2B-1: A Multi-Pronged Approach to Engaging Communities About Cancer

Evelyn Gonzalez, Armenta Washington, Rosa Ortiz, Linda Hammell, Nestor Esnaola
Fox Chase Cancer Center, Philadelphia, PA, USA

Abstract: Background/purpose: The Office of Community Outreach is Fox Chase Cancer Center’s (FCCC) bridge to the community. Through offsite cancer education, screening, and research programs, we bring the high quality information and services expected from a National Cancer Institute-designated Comprehensive Cancer Center (NCI CCC) directly and conveniently to neighborhoods throughout the Greater Philadelphia region. Description: At Fox Chase, we utilize a multi-pronged approach to reach diverse audiences with up-to-date cancer information and services that are focused on improving the health of communities in the region. Such efforts include free, bilingual cancer education, cancer screening via a mobile screening unit and community dialogues focused on research participation as well as recruitment to clinical trials and biospecimen research studies. Institutional and foundational funding along with funds provided by NCI’s Center to Reduce Cancer Health Disparities has enabled FCCC to increase the publics’ understanding of cancer, increase access to care, provide navigation into health systems, and garner interest and participation in medical research. Evaluation: This innovative, multi-pronged approach is working. The speaker’s bureau is evaluated by collection of data via pre- and post-test with each participant. In 2015, we have reached more than 6000 people with our education, screening, and research programs. Our educational programs have increased participant’s knowledge of cancer by an average of 47 %. For the screening program, we track the numbers of participants screened, the number requiring follow-up, and those diagnosed with cancer. Lastly, we have engaged the community to participate in research and over 150 community members have participated in our recent studies. Usefulness: This is a unique program that utilized community partnerships and multiple funding sources to engage diverse communities across the cancer continuum in an effort to improve health outcomes. Learning Objectives: At the end of this session, the participant shall be able to describe at least three approaches to community engagement to address cancer health disparities. References: Fleisher L, Davis SN, Gross L, Bagden L, Zakrzewski D, González E, et.al. Lessons Learned from Implementing a Prostate Cancer Risk Assessment Program for Underserved High-Risk Men in the Community: Prostate REACH. J Cancer Educ. 2016 Mar;31(1):191-7. Simon MA, de la Riva EE, Bergan R, Norbeck C, et.al. Improving diversity in cancer research trials: the story of the Cancer Disparities Research Network. J Cancer Educ. 2014 Jun;29(2):366-74. Torres S, de la Riva EE, et.al. The Development of a Communication Tool to Facilitate the Cancer Trial Recruitment Process and Increase Research Literacy among Underrepresented Populations, J Cancer Educ. 2015 Dec;30(4):792-798.

2B-2: Incorporating Interprofessional Education and Practice Within the Radiation Oncology Department at the Odette Cancer Centre Toronto, Ontario, Canada—Challenges and Opportunities

Ewa Szumacher, Lisa Di Prospero, Elizabeth McLaney
Sunnybrook Health Sciences Centre, Toronto, ON, Canada

Abstract: Background/Purpose: Interprofessional education and practice are integral to the vision of the Radiation Oncology Department at Sunnybrook Odette Cancer Centre, University of Toronto. Description: Collaboration between radiation therapists, radiation nurses, radiation oncologists, and other healthcare providers lead to successful collaborations related to (1) undergraduate trainees’ education, (2) continuing education, and (3) patient education. Undergraduate nursing and radiation therapy students’ have been undergoing clinical electives in breast and genitourinary oncology clinics. Students from the Faculty of Medicine at U of T are mentored during their Determinants of Health Care research course, where interprofessional projects related to patient-centered care in oncology are developed, successfully conducted, and disseminated. Interprofessional Radiation Oncology monthly rounds have provided opportunities for ongoing dialogue and foster future research collaborations among members of the department from different professions. More recently, a New Breast Cancer Geriatric Pre-assessment clinic was established where interprofessional team members consisting of a medical oncologist, radiation oncologist, geriatrician, psychiatrist, occupational therapist, pharmacist, nurses, and radiation therapist are involved in patients’ care. Scholarship and research output from all of these interprofessional initiatives, such as manuscripts published in peer-reviewed journals and presentation at the local, national, and international meetings, have been generated. Evaluation: Despite the plethora of interprofessional activities that have been successfully developed and incorporated in our department, there are challenges that exist and need to be addressed to enhance interprofessional care. Some of these challenges are related to inadequate research resources, departmental priorities, time commitment, time protection for educational activities, budget constraints, barriers in establishing collaboration with other centers in Canada and globally, and others. Usefulness: In order to deliver precision medicine, it is becoming evermore necessary to work as a team and develop interprofessional strategies related to student education, continuing education, and patient education, in order to provide the best care to patients. Learning Objectives: (1) The participant shall be able to identify three examples of successful interprofessional scholarship projects conducted in radiation oncology at the Odette Cancer Centre in Toronto. (2) The participant shall be able to identify a challenge and an opportunity with regards to interprofesional care. References: Head, B., Schapmire, T, Hermann, C., Earnshaw, L., Faul, A., Jones, C., Kayser, K., Martin, A., Shaw, M., Woggon, F., & Pfeifer, M. (2014). The interdisciplinary curriculum for oncology palliative care education (iCOPE): meeting the challenge of interprofessional education. Journ Palliat Med, 17(10):1107-1114. Lee, C., Doran, D., Tourangeua, A., & Fleshner, N. (2014). Perceived quality of interprofessional interactions between physicians and nurses in oncology outpatient clinics. Euro Journ Onco Nurs, 18(6):619-625

