Contextual Factors Relevant to Implementing Social Risk Factor Screening and Referrals in Cancer Survivorship: A Qualitative Study

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Astorino, Joseph A. ; Pratt-Chapman, Mandi L. ; Schubel, Laura ; Lee Smith, Judith ; White, Arica ; Sabatino, Susan A. ; Littlejohn, Robin ; Buckley, Bryan O. ; Taylor, Teletia ; Arem, Hannah
• Description:
  Introduction
  
  Social risk factors such as food insecurity and lack of transportation can negatively affect health outcomes, yet implementation of screening and referral for social risk factors is limited in medical settings, particularly in cancer survivorship.
  
  Methods
  
  We conducted 18 qualitative, semistructured interviews among oncology teams in 3 health systems in Washington, DC, during February and March 2022. We applied the Exploration, Preparation, Implementation, Sustainment Framework to develop a deductive codebook, performed thematic analysis on the interview transcripts, and summarized our results descriptively.
  
  Results
  
  Health systems varied in clinical and support staff roles and capacity. None of the participating clinics had an electronic health record (EHR)–based process for identifying patients who completed their cancer treatment (“survivors”) or a standardized cancer survivorship program. Their capacities also differed for documenting social risk factors and referrals in the EHR. Interviewees expressed awareness of the prevalence and effect of social risk factors on cancer survivors, but none employed a systematic process for identifying and addressing social risk factors. Recommendations for increasing screening for social risk factors included designating a person to fulfill this role, improving data tracking tools in the EHR, and creating systems to maintain up-to-date information and contacts for community-based organizations.
  
  Conclusion
  
  The complexity of cancer care workflows and lack of reimbursement results in a limited ability for clinic staff members to screen and make referrals for social risk factors. Creating clinical workflows that are flexible and tailored to staffing realities may contribute to successful implementation of a screening and referral program. Improving ongoing communication with community-based organizations to address needs was deemed important by interviewees.
  
  
• Subjects:
  Cancer Survivors Early Detection Of Cancer Humans Neoplasms Qualitative Research Referral And Consultation Risk Factors
• Source:
  Prev Chronic Dis. 2024; 21
• DOI:
  http://dx.doi.org/10.5888/pcd21.230352
• ISSN:
  1545-1151
• Pubmed ID:
  38573795
• Pubmed Central ID:
  PMC10996388
• Document Type:
  Journal Article
• Funding:
  U01 DP006639/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  21
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:f374f1d4b3cabb67537bd5acad97c51711e9825573f5930b623b599a0fe5a838b2f52bc83b17cfe8b5b99417ace7f55d50b5322d35e9131f02b65063b9c51128
• Download URL:
  https://stacks.cdc.gov/view/cdc/154770/cdc_154770_DS1.pdf
• File Type:
  [PDF - 483.94 KB ]