Click on the poster session below to view all abstracts in that session. Abstracts and information for plenary and concurrent sessions are accessible via the online schedule.
P1-A– Meeting the diverse but unique educational needs of young women diagnosed with breast cancer: a toolkit approach
Lori Flowers, Michelle Esser, Jean Rowe, Stacy Lewis, Megan McCann
Young Survival Coalition, New York, NY, USA
Abstract: Background: Approximately 13,000 women under age 40 are diagnosed with breast cancer in the US annually. Young women (YW) face more aggressive cancers, lower survival rates and unique psychosocial concerns. Young Survival Coalition (YSC) developed a navigator series to provide educational and organizational tools for YW diagnosed with breast cancer at any stage of their journey, providing pertinent information to empower them to be their own best health advocates. Description: YSC surveyed newly diagnosed YW with breast cancer (308) living with metastatic disease (300), post-treatment (268), and long-term (5+ years past diagnosis) (461) to determine their unique needs and concerns. Based upon these survey results, YSC developed 4 tools to provide information to help YW cope. The Newly Diagnosed Navigator (NDN) provides information and tools as well as a glossary and lists of questions to ask doctors. The Metastatic Navigator (MN) helps a YW understand her diagnosis, discusses treatment options and provides practical tips. The Post-Treatment Navigator (PTN) provides support for the YW’s adjustment to life after treatment and breast cancer. The Long-Term Navigator (LTN) discusses this population’s particular concerns, including long-term side effects and fear of recurrence. Evaluation: To date, 6,369 NDNs, 2,623 MNs, 2,774 PTNs and 1,240 LTNs have been distributed. Completed evaluations indicated these tools have increased recipients’ knowledge, what to expect physically and emotionally and have improved their knowledge of available resources. Navigator distribution will continue with plans to translate the navigators into other languages. All navigators are currently available for viewing online. Usefulness: Young breast cancer survivors are an underserved population with varied concerns which need addressing. YSC meets those unique needs through its “toolkit” of navigators. All YSC resources are free and can be received in person, ordered through email, phone, and online request or viewed/downloaded online. Relation to Theme: This abstract describes free four printed tools created by Young Survival Coalition directed to the educational needs of young women diagnosed with breast cancer at any stage of their journey. These tools include the newly diagnosed navigator, post-treatment navigator, metastatic navigator and long-term navigator. Learning Objectives: 1.The participant shall be able to describe 3 unique issues faced by young women with breast cancer. 2. The participant shall be able to identify 3 information needs of young women diagnosed with breast cancer. 3. The participant shall be able to identify 4 tools to aid a young woman diagnosed with breast cancer. References: 1. American Cancer Society. Breast Cancer Facts & Figures 2013-2014. 2. Anders CK, Hsu DS, Broadwater G, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol. 2008; 26(20): 3324-3330. 3. Bloom JR, Stewart SL, Oakley-Girvan I, Banks PJ, Shema S. Quality of life of younger breast cancer survivors: persistence of problems and sense of well-being. PsychoOncology. 2012; 21(6):655-665.
P3-A – Developing a Community Theater Program for Cancer Prevention
Jane Montealegre, Ivan Valverde, Roshanda Chenier, Anedny Laubscher, Glori Chauca, Maria Jibaja-Weiss
Baylor College of Medicine, Houston, TX, USA
Abstract: Background/Purpose: Disparities in cancer screening contribute to the increased burden of cervical (CxC), colorectal (CRC), and breast cancer (BC) in medically underserved minority populations. Innovative strategies are needed to disseminate screening education to these populations in a culturally sensitive manner. We developed a community theater program designed to promote CxC, CRC, and BC screening among medically underserved Hispanic, African American, and Vietnamese communities in Houston, Texas. Description: 2 plays and 9 monologues (3 for each target population) were developed. Synopses and scripts were created by professional playwrights based on theory-based messages and with oversight from a clinical advisory board. Professional actors enacted the performances. Community venues for live performances were identified within medically underserved areas with a high incidence of CxC, CRC, and/or BC. A brief survey was used to assess audience members’ intentions to obtain screening before and after the performance. Evaluation: Since January 2014, 25 monologues and 2 plays have been performed. Total attendance was of 1,379 individuals (average = 33/monologue and 121/play). Surveys (n = 987, response rate = 72%) indicate a 22% increase overall in the proportion of audience members’ reporting that they are “highly likely” to obtain a screening test following the performance (from 53-72% pre- to 72-90% post-performance). Feedback from community partners indicates that the monologues especially are highly regarded due to their brief duration. Usefulness: Community theater may be an effective tool to communicate health messages to promote cancer screening in medically underserved minority populations. Following an intense development phase, a repertoire of monologues and full-length plays is available for ongoing performances. Sustainability and dissemination are augmented by the use of monologues, which are brief in duration and require minimal set-up and a single actor. Relation to Theme: Diverse populations often suffer health disparities due to lack of awareness of their needs. Community theater may be an effective way to reach populations that are medically underserved. Developing culturally-appropriate dialogue and themes serves to properly communicate messages of awareness. Learning Objectives: After the presentation, the participant shall be able to determine the ways in which community theater in three different populations can be developed to promote awareness of cancer screening. References: 1. Faigin DA, Stein CH. “Community-based theater and adults with psychiatric disabilities: social activism, performance and community engagement.” Am J Community Psychol. 2015 Mar;55(1-2):148-63. 2. Cueva M, Kuhnley R, Slatton J, Dignan M, Underwood E, Landis K. “Telenovela: an innovative colorectal cancer screening health messaging tool.” Int J Circumpolar Health. 2013 Aug 5;72:21301.