2B-3: Fertility Preservation for Cancer Patients: Yes, What Nurses Think Matters! Survey Tool Development, Implementation, and Analysis Guides Appropriate Interventions

Maria Grabowski, Deborah Spitzer, Shaghayegh Zaie, Catherine Close, Sonja Stutzman, DaiWai Olson
UT Southwestern, Dallas, TX, USA

Abstract: The 2006 American Society of Clinical Oncology—Quality Oncology Practice Initiative guidelines state infertility risks should be discussed prior to initiation of fertility-reducing therapies for fertile cancer patients. A decade later, compliance in initiating fertility preservation (FP) guidelines remains low. Despite the pivotal role of nursing, research and tools are lacking regarding the role of nurses’ attitudes and behaviors towards FP. The purpose of this study is to develop a tool to evaluate potential barriers for nurses recommending FP as an option for newly cancer diagnosed patients. Instrument development engaged content expert’s in field testing and an online survey (phase I) assessing nursing behaviors toward FP in cancer patients. Following initial factor analysis, an anonymous online survey (phase 2) was sent to local oncology nurses. The endpoint of the study is a sound survey assessing nursing behaviors toward FP in cancer patients. Standardized descriptive measures of central tendency were used describing baseline characteristics for the sample. Factor analysis was completed using SAS v9.3 with orthogonal rotation.

Scree plot was examined for factors, retaining loading >0.30. Analysis of first 67 responses (phase 1) supports a 15-item (5-factor) survey tool. Phase 2 included 224 respondents and was used to develop the final (5factor, 15-item) instrument. Preliminary results suggested need to address education, referral availability, and system refinement. These preliminary results have been used to guide current FP nursing education content. Cancer patients of child-bearing age worry how treatment will affect their ability to have a child. This survey may be beneficial in identifying nursing FP attitudes, barriers, and educational needs related to patient teaching and will support system-wide implementation of comprehensive FP programming. Study limitations include surveying nurses from variable settings and FP resources. Future research includes pre-post-testing nurses to determine effectiveness of interventions. Learning Objectives: The participant will be able to identify one approach to assess oncology nurses attitudes regarding fertility preservation in cancer patients. The participant will be able to identify two key components required in nursing education content to ensure fertile cancer patients are informed of their fertility preservation options. References: Bower B, Quinn, G. Fertility Preservation in Cancer Patients: Ethical Considerations. Reproductive Health and Cancer in Adolescents and Young Adults, Advances in Experimental Medicine and Biology Volume 732, 2012, pp 187-196. Penrose, R, Beatty, L, Mattiske, J, Koczwara, B. The Psychosocial Impact of Cancer-Related Infertility on Women. CJON 2013, 17(2), 188-193 DOI: 10.1188/13.CJON.188-193. Tallent, Aaron. American Society of Clinical Oncology’s Quality Oncology Practice Initiative (QOPI®). Journal of Clinical Oncology, March 11, 2013. http://www. eurekalert.org/pub_releases/2013-03/asoc-sbf031113.php

2B-4: Improving Communication Across the Cancer Trajectory

Jo Hanson, Elaine Wittenberg, Betty Ferrell
City of Hope Comprehensive Cancer Center, Duarte, CA, USA

