4A-1: Building healthcare provider patient education competencies through resource development consultations

Aileen Trang¹, Janet Papadakos², Nazek Abdelmutti², Aman Sium², Tina Papadakos², Audrey Jusko Friedman^2
1Toronto General Hospital, ELLICSR Centre,, Toronto, Canada ²Princess Margaret Cancer Centre, Toronto, Canada

Abstract: Background: Healthcare providers (HCPs) who have strong patient education (PE) competencies can better respond to patient needs. HCP PE competencies are usually built through formal training programs and in-services however these competencies can also be built through resource development consultations with Patient & Family Education Program (PFEP) staff. Description: PFEP staff work collaboratively with HCPs to develop resources for patients and families. The PFEP uses a consultation process to work with HCPs to define resource content and transform it into something actionable and meaningful to patients. HCPs take the role of subject matter expert and the PFEP takes responsibility for plain language review. As part of this process, the PFEP discusses various adult learning theories and principles with HCPs and because HCPs are already motivated to develop a resource, they are primed to receive this relevant learning. Although we did not intend to infuse training into resource development consultations, we have seen that these can be very effective means of educating HCPs during a highly teachable moment. Evaluation/Usefulness: HCPs who receive PE training during resource development consultations demonstrate growth in PE competencies with each proceeding resource development project. We have seen that HCPs that have worked with us require less plain language consultation. An emergent outcome of this collaboration is that these HCPs become PE champions for their disease site groups and engage other HCPs in PE work. They further help PFEP staff maintain close, ongoing working relationships with site group colleagues. Relation to Theme: Building PE competencies in HCPs can better enable them to communicate important medical instructions and information to patients and families, better respond to patients’ needs, and in turn, help reduce disparities between those with adequate and limited health literacy. Although formal training has been shown to be effective in building Learning Objectives: The participant shall be able to understand how to incorporate healthcare provider patient education competency training into resource development project work. References: 1. Visser, A., & Wysmans, M. 2010. Improving patient education by an in-service communication training for health care providers at a cancer ward: Communication climate, patient satisfaction and the need of lasting implementation. Patient Education and Counseling, 78(3); 402-408. 2. Hoving, C., Visser, A., Mullen, P.D., & van den Borne, B. 2010. A history of patient education by health professionals in Europe and North America: From authority to shared decision making education. Patient Educatio and Counseling, 78(3); 275-281.

4A-2: Making pathology reports meaningful to patients: A plain language intervention

Aman Sium, Janet Papadakos, Angela Dosis, Vincenzo Addario, Audrey Jusko Friedman, Danny Ghazarian
Princess Margaret Cancer Centre, Toronto, Canada

Abstract: Background/Purpose: Following guidelines from the College of American Pathologists and the American Society of Clinical Oncology, cancer centers in Ontario are mandated to provide oncology patients with copies of their pathology reports. This mandate is to promote greater transparency between patients and physicians. Pathology reports are complex however. As such the spirit of the mandate cannot be fulfilled if reports are supplied without interpretation. Description: We sought to develop an approach to supply patients with a companion version of their pathology reports that would help them understand it. To do this, we surveyed patients to learn what was most important to them. We continued to solicit patient response until we reached saturation and were able to identify the most important themes. We found that patients were interested in only a small amount of information in the reports. Rather than developing an approach to interpreting the full pathology report, we focused on a method of relaying only the salient information to patients. This involved developing a plain language synoptic report that translates complex medical terms into words that lay people can understand. This “patient-friendly” synoptic report is given to patients as an addendum to the full-length pathology report. Evaluation: The patient-friendly synoptic report is undergoing a formative evaluation in the Breast Clinic at the Princess Margaret Cancer Centre in Toronto, Ontario with plans to be adopted hospital-wide. Results of the evaluation will be shared. Usefulness: Patient-friendly synoptic reports seek to enhance access to information, as well as support patients to comprehend and make decisions based upon that information. The process of making the patient-friendly synoptic report, as well as the outcomes and metrics for measuring its effectiveness, are applicable to all cancer groups. Relation to Theme: This abstract addresses the theme of “Cancer Education in Diverse Populations: Disparities, Genomics and Innovations”. The development of patient-friendly health reporting strengthens knowledge translation, and helps to mitigate the effects of low health literacy. Learning Objectives: The participant shall be able to identify a process for developing, implementing, and evaluating the effectiveness of patient-friendly reporting. References: 1. Keselman, A et al (2007). Towards consumer-friendly PHRs: Patients’ experience with reviewing their health records. AMIA Annual Symposium Proceedings 2007, pp.399-403. 2. Zarcadoolas, C. (2011). The simplicity complex: Exploring simplified health messages in a complex world. Health Promotion International, 26(3), pp.338-350.