P5-A: Enhancing Clinical Trials Accrual and Informed Consent Via Community-Based Research
Georiga Robins Sadler1, Vanessa Malcarne2, Natasha Riley3, Natasha Mazon1
1University of California San Diego, Moores Cancer Center, San Diego, CA, USA, 2San Diego State Universsity, San Diego, CA, USA, 3Visa Community Clinic, Vista, CA, USA
Abstract: Introduction: The slow accrual of participants to research studies is a universal challenge for researchers. Accruing samples that are representative of the nation’s diverse socio-demographic characteristics is even more challenging. The literature is replete with studies that have identified multiple factors that contribute to this challenge to advancing medical science. Methods: This research team has created and tested multiple programs designed to help the public understand the personal and community benefits that can be accomplished when study participants from diverse communities can be recruited quickly. Results: Each of the studies showed that the groups that received the experimental clinical trials educational intervention had significantly greater gains in knowledge, attitudes, and perceptions favorable to clinical trials participation compared to the control group. However, the control groups also demonstrated changes that were favorable to future clinical trials participation, albeit at a lesser extent. Discussion/Conclusion: The only common ground between the two groups was the actual process of participating in a research study. Possibly, the act of participating in a clinical research study gave participants in both groups the opportunity to meet people who conduct research, learn about the research and consenting process, experience being part of a research study, develop a sense of how their participation might benefit themselves and others, and develop a trusting relationship with a person who conducts research. These experiences may have been sufficient to trigger the observed advances in the control group between baseline and follow-up. Further research is warranted to assess whether on-going community-based research might have the triple community benefit of increasing the community’s understanding of research, conducting minimally intrusive research that could benefit the community, and also increase community understanding of research and the consenting process, progress that could encourage interest in clinical trials participation should they be offered at a later date. Relation to Theme: Accruing samples with diverse charactistics is critical to determining the degree to which research findings can be generalized with confidence. This analysis of data gathered from multiple studies demonstrates that the simple act of engaging people in a minimally intrusive research study can help reduce barriers to research study participation. Learning Objectives: The participant shall be able to understand the barriers to research study participation and how engaging people in the simplest studies can be effective in reducing barriers to participation in more complex studies. References: 1. Robinson, JM, Trochim WMK. An examination of Community Members’, Researchers’, and Health Professionals’ Perceptions of Barriers to Minority Participation in Medical Research: An Application of Concept Mapping, Health & Ethnicity, (2007)12:5,521-39, DOI: 10.1080/13557850701616987 2. Michaels M, et al. The Promise of Community-Based Advocacy and Education Efforts for Increasing Cancer Clinical Trials Accrual. J Cancer Educ, (2012) 27:67-74. DOI: 10.1007/s13187-011-0271-6.
P7-A: Making Impacts on Health Disparities through Innovative Community Benefit Programming
Bonnie Bristow1, Nadia Zygowski1, Merrylee McGuffin2
1Odette Cancer Centre, Toronto, Canada, 2Sunnybrook Health Sciences Centre, Toronto, Canada
Abstract: Background: Geriatric breast cancer patients have specialized needs compared to younger patients. Currently, there is disparity of care, with comprehensive cancer centres unable to adequately respond to the needs of this population. Specialized geriatric oncology clinics in Europe focus on care for older patients and are increasingly of interest in Canada due to the aging population. This study examines radiation therapist (RT) views on the need for specialized geriatric oncology clinics for women over age 70 with early stage breast cancer. Methods: The study utilized a cross sectional survey design, with Likert scale, multiple choice and open ended questions. Surveys were sent out via email to all RTs registered with the Canadian Association of Medical Radiation Technologists. Demographic information was collected. Descriptive statistics and χ² tests were used to analyze quantitative data. Responses to open ended questions were compiled for thematic analysis. Results: 240 therapists completed the survey (17% response rate). 90% of RTs were unaware of specialized geriatric oncology clinics but 65% felt these clinics could be useful. RTs in treatment delivery had a significantly higher awareness of these clinics than RTs working in other areas (χ² = 6.29, p= 0.043). 60% of RTs felt knowledgeable and confident in recognizing and helping with the special needs of this population. 80% of RTs were not familiar with assessment tools geared towards geriatric patients but 85% felt these tools would be useful. Discussion: Canadian RTs report that older women with breast cancer could benefit from specialized geriatric oncology clinics and assessment tools geared toward this population. However, most RTs were not familiar with these assessment tools indicating a need for education regarding their application within the clinic environment. Regardless, many RTs felt knowledgeable and confident in recognizing and helping with the special needs of their geriatric patients. Relation to Theme: This study examines radiation therapist attitudes towards specialized geriatric oncology clinics. Such clinics are currently not in use in Canada and they present an innovative solution aimed at helping an underserviced sector of our diverse patient population. Learning Objectives: 1. The participant shall be able to list at least three benefits that could be experienced by geriatric breast cancer patients if they are able to attend specialized geriatric oncology clinics prior to undergoing cancer treatment. 2. The participant shall be able to list at least three perceived drawbacks to specialized geriatric oncology clinics as expressed by front-line health care workers.. References: 1. Extermann, M, Meyer, J, McGinnis, M, Crocker, T, Corcoran, TT, Yoder, MB, Haley, WE, Chen, H, Boulware, D, & Balducci, L. A comprehensive geriatric intervention detects multiple problems in older breast cancer patients. Critical Reviews in Oncology/Hematology, 2003, 49(1): 69-75. 2. Horgan, A, Leighl, NB, Coate, L, Liu, G, Palepu, P, Knox, JJ, Perera, N, Emami, M, & Alibhai, S, Impact and Feasibility of a Comprehensive Geriatric Assessment in the Oncology Setting: A Pilot Study. American Journal of Clinical Oncology.
P9-A: Educating diverse and medically underserved populations about lung cancer screening using low dose computed tomography: opportunities and challenges
Shiraz I Mishra1, Andrew Sussman1, Robert Rhyne1, Christina Getrich2, Kathryn Taylor3, Ambroshia Murrietta1, Richard M Hoffman4
1University of New Mexico School of Medicine, Albuquerque, New Mexico, USA, 2University of Maryland, College Park, MD, USA, 3Georgetown University Medical Center, Washington DC, USA, 4University of Iowa Carver College of Medicine, Iowa City, IA, USA
Abstract: Background/Purpose: Lung cancer is the leading cause of cancer death in the United States, accounting for one-third of all cancer deaths. Screening for lung cancer with chest x-rays (CXR) and/or sputum cytology has not proven effective in reducing lung cancer mortality. The National Lung Screening Trial (NLST) demonstrated the efficacy of three rounds of annual lung cancer screening with low dose computed tomography (LDCT) in significantly reducing lung cancer mortality among heavy smokers compared to undergoing CXR. Consequently, national guidelines recommend screening high-risk smokers with LDCT. However, translating this evidence to practice is challenging, especially since the NLST did not have adequate representation of the diverse (racial/ethnic, socio-economic) populations experiencing disparities in lung cancer mortality. We characterized patients’ perspectives about lung cancer screening using LDCT, with the goal of developing decision support aids to inform patients about LDCT and lung cancer screening. Methods: Qualitative, in-depth interviews with patients purposefully selected from a Federally Qualified Health Center and a cancer center-affiliated multidisciplinary chest clinic. We conducted the interviews between February and September 2014 that focused on the patients’ smoking history, perspectives regarding lung cancer screening, and information needs to support education and decision making. Results: We reached thematic saturation after interviewing 20 patients, 10/site. None of the patients had heard about the screening test. Generally, there was high receptivity to screening, with the primary challenges being cost, anxiety and stress. Patients were largely not influenced by potential test-related negative consequences such as false positives, invasive diagnostic tests, radiation, continued surveillance. Moreover, patients indicated they may continue smoking if the test was negative. About their educational needs, patients preferred in-person discussions supported by written materials to guide decision making. Conclusions: Patients were not informed about LDCT screening and could benefit from educational tools to support shared decision making about lung cancer screening. Relation to Theme: Applicability of the NLST findings to racially/ethnically diverse and low-resourced populations, with limited access to health care resources is unclear. The study findings provide invaluable insights to develop educational and information tools to support shared decision making about lung cancer screening among these high risk diverse and medically underserved populations. Learning Objectives: 1. The participant shall be able to list at least one patient preferred mode of communicating complex risk-based information regarding LDCT screening for lung cancer to inform shared decision making. 2. The participant shall be able to identify at least two patient identified challenges in implementing LDCT screening. References: 1. Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409. Epub 2011/07/01. 2. Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, et al. SEER Cancer Statistics Review, 1975-2011. Bethesda, MD: National Cancer Institute, 2014. 3. Bryan L, Westmaas L, Alcaraz K, Jemal A. Cigarette smoking and cancer screening underutilization by state: BRFSS 2010. Nicotine Tob Res. 2014;16(9):1183-9. Epub 2014/04/04. 4. Moyer VA. Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-8. Epub 2014/01/01.
P11-A: Lower incidence of tobacco-related cancers in Cyprus compared to other countries
Evi Farazi1, Lina Lander2, Pavlos Pavlou3, Katherine Watkins2, Lynne Le2, Amr Soliman2
1University of Nicosia, Nicosia, Cyprus, 2University of Nebraska Medical Center, Omaha, NB, USA, 3San Diego State University, San Diego, CA, USA, 3Ministry of Health, Nicosia, Cyrpus
Abstract: Tobacco smoking has been associated with the development of various cancers. In Cyprus, 39% of men and 14% of women reported daily smoking in the latest report of 2008, thus making tobacco smoking a significant health concern. The objective of this study was to investigate the incidence of tobacco-related cancers in Cyprus by geographic region and compare it with other countries in order to better understand the impact of tobacco in Cyprus. Data on lung, urinary bladder, oral, pharyngeal, head/neck, and laryngeal cancers were obtained from the Cyprus Cancer Registry (1998-2008). Univariate analysis comparing tobacco-related cancers and all other cancers were conducted with respect to age at diagnosis, age groups, sex, smoking status, disease stage, and rural/urban status. Our results revealed that patients with tobacco-related cancers were older than those with non-tobacco cancers (mean age 67.2 + 12.4 vs. 62.4 +17.1, p. Relation to Theme: This work addresses the incidence of cancers associated with tobacco in Cyprus and compares this incidence with that of other countries. Understanding the incidence patterns of such cancers can help cancer educators concentrate on geographic areas where the incidence of these cancer types is the highest. Learning Objectives: The participant shall be able to appreciate that the incidence of tobacco-related cancers can vary geographically within a country. The identification of areas of higher tobacco-related cancer incidence can help cancer educators prioritize where their efforts should be directed to. In addition, the participant will learn about the variation of tobacco-related cancer incidence among different countries. Finally, the participant will be introduced to the idea that despite high smoking prevalence certain populations exhibit lower tobacco-related cancer incidence. Further studies in such populations can reveal genetic and environmental factors that render them resistant to the development of cancers associated with tobacco. References: 1. Ng M et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA, 2014; 311(2):183-192. 2. Wlodarczyk A, Raciborski F, Opoczynska D, Samolinski B. GATS PWG: Daily tobacco smoking patterns in rural and urban areas of Poland–the results of the GATS study. Ann Agric Environ Med. 2013; 20: 588-594. 2. Saikia BJ et al. Interaction of XRCC1 and XPD gene polymorphisms with lifestyle and environmental factors regarding susceptibility to lung cancer in a high incidence population in North East India. Asian Pac J Cancer Prev. 2014; 15:1993-1999.
P13-A: Pilot Testing of a Spanish Language Biobanking Educational Intervention: Biobanco: una esperanza de cura para el cáncer
Kristen Wells1, Mariana Arevalo2, Cathy Meade3, Sharon Baik4, Lynne Klasko3, Liliana Gutierrez3, Andres Hernandez5, Gwendolyn Quinn3, Ji-Hyun Lee6, Paul Jacobsen3, Clement Gwede3
1San Diego State University, San Diego, CA, USA, Nicosia, Cyprus, 2University of Texas Health Science Center at Houston, Houston, TX, USA, 3H. Lee Moffitt Cancer Center, Tampa, FL, USA, 4San Diego State University/University of California San Diego, San Diego, CA, USA, 5University of Central Florida, Orlando, FL, USA, University of New Mexico Cancer Center, Albuquerque, NM, USA
Abstract: Background/Purpose: Biospecimens are biological samples taken from the body and stored in biobanks for scientific research. Research suggests community members have low awareness about biospecimen research, and few Spanish-language educational materials exist. We conducted a pilot test of a Spanish-language multimedia biobanking educational intervention entitled Biobanco: una esperanza de cura para el cáncer (targeted DVD + booklet) in a federally qualified health center. Methods: Seventy-four Hispanics, who preferred receiving information in Spanish (mean age: 38 years; 85% female), were randomized to either the intervention group (n=37) or control group (n=37), which received a National Cancer Institute (NCI) biobanking brochure (Lo que usted debe saber antes de dar sus tejidos para investigación médica). Using the validated BANKS and Biomedical Research Trust surveys, data on knowledge about and attitudes toward biospecimen donation and biobanking, self-efficacy for participating in a biobank, intention to donate a biospecimen for research, and trust in biomedical research were collected prior to intervention delivery (baseline) and 7-28 days later (follow-up). Results/Findings: Among intervention group participants, self-efficacy for donating a biospecimen (mean change:11.5; 95% Confidence interval [95%CI]: 2.7, 20.3), knowledge regarding biospecimen donation and biobanking (mean change:0.1; 95%CI: 0.05, 0.15), and trust in biomedical research (mean change:8.5; 95%CI: 0.7, 16.2), increased from baseline to follow-up. Knowledge also increased from baseline to follow-up in the control group (mean change:0.08; 95%CI: 0.02, 0.13). Intention to donate urine remained high in the intervention group and decreased in the control group (mean difference in change scores: -0.55; 95% CI: -1.05, -0.06). Discussion: Biobanco: una esperanza de cura para el cáncer is a promising intervention for increasing knowledge related to biospecimen donation and biobanking, self-efficacy for donating a biospecimen, and biomedical research trust and maintaining high intention to donate urine. A larger study is necessary to evaluate its efficacy. Relation to Theme: This abstract relates to both cancer education in diverse populations and innovations in cancer treatment research that include genomics. In fact, the abstract describes the first known Spanish-language multimedia intervention to inform community members about cancer-related biospecimen research and pilot tests this intervention as compared to written educational material. Learning Objectives: The participant shall be able to describe the Biobanco: una esperanza de cura para el cáncer intervention’s impact on knowledge regarding biospecimen donation and biobanking, self-efficacy for donating a biospecimen, biomedical research trust, and intention to donate urine. References: 1. Gao, W., Ma, G. X., Tan, Y., Fang, C., Weaver, J., Jin, M., Godwin, A. K. (2014). Culturally appropriate education intervention on biospecimen research participation among Chinese Americans. Cancer Epidemiology Biomarkers & Prevention, 23(3), 383-391. 2. Kiviniemi, M.T., Saad-Harfouche, F.G., Ciupak, G.L., Davis, W., Moysich, K., Hargrave, N.C., … Erwin, D.O. (2013). Pilot intervention outcomes of an educational program for biospecimen research participation. Journal of Cancer Education, 28, 52-59.
P15-A: A multi-ethnic comparison of CRC screening related knowledge, attitudes and behaviors among older adults in Florida
Jordan Neil, Janice Krieger, Thomas George
University of Florida, Gainesville, FL, USA
Abstract: Background: Colorectal cancer (CRC) is the second leading cause of cancer death in both men and women. Efforts to increase screening utilization have significantly reduced CRC mortality rates in the past three decades. However, there remain disparities between Caucasians and minorities in CRC screening uptake and CRC-related deaths. Before CRC screening interventions can be developed to address the needs of minority populations, formative research is needed to understand potential group differences in CRC knowledge, behavioral risk factors, and screening behaviors. Methods: An online survey was administered in March 2015 (Colorectal Cancer Awareness Month) and completed by 747 participants, including African American (AAs) n=70, Latinos n=112, Caucasians n=565. The sample consisted of permanent residents of Florida aged 50-75. Knowledge scores were measured across eight items that assessed CRC prevalence, survival rates, screening guidelines, and physiology. Participants self-reported behavioral risk factors for CRC (N=5) and past CRC screening history. Results: Less than half of participants were within guidelines for CRC screening (n = 324), with African Americans significantly less likely than Caucasians and Latinos to be within guidelines [F(2, 744)=4.47, pF(2, 744)=4.01, pM=1.83, SD=1.29) and Caucasians the highest (M=2.30, SD=1.32). There were no significant differences among demographic groups on the number of behavioral risk factors. CRC knowledge was negatively associated with behavioral risk factors (r = -.16, p r =.15, p r = -.53, p Discussion: This study provides formative insight into key variables that play an important role in the screening behaviors of minorities. These insights may prove valuable in the development of educational interventions to increase CRC screening rates. Relation to Theme: This abstract relates directly to the conference theme as it addresses the CRC educational needs of medically underserved populations. The authors believe this submission facilitates critical discussion about improving CRC knowledge, attitudes, and behaviors among diverse groups, and hopes to advance future educational interventions. Learning Objectives: 1. The participant shall be able to identify differences and similarities across population groups as related to colorectal cancer knowledge, behavioral risk factors, and screening behaviors. 2. The participants shall be able to define the relationship among colorectal cancer knowledge, behavioral risk factors, and screening behaviors among underserved populations. References: 1. Gupta, S., Halm, E. A., Rockey, D. C., Hammons, M., Koch, M., Carter, E. & Skinner, C. S. (2013). Comparative effectiveness of fecal immunochemical test outreach, colonoscopy outreach, and usual care for boosting colorectal cancer screening among the underserved: A randomized clinical trial. JAMA Internal Medicine, 173(18), 1725-1732. 2. Jerant, A., Kravitz, R. L., Fiscella, K., Sohler, N., Romero, R. L., Parnes, B., … & Franks, P. (2013). Effects of tailored knowledge enhancement on colorectal cancer screening preference across ethnic and language groups. Patient Education and Counseling, 90(1), 103-110.
P17-A: Survival Trends of Acute Myeloid Leukemia (AML) in the United States: A SEER Database Analysis
Lata Nawal, Vijaya Bhatt, Gleb Haynatzki, Baojiang Chen, Kailash Mosalpuria, KM Monirul Islam
University of Nebraska Medical Center, Omaha, NE, USA
Abstract: Background: Acute Myeloid Leukemia (AML) accounts for only 1% of all new cancers but if not treated immediately is associated with rapid progression and death. While survival of adult AML patients has increased significantly over the last decade, there is conflicting data about this improvement across population subsets with regards to age, gender, race etc. Method: The Surveillance, Epidemiology, and End Result (SEER) registry18 was used to identify AML cases from 1988 to 2011. Extended Cox regression model was used to compare overall survival for all AML patients based on different demographic factors age, gender, race, marital status, and insurance status. Result: A cohort of 23,775 AML patients was analyzed. Proportion of AML patients was statistically significant by age (elderly vs young adults: 73% vs 27. Conclusion: OS improved after 2002. However, elderly, singles, and those with Medicaid patients with AML had worse survival. Targeted interventions are needed to improve outcomes in above subsets. Relation to Theme: The aim of this abstract is to educate the audience about disparities in survival with respect to certain epidemiological factors i.e. age, gender, race, marital status, and insurance status. Learning Objectives: Identify the role of various epidemiologic factors on survival in AML patients. References: 1. Nazha, A. (2014). Acute myeloid leukemia in the elderly: do we know who should be treated and how? Leukemia & lymphoma, 55(5), 979-987. doi: 10.3109/10428194.2013.828348 2. Thein, M. S., Ershler, W. B., Jemal, A., Yates, J. W., & Baer, M. R. (2013). Outcome of older patients with acute myeloid leukemia. Cancer, 119(15), 2720-2727.
P19-A: A Feasibility Trial of Geriatric Assessment and Integrated Care Plan for Older Cancer Patients
Martine Puts1, Schroder Sattar1, Kara McWatters1, Katharine Lee1, Raymond Jang2, Eitan Amir2, Monika Krzyzanowska2, Anthony Joshua2, Shabbir Alibhai2
1University of Toronto, Toronto, Canada, 2University Health Network, Toronto, Canada
Abstract: Background: The majority of persons diagnosed with cancer are older adults. A comprehensive geriatric assessment (CGA) can identify current health care issues, start interventions to prevent/postpone adverse outcomes and maintain/improve the functional status and well-being of older adults. We explore the impact of a CGA within an integrated care plan in optimizing outcomes in older patients with advanced breast (BC), gastrointestinal (GI) or genitourinary (GU) cancer Methods: A two-group parallel single-blind phase II RCT is enrolling 60 patients aged 70 years and over, diagnosed with GI, GU or BC, referred for first line chemotherapy or having received 6 months, ECOG PS 0-2 and able to provide informed consent. Randomization to intervention and control group is 1:1 and stratified based on treatment intent (adjuvant vs. palliative). The intervention includes a full CGA by a multidisciplinary geriatric team followed by an integrated care plan to address the issues identified. Based on the CGA and discussion with the patient, tailored evidence-based interventions will be carried out by the team using a standardized intervention protocol. Participants in the intervention group are seen by the intervention team at baseline for the CGA and development of the integrated care plan; and at 3 and 6 months to assess intervention fidelity and measure outcomes. The co-primary outcomes are: 1) maintaining/improvement in Quality of life (EORTC QLQ-C30); 2) Modification of the cancer treatment plan. Results: 26 of 60 planned patients have been enrolled in the trial. This will be one of the first RCTs of CGA in geriatric oncology to show feasibility and provide estimates of impact and patient reported outcome to inform the design of a phase 3 trial. Relation to Theme: Our study addresses cancer education in diverse populations, namely the older adults with cancer. Patient education is a major component of the integrated care plan developed based on the geriatric assessment with the older adult. Learning Objectives: The participant will be able to understand patient health and education needs of the underserved population of older adults with cancer. References: 1 Eur J Cancer Care (Engl). 2015 Mar;24(2):143-6. 2. Integration of geriatric oncology in daily multidisciplinary cancer care: the time is now.
P21-A: Building a Foundation to Accelerate Rates of HPV Vaccination in Western New York
Cristina Villagra, Suky Martinez, Anibal Cortes, Vir Patel, Lina Jandorf
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Abstract: Background: Human Papilloma Virus (HPV) infection with oncogenic strains is associated with the development of anogenital and oral cancers and precancers in males and females. Although HPV vaccines have been available and routinely recommended for adolescents for several years , only one-third females and 7% of boys ages 13-to-17-years have received all three recommended doses. Our goal was to complete an environmental scan to identify and understand barriers and opportunities to enhance HPV vaccination uptake. Methods: This project relied upon a mixed methods approach. Qualitative data was collected using structured interviews (n=60) including clinicians, colleges, school based health centers and public health agencies across Western New York state. Breakdown of those interviewed included 35% physicians; 11.7% PA/NPs; 23.3% RN/LPN or 30% other professionals. Sources of quantitative data included surveys by parents (n=54) and data from the New York State Department of Health. Results: We are in the process of compiling results from the environmental scan activities. The data will be summarized and presented at an upcoming stakeholder summit and will be used to create a workplan including ideas for developing active interventions and educational programs to increase HPV vaccination uptake. Discussion: We anticipate that this effort will yield a compendium of information summarizing local/regional data, programs and resources focused on HPV vaccination and aid in cataloging the challenges to HPV vaccination specific to the Western New York State region to inform the development of future interventions. Relation to Theme: Low utilization of HPV vaccination in the United States is a public health concern that needs to be addressed. To make an impact, a multi-prong approach will be required including effective use of communication strategies, educational messaging for providers and patients, social media and policy interventions. Learning Objectives: The participant shall be able to understand challenges, barriers and opportunities related to uptake of HPV vaccination. References: 1. Stokley S, Jeyarajah J, Yankey D, et al. Human papillomavirus vaccination coverage among adolescents, 2007-2013, and postlicensure vaccine safety monitoring, 2006-2014 – united states. MMWR Morb Mortal Wkly Rep. 2014; 63:620-624. 2. Niccolai LM, Mehta NR, Hadler JL. Racial/ethnic and poverty disparities in human papillomavirus vaccination completion. Am J Prev Med. 2011; 41:428-433.
P23-A: Head and neck cancer risk perception in smoking vs. non-smoking Hispanics
Danielle Scarola1, Charles Moore2, Oswaldo Henriquez2
1Emory University School of Medicine, Atlanta, GA, USA, 2Emory University Department of Otolarynology, Atlanta, GA, USA
Abstract: Background/Purpose: Research has shown a difference in perception of general cancer risk as well as head and neck cancer risk in smokers as compared to non-smokers. Past studies have shown that smokers believe that smoking is a high-risk behavior, but do not see themselves as being at a higher risk for cancer. Ideas of risk perception have been shown to differ between smokers who have attempted to quit as compared to those with no quit attempts. Many similar studies have been done in African American and Caucasian populations with limited information on risk perception in the Hispanic cohort. Methods: A 28-item questionnaire was used to assess demographic information, smoking status and head and neck cancer risk perception in a group of Hispanic individuals who attended the Latin American Society health fair in Atlanta. Results/Findings: In the Hispanic population, non-smokers tend to perceive head and neck cancer as more dangerous than do smokers. Both groups overestimate the lifetime risk of head and neck cancer and had similar responses when asked how much quitting smoking lowers the risk of head and neck cancer. Discussion: Findings indicated differences in risk perception for smokers compared to non-smokers in the Hispanic population. A better understanding of the cultural and social factors that contribute to risk perception will allow health care providers to tailor prevention strategies to specific at-risk populations. Relation to Theme: Understanding patient cancer risk perception is a critical first step in initiating educational interventions for prevention. While we are aware of differences in perception in the Caucasian and African American populations, the risk awareness in Hispanics has not yet been assessed. Learning Objectives: The participant shall be able to define at least two ways Hispanic smokers and non-smokers differ in their perception of head and neck cancer risk. References: 1. White LJ, Chin-Quee AL, Berg CJ, Wise JC, Hapner ER. Differences in head and neck cancer risk perception between smoking and nonsmoking NASCAR attendees. Otolaryngol Head Neck Surg. 2012;147(1):63-68. doi:10.1177/0194599812438662. 2. Savoy E, Reitzel LR, Scheuermann TS, et al. Risk perception and intention to quit among a tri-ethnic sample of nondaily, light daily, and moderate/heavy daily smokers. Addict Behav. 2014;39(10):1398-1403. doi:10.1016/j.addbeh.2014.05.002.
P25-A: Health Beliefs, Culture, and Ethnic Experience of Asian-American Women
Amanda Whitely1, Sandy Bohan1, Vanessa Malcarne1, Georgia Robins Sadler2
1San Diego State University, San Diego, CA, USA, 2University of California San Diego, Moores Cancer Center, San Diego, CA, USA
Abstract: Background/Purpose: Cancer is the leading cause of death for Asian-American women. Complicit are their cancer-related perceptions and behaviors, such as low perceived risk and screening compliance, and use of alternative medicine. Health beliefs and acculturation impact such perceptions and behaviors; for Asian-American women, this is not well understood. This study profiled Asian-American women’s health locus of control (HLC) beliefs, cultural values (CVs), and ethnic experience (EE) and investigated how these parameters are related to each other. Methods: Adult Asian-American women (N = 43) completed the Multidimensional Health Locus of Control Scales (MLHC), Asian American Values Scale – Multidimensional (AAVSM), and Scale of Ethnic Experience (SEE). Mean scores for each provided descriptive statistics. Pearson correlations were computed to assess the relationships (1) of MHLC scales with each other, (2) between MHLC scales and AAVSM, and (3) between MHLC scales and SEE. Results/Findings: Participants more strongly endorsed personal control (Internal) than three categories of external control (Powerful Others, Chance, God) over health. On average, they expressed mid-level adherence to Asian-American CVs (Collectivism, Conformity to Norms, Emotional Self-control, Family Recognition through Achievement, Humility) and low- to mid-level perceptions in four areas of their EE (Ethnic Identity, Perceived Discrimination, Mainstream Comfort, Social Affiliation). MHLC-Internal scores were negatively correlated with MHLC-Powerful Others scores (r = -0.424, p r = -0.307, p. Discussion: MHLC scales for Asian-American women were generally independent. Overall, their HLC beliefs were not related to their EE or adherence to CVs. Except, women reporting weaker Asian-American ethnic identity were more likely to believe that chance exerts control over their health. Because the sample size limited power, further study is warranted to elucidate relationships between cultural and control beliefs that may impact cancer-related behaviors. Relation to Theme: Cultural competency is necessary to bridge ethnic/racial divides. Understanding the health and cultural beliefs and minority experiences of Asian-Americans demonstrates a respect for their unique perspective, values, traditions, and health challenges. With such respect and understanding, research can begin to envelope Asian-Americans into the goals of quality cancer education. Learning Objectives: Identify the predominant health locus of control endorsed by Asian-American women that may impact their cancer-related health perceptions and behaviors. References: 1. Iskandarsyah, A., de Klerk, C., Suardi, D.R., Sadarjoen, S.S., & Passchier, J. (2014). Health locus of control in Indonesian women with breast cancer: a comparison with healthy women. Asian Pac J Cancer Prev, 15 (21), 9191-7. doi: 10.7314/APJCP.2014.15.21.9191. 2. Skidmore, J.R., Dyson, S.J., Kupper, A.E., & Calabrese, D. (2014). Predicting Illness Behavior: Health Anxiety Mediated by Locus of Control. American Journal Of Health Behavior, 38 (5), 699-707. doi: 10.5993/AJHB.38.5.7.
P27-A: Delta 32 Mutation in CCR5 gene and its Association with Breast Cancer
The Karachi Institute of Biotechnology and Genetic Engineering, University of Karachi, Karachi, Pakistan
Abstract: Background/Purpose: Chemokine C-C motif receptor type 5 (CCR5) is a chemokine receptor protein, which is present on the cell surface. Its potential role in cancer progression and metastasis has been implicated. Deletion mutation of 32 base pairs (bp) in the open reading frame of the CCR5 gene (CCR5Δ32) may lead to the malformation of the protein. This study aimed to examine the role of CCR5Δ32 mutation and its association with breast cancer. Methods: Blood samples of 250 breast cancer patients were included in the study. The samples were compared with age and sex matched healthy control. Mutation of CCR5Δ32 was analyzed by sequence specific primers by polymerase chain reaction (PCR). They were examined on Agarose gel electrophoresis. Results/Findings: Two types of CCR5 allelic mutations were found in the breast cancer samples. The mutation was of 32 (bp) DNA fragment. Homozygous insertion (I/I) and heterozygous deletion (I/D) was found in the open reading frame of the regulatory region of the gene. Discussion: This deletion in the promoter region of the CCR5 gene produces a non-functional receptor which may increase inflammation, leading to the enhanced progression of tumor. Relation to Theme: The reasech mention in abstract is the original work conducted in the Pakistan. These aspects and finding will be beneficial in the education of cancer genetics and there alterations in gene. Learning Objectives: The objective of the study is to find out the alteration in Chemokine C-C motif receptor type 5 (CCR5) and its association with breast cancer. References: J Ethnopharmacol. 2015 Mar 13;162:39-46. doi: 10.1016/j.jep.2014.12.036. Epub 2014 Dec 29.
