seems to indicate that survivorship care plans have value to survivors, oncology specialist providers, and primary care providers. Yet, the existence of cost and time restraints are major barriers to creation and use of survivorship care plans, and the expectations that EMR can simplify and expedite survivorship care plan development have yet to be realized.
Nurses participating in the development of survivorship programs can contribute to successful implementation of EMR-facilitated survivorship care plans by involvement in strategic planning processes, and establishment of reasonable timelines to address the known and unknown barriers, and assuring the resulting EMR product includes essential data and information.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
IntroductionDelaying cancer treatment following diagnosis impacts health outcomes, including increasing patient distress and odds of mortality. Interventions to promote timely healthcare engagement ...may decrease patient-reported stress and improve quality of life. Community health workers (CHWs) represent an enabling resource for reducing delays in attending initial oncology treatment visits. As part of an ongoing programme evaluation coordinated by the Merck Foundation, we will implement a pilot navigation programme comprising CHW-conducted needs assessments for supporting patients and their caregivers. We aim to investigate (1) the programme’s influence on patients’ healthcare utilisation within the period between their first diagnosis and initial treatment visit and (2) the logistic feasibility and acceptability of programme implementation.Methods and analysisWe will employ a hybrid implementation design to introduce the CHW navigation programme at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. CHW team members will use a consecutive sampling approach. Participants will complete the Problem-Checklist, Chronic Illness Distress Scale and the Satisfaction with Life Domains instruments. CHWs will provide tailored guidance by sharing information available on the Johns Hopkins Electronic Resource databases. The investigators will evaluate patients’ time to initial oncology treatment and healthcare utilisation by reviewing electronic medical records at 3 and 6 months postintervention. Bivariate analyses will be completed to evaluate the relationships between receiving the programme and all outcome measures.Ethics and disseminationThis study’s protocol was approved by the Johns Hopkins School of Medicine’s institutional review board (IRB00160610). Informed consent will be obtained by phone by the CHW navigator. Dissemination planning is ongoing through regular meetings between members of the investigator team and public members of two community advisory groups. Study plans include collaborating with other experts from the Johns Hopkins Institute for Clinical and Translational Research and the Johns Hopkins Center for Health Equity for ideating dissemination strategies.
PDF