4A-3: Cancer Clear & Simple: A Culturally Appropriate, Community-Driven Cancer Education Program

Rebecca Linskens¹, Erin Bailey¹, Rick Strickland¹, Amy Williamson¹, Alexandra Adams^2
1University of Wisconsin Carbone Cancer Center Cancer Health Disparities Initiative, Madison, WI, USA, ²University of Wisconsin Department of Family Medicine, Madison, WI, USA

Abstract: Cancer Clear & Simple (CC&S) materials evolved out of a rural Wisconsin community’s desire to learn more about cancer. In 2010, the Cancer Health Disparities Initiative (CHDI) partnered with an underserved rural community to select, adapt, test and implement an evidence-based cancer education program. CHDI and community partners collaborated to select the Alaska Native Tribal Health Consortium’s Understanding Cancer as the base text and used a tiered process to adapt and test the materials. CHDI has since been adapted in partnership with African American and Latino communities. CC&S materials include a three-part curriculum, over 45 handouts and a Train-the-Trainer Manual. The intent of CC&S is to communicate culturally appropriate cancer education and provide a catalyst for empowering communities. Using a learner-centered approach, participants critically reflect upon, synthesize, and apply cancer information to their everyday life. Interactive hands-on activities, such as role playing, are included to reinforce deeper understandings, and promote comprehensive ways of learning throughout the educational sessions. Extensive evaluation of CC&S has occurred since 2011. Both rural and African American adaptations increase participant knowledge about cancer basics, prevention and screening, and improve behavioral intent. CHDI is currently testing a CC&S hybrid version with a local Latino community. CHDI has also partnered with a health services researcher to evaluate the impact of CC&S on long-term behavioral change, including cancer screening. Attendees will understand how CC&S has enhanced cancer education through a participatory approach founded on health literacy principles. Delivering dynamic, relevant content, CC&S has been shown to increase participant knowledge and behavioral intent. Learners have described these materials as accessible, engaging, practical, and action-oriented. They have also described how incorporating interactive activities helps to create a supportive learning environment, breaking the silence that often surrounds cancer within communities. Relation to Theme: CC&S is a key component of CHDI’s efforts to reduce cancer disparities through community-based research, education and training with underserved populations. Sharing the development, implementation and evaluation of CC&S illustrates effective, results-oriented bridge-building between academic institutions and community partners, an essential part of long-term disparities reduction. Learning Objectives: Attendees will understand how CC&S has brought cancer education to life through a participatory approach founded on health literacy principles. References: 1. Kuhnley R, Cueva M. Learning about cancer has brightened my light: cancer education for Alaska Community Health Aides and Community Health Practitioners (CHA/Ps). J Cancer Educ. 2011;26(3):522-529. 2. Cueva M, Hicks T, Kuhnley R, Cueva K. A Wellness Course for Community Health Workers in Alaska: “wellness lives in the heart of the community”. Int J Circumpolar Health. 2012;71:19125.

4A-5: Patients as Partners in Care: Implementation of a Patient Portal as Part of a Patient and Family Education Program Strategy

Nazek Abdelmutti¹, Selina Brudnicki¹, Lembi Bishop¹, Mark Barszczyk², Ahmed Shah², Helen Dewar¹, Rita Kang¹, Audrey Jusko Friedman^1
1University Health Network, Toronto, Canada; ²University of Toronto, Toronto, Canada

Abstract: Background: The University Health Network in Toronto, Canada is rolling out the myUHN Patient Portal, a web based tool providing real time access to the patient health record, beginning with early adopters in oncology. Implementation and operations of the portal are uniquely and strategically aligned with the Patient and Family Education Program. Given the documented disparities in utilization and accessibility of patient portals amongst people with low health literacy, we sought to integrate the portal into organizational culture with health literacy as a central tenant of our strategy. Description: Utilizing an adapted framework for e-health change, an implementation plan for the first phase of the portal was designed to support uptake by patients and integration of the portal into provision of quality care by healthcare providers. This encompassed identifying patient, staff and organizational requirements for stakeholder engagement, communication, integration, education and evaluation as part of a continuous cycle that addressed health literacy at each step. Evaluation: The adapted framework identified key requirements to support uptake of the portal. For patients, this included development of quality, plain language text and audiovisual tools to support the patient as a partner in care. For health care professionals, this included facilitating the use of clinical teaching tools to support management of care and improving the quality of clinical documentation as a means of enhancing patient-provider communication. Evaluation requirements included ongoing assessment of patient and staff perceptions on usability, utilization and impact on clinical care. Usefulness: As patient portals evolve and become increasingly ubiquitous, addressing health literacy related disparities in access and use of web based tools in health care is a significant challenge. The approach and tools described present a framework for the role of patient education programs in implementation, adoption and evolution of patient portals as we move towards espousing the attributes of health literate organizations. Relation to Theme: A growing body of literature indicates that disparities exist amongst people with low health literacy in the utilization of patient portals, presenting a critical role for patient educators to develop strategies that mitigate health literacy concerns at programmatic and organizational levels. Learning Objectives: 1. The participant shall be able to identify the impact that patient portals have on patient satisfaction, patient engagement, and health outcomes. 2. The participant shall be able to identify how health literacy presents disparities in access to and utilization of patient portals. 3. The participant shall be able to adapt a framework from which patient education programs can assess organizational requirements from the implementation and evolution of patient portals. References: 1. Zarcadoolas C, Vaughon WL, Czaja SJ, Levy J, Rockoff ML. Consumers’ Perceptions of Patient-Accessible Electronic Medical Records. J Med Internet Res 2013;15(8):e168. 2. Kruse CS, Bolton K, Freriks G. The Effect of Patient Portals on Quality Outcomes and Its Implications to Meaningful Use: A Systematic Review. J Med Internet Res 2015;17(2):e44.

Abstract withdrawn by author.