P29-A: Promoting precision medicine: A comparison of perceived benefits, harms, and prospective utilization between African Americans and Caucasians
Jordan Neil, Kim Walsh-Childers, Priya Gopalan
University of Florida, Gainesville, FL, USA
Abstract: Background: As a subset of precision medicine (PM), precision oncology aims to enrich and modify ongoing prevention practices to make enhanced judgments on an individual’s cancer risks and ideal diagnostic and therapeutic strategies. However, there remain challenges for providers to educate underserved patient populations about the efficacy of PM as a tool for augmented care. These challenges are made markedly more difficult due to cultural and health literacy barriers across demographics. This study aims to better understand whether African Americans (AAs) and Caucasians perceive PM differently, and whether those differences impact prospective utilization. Method: An online survey was completed by 840 participants, comprising AAs (n=420) and Caucasians (n=420). Items measured PM’s perceived benefits (alpha=.93) and harms (alpha=.85), health literacy skills (alpha=.85), informed decision-making about PM (alpha=.64), patient comorbidities, trust in healthcare provider, and willingness to use PM as a tool in future decisions about cancer treatment. Results: There were significant differences in the perceived benefits of PM [F(2, 838)=6.79, pM=4.40, SD=.72) and Caucasians (M=4.26, SD=.75), but not in the perceived harms. AAs (M=3.55, SD=.66) felt they had a greater capacity to make informed decisions about PM [F(2, 838)=5.59, pM=3.39, SD=.80). Moreover, AAs (M=3.70, SD=.96) were significantly more likely to utilize PM for future cancer decision-making [F(2, 838)=5.41, pM=3.53, SD=1.1). There were no significant differences in health literacy skills or trust in healthcare provider, but participants with a greater number of comorbidities were more likely to report harms associated with PM (r =.12, p. Discussion: This study provides formative research into how PM is currently understood by key patient populations. These findings indicate an overall willingness to utilize PM as a method for enhanced preventive care, but, at this stage, patient-tailored educational and awareness efforts should remain paramount to facilitate patient uptake. Relation to Theme: This abstract relates to the overarching conference theme by addressing the intersection of genomic medicine and the ongoing efforts to educate underserved, at-risk populations about advances in cancer prevention. The findings from this study also provide valuable insight into the prospective utilization of precision medicine among differing demographic groups. Learning Objectives: 1. The participant shall be able to effectively identify the differences between Caucasians and African Americans in the perceptions of benefits and harms of precision medicine. 2. The participant shall be able to identify how a greater number of comorbidities is a predictor in greater patient perception of harms of precision medicine. References: 1. Gollust, S. E., Gordon, E. S., Zayac, C., Griffin, G., Christman, M. F., Pyeritz, R. E., … & Bernhardt, B. A. (2012). Motivations and perceptions of early adopters of personalized genomics: perspectives from research participants. Public Health Genomics, 15(1), 22. 2. Collins, F. S., & Varmus, H. (2015). A new initiative on precision medicine. New England Journal of Medicine, 372(9), 793-795.
P31-A: Creating and Implementing Low Literacy Cancer Education Materials: Bridging the Gap in sub-Saharan Africa
Maia Olsen1, Leana May1,2, Veronica Manzo3, Carlos Cardenas4
1Partners in Health, Boston, MA, USA, 2Boston Children’s Hospital, Boston, MA, USA, 3Stanford University, Stanford, CA, USA, 4The MEME Design, Cambridge, MA, USA
Abstract: Background/Purpose: Global Oncology (GO) is a non-profit community of professionals and student volunteers helping global partners alleviate suffering through providing the highest quality cancer care. GO has developed cancer educational materials for low-literate patient populations in sub-Saharan Africa and Haiti, in collaboration with THE MEME Design in Cambridge, MA. Early versions of the materials are being piloted and evaluated in different global locations. Through this project, GO aims to improve psychosocial support and patient education in resource-limited settings. Description: In order to develop clinically relevant and culturally appropriate materials, GO has collaborated with graphic designers at MEME, clinicians at Queen Elizabeth Central Hospital (QECH) in Malawi and Partners In Health (PIH) sites in Haiti and Rwanda, and consulted with experts throughout the care continuum. In addition to design, GO and its partners are investigating ways to integrate the booklets into clinical protocols and create a platform to better engage patients and families in the treatment process. Evaluation: With the roll out of materials at various partner sites, GO has conducted focus groups and interviews to evaluate effectiveness and use of the booklets, as well as to refine content. Overall, feedback has been positive – nurses and patients have commented that the content is understandable for low-literate audiences, and evidence has suggested that the booklets are a useful tool in teaching patients about treatment. Throughout 2015, GO will continue to assess and support partnerships in Rwanda, Malawi, and Haiti. Usefulness: Moving forward, GO will explore ways to expand this initiative, by collaborating with new partner sites, translating the document into local languages, and exploring avenues to share copyrighted materials online. Lessons learned through the design process for populations in sub-Saharan Africa and Haiti could be applied more widely in cancer education, by providing a template to create adapted educational material for low literacy populations and culturally diverse communities. Relation to Theme: This project focuses on expanding and addressing gaps in cancer patient education in low-literate populations in sub-Saharan Africa. The materials were initially designed to help address the wide differences in patient literacy levels and promote treatment adherence by helping patients understand cancer and treatment at a partner site with broad applicability. Learning Objectives: The participant shall be able to 1. Identify barriers to cancer care in low-income settings and the role education can play in patient adherence to treatment and outcomes. 2. Understand the design process behind creating low literacy patient education materials on cancer and chemotherapy. 3. Identify the role of culture and language in creating low literacy patient education materials 4. Understand how a multi-stakeholder, cross cultural process impacted content development and design of materials targeted to low-literacy patient communities in sub-Saharan Africa and Haiti. References: 1. Hubley J. Patient education in the developing world — a discipline comes of age. Patient Education and Counseling. 2006 Apr;61(1): 161-4. 2. Zimmerman M, Newton N, Frumin L, Wittet S. Developing Health and Family Planning Materials for Low-Literate Audiences: A Guide [Internet]. PATH; 1996, p1-66. 3. Seligman HK, Wallace AS, DeWalt DA, Schillinger D, Arnold CL, Silliday BB, et al. Facilitating Behavior Change With Low-Literacy Patient Education Materials. American Journal of Health Behavior. 2007. Aug1;31(1):S69-S78. 4. Carstens A, Maes A, Gangla-Birir L. Understanding visuals in HIV/AIDS education in South Africa: differences between literate and low-literate audiences. African Journal of AIDS Research. 2006;5(3):221-32.
P33-A: Engaging Health Professionals in Development of Education Materials for Hematopoietic Cell Transplant Patients
Jackie Foster1,2, Lensa Idossa1,2, Heather Moore2, Stacy Stickney Ferguson1, Elizabeth Murphy1,2
1National Marrow Donor Program, Minneapolis, MN, USA, 2Be the Match, Minneapolis, MN, USA
Abstract: Background/Purpose: Quality patient education resources are an important component of cancer care.1 As patient populations become increasingly diverse, culturally and linguistically appropriate patient education resources are necessary for positive health outcomes.2,3 Although it is optimal to engage the target patient population in the planning stage, frontline health professionals may offer insight into resource appropriateness and suitability. A process to collaborate with hematopoietic cell transplant (HCT) health professionals to improve patient education resources is described. Description: Two multidisciplinary advisory groups (AGs) of HCT health professionals formed to advise on the content, format, use and cultural suitability of patient education resources on HCT. The Patient Education Advisory Group (PEAG) and Patient Education Advisory Group-Diverse Populations (PEAG-DP) are comprised of 16 and 15 members, respectively. PEAG members regularly educate patients and caregivers on HCT while PEAG-DP members primarily serve HCT medically underserved populations. Since inception, the AGs have advised on 10 patient education resources. Their feedback is gathered via email or phone, and reviewed by the content development team during resource planning. Evaluation: To evaluate the PEAG, a web-based survey was administered resulting in 63% response. The survey measured: 1) overall satisfaction among AG members; 2) satisfaction with the resource review process; and 3) perceived value of the AG in developing optimal patient education resources. All respondents rated their membership experience as ‘very good’ and most (90%) reported that the PEAG is developing optimal educational resources. A satisfaction survey is planned for the PEAG-DP. Usefulness: Frontline health professionals bring valuable perspective and insight into an array of diverse HCT patient experiences and learning needs. Therefore, gathering feedback on the content, format, use and cultural suitability of patient education resources from HCT health professionals is a useful strategy for developing appropriate and effective patient education resources. Initiatives to increase engagement of diverse patient volunteer reviewers are underway. Relation to Theme: Providing culturally and linguistically appropriate health education resources is essential to reducing disparities and ensuring patient-centered care.2,3 Comprehensive review and input from patients and health professionals are useful strategies for ensuring appropriateness and optimizing the effectiveness of patient education resources. Learning Objectives: The participant shall be able to: 1) Describe a process for engaging health professionals in review of patient education resources for content, format, use and cultural suitability; and 2) Write a discussion guide to elicit useful feedback on the cultural suitability of a patient education resource from health professionals. References: 1. Friedman, A., Cosby, R., Boyko, S., Hatton-Bauer, J. & Turnbull, G. (2011). Effective teaching strategies and methods of delivery for patient education: a systematic review and practice guideline recommendations. Journal of Cancer Education, 26, 12–21. doi: 10.1007/s13187-010-0183-x 2. Medically Underserved Areas/Populations. (n.d.). Retrieved March 11, 2015 from http://www.hrsa.gov/shortage/mua/index.html. 3. Migration Policy Institute. (2011). LEP Data Brief. Retrieved March 10, 2015 from http://www.migrationinformation.org/integration/LEPdatabrief.pdf
P35-A: Cancer Education Displays: Using diversity and collaboration to better equip cancer patients and their loved ones through treatment and beyond
Niki Alpers, Jeff Yancey, Donna Branson
Huntsman Cancer Institute, Salt Lake City, UT, USA
Abstract: Background/Purpose: Cancer patients, survivors, and loved ones find information in a variety of methods and with varying levels of trust. Finding reliable information is helpful in developing empowerment of cancer patients and their loved ones. Further, educational strategies are effective in reducing discomfort from side effects of cancer treatments. One strategy for addressing educational needs is creating educational displays in English and Spanish. This poster describes the features of a consistent, topical approach to educational displays and how it may empower the diverse population of patients through the decision-making process. Description: The bilingual educational displays provide information and resources about various topics to Huntsman Cancer Institute (HCI)’s diverse patient population and their families as they navigate their cancer journey. Topics rotate regularly and correspond with cancer awareness months. Health educators collaborated with communications and graphic design staff to integrate various materials and ensure that display boards were up-to-date. Materials include a monthly newsletter of current topics, resources available in HCI’s Cancer Learning Center, and appropriate photos including differing ages, race, and gender. Materials integrate a color scheme to brand and coordinate topics for easy recognition. Evaluation: Materials are tracked and replenished regularly providing solid information on what topics HCI’s audience utilizes most. As new resources become available, they’re incorporated into displays and materials. Placement and cost effectiveness is key to generating foot traffic and keeping information stocked. Posters are reviewed regularly to ensure the content and appearance are current and accurate. Usefulness: Careful planning and coordination will allow cancer treatment centers to provide cost-effective, targeted education to patients and their loved ones. Coordinated displays can be used for other disease types and languages. Lessons illustrated in this presentation will assist medical professionals in other settings to establish and enhance educational displays. Relation to Theme: Cancer Education Displays: Using diversity and collaboration to better equip cancer patients and their loved ones through treatment and beyond reveals one the innovative strategies in which Huntsman Cancer Institute disseminates cancer information to a diverse patient population. Learning Objectives: 1. The participant shall be able to identify 3 ways to coordinate displays with other educational outlets within his or her facility. 2. The participant shall be able to implement 3 methods to increase his or her audience’s use of display materials. References: 1 Sahin, Z. A. & Erguney, S. (2015) Effect on symptom management education receiving patients of chemotherapy. Journal of Cancer Education [Epub ahead of print, Mar 27] 2. Shahrokni, A., Mahmoudzadeh, S. & Lu B.T. (2014). In whom to cancer survivors trust online and offline? Asian Pacific Journal of Cancer Prevention, 15(15), 6171-6.
P37-A: Altruism and Clinical Trials amongst East Asian-American and Pacific Islander Women
Natasha Mazon1, Sandy Bohan2, Vanessa Malcarne2, Georgia Robins Sadler3
1University of California San Diego, La Jolla, CA, USA, 2San Diego State University, San Diego, CA, USA, 3University of California San Diego, Moores Cancer Center, San Diego, CA, USA
Abstract: Background/Purpose: The Asian-American and Pacific Islander (API) communities are historically underrepresented in cancer clinical trials (CTs). If unaltered, this underrepresentation may exacerbate existing cancer health disparities. For example, APIs have the highest incidence of liver cancer compared to all other Americans. The willingness of APIs to participate in CTs has not been fully investigated, especially in the context of altruism – the unselfish regard for the welfare of others. This study explored altruistic perceptions of CTs participation of two API cultures: East Asian-American (EA) and Pacific Islander (PI). Methods: Adult EA (Chinese, Japanese, Korean; n = 15) and PI (Chamorro, Native Hawaiian, Samoan; n = 10) women participated in individual, semi-structured interviews, conducted in English. During the interviews, they were prompted to discuss the most important benefits of and primary reasons for participating in CTs. The interview transcripts were analyzed using the constant comparative method. Results/Findings: EA women prominently valued personal benefits of CTs participation (receiving cutting-edge care and new treatments, playing an active role in one’s own health care). In comparison, the opportunity to help their community through participation in CTs often received the lowest valuation. In contrast, for PI women, helping their community was generally equal with personal benefits in importance. EA women’s primary reason for participating in CTs focused on improving their