Abstract: Background/Purpose: With support from the National Cancer Institute, four national communication courses are being offered to competitively selected two-person oncology nurse-teams. The objective of the courses is to provide nurses with tools to increase their communication skills, teach communication skills to colleagues, and implement new processes for patient-centered care. This study will describe the course and present data from participants. Methods: An interdisciplinary team of experts developed the curriculum known by the acronym COMFORT. The curriculum, emphasizing team communication, teaches nurses how to provide life-altering news, assess patient/family health literacy needs, practice mindful communication, acknowledge family caregivers, and address communication openings and goals. Using the COMFORT curriculum, the course provides oncology nurse-teams, from nationwide cancer settings, with focused communication training on communication across the cancer trajectory: diagnosis, treatment, survivorship planning, end of life, and bereavement. Prior to the course, nurse-teams completed surveys reporting communication educational offerings at their institution, perceived effectiveness of communication with patients at their institution, and their own degree of difficulty with communication topics. Results/Findings: After the first two courses, survey results from nurseteams (n = 95 teams/187 individuals) showed more than 70 % of participants’ organizations do not provide training on breaking bad news, care transitions, or talking about recurrence, and 60 % do not provide training on talking about goals of care. Teams rated (0 = not effective, 10 = very effective) communication with patients during bereavement (3.77), end of life (4.8), survivorship (4.9), and time of death (5.0) as least effective. The most difficult communication topics (0 = not difficult, 10 = very difficult) were handling conflict among patients and family (5.4), handling conflict among team members (5.2), and initiating talks with patients about hospice and palliative care topics (5.0). Discussion: This nationwide training provides oncology nurses with focused communication training on communication and addresses the needs of patients and families throughout the  cancer trajectory. Two more courses will be offered (communicatecare.com). Learning Objectives: The participant shall be able to describe at least two components of the COMFORT curriculum. The participant shall be able to identify at least two communication challenges identified in the communication effectiveness survey. References: McLennon, S. M., Lasiter, S., Miller, W. R., Amlin, K., Chamness, A. R., & Helft, P. R. (2013). Oncology nurses’ experiences with prognosisrelated communication with patients who have advanced cancer. Nurs Outlook, 61(6), 427-436. Bylund, C.L., Brown, R.F., Bialer, P.A., Levin, T.t., Lubrano di Ciccone, B, Kissane, D.W. (2011). Developing and implementing an advanced communication training program in oncology at a comprehensive cancer center. J Cancer Educ, 26(4), 604-611. Helft, P. R., Chamness, A., Terry, C., & Uhrich, M. (2011). Oncology nurses’ attitudes toward prognosis-related communication: a pilot mailed survey of oncology nursing society members. Oncol Nurs Forum, 38(4), 468-474.

2B-5: Linking Internally Produced Resources with EHR Technology in an Ambulatory Oncology Setting

Paula Schultz, Regina Carlisle, Debra Woo, Melissa O’Grady
University Hospitals Seidman Cancer Center, Cleveland, OH, USA

Abstract: Background: Online resources and/or commercially available education packages are often used with electronic health record (EHR) technology to meet meaningful use requirements for patient specific education. While these resources provide a wide range of basic patient education, their content specific to cancer, its treatment, and side effects is often limited. Numerous studies have shown that the information needs of cancer patients are complex and dynamic. A lack of cancer-related resources within programs suggested by the EHR can result in unmet patient education needs. Using internally produced cancer patient education resources with EHR technology can meet meaningful use requirements in a way that is relevant to cancer patient care. Purpose: In 2015, the University Hospitals Seidman Cancer Center (UHSCC) Office of Patient and Public Education (OPPE) joined a task force led by the UHSCC Information Technology (IT) department to implement meaningful use requirements for patient-specific education in the ambulatory oncology setting. The OPPE recommended developing a patient education clinic note that integrates the cancer center’s own patient education resources into EHR technology. Description: Working with IT and a multidisciplinary team, an ambulatory hematology/oncology patient education clinic note was built. The note includes 135 cancer-specific educational topics through which the EHR intuitively generates suggestions for education and provides direct web links to more than 80 of UHSCC’s own resources. Evaluation: Rolled out in February 2016, the patient education clinic note has been well received by ambulatory hematology/ oncology nurses who describe it is easy to use, convenient, and pertinent to patient education needs. The note has been adopted by UHSCC’s pediatric oncology division and is being considered for inpatient EHR patient education documentation. Usefulness: The project is currently in the optimization process. Evaluations will be shared, along with discussion of future direction for the project. Learning Objectives: Participants shall be able to identify at least two ways that cancer patient educational needs are not met through online resources and/or commercially available education packages often used with electronic health record (EHR) technology, understand techniques to integrate internally produced cancerspecific patient education resources into EHR technology to meet meaningful use for patient specific education, and evaluate the effectiveness of EHR-integrated cancer-specific resources in patient education and electronic documentation. References: Clauser, Wagner, Aiello Bowles, Tuzzio, & Greene, (2011). Improving modern cancer care through information technology. American Journal of Preventative Medicine, 40(5 Suppl 2), S198-S207. doi:10.1016/j.amepre.2011.01.014. Del Fiol, G., Huser, V., Strasberg, H. R., Maviglia, S. M., Curtis, C., & Cimino, J. J. (2012). Implementations of the HL7 context-aware knowledge retrieval (“infobutton”) standard: Challenges, strengths, limitations, and uptake. Journal of Biomedical Informatics, 45, 726-735. doi:10.1016/j. jbi.2011.12.006. Matsuyama, R. K., Kuhn, L. A., Molisani, A., & Wilson-Genderson, M. C. (2013). Cancer patient information needs the first nine months after diagnosis. Patient Education and Counseling, 90, 96-102. doi:10.1016/j.pec.2012.09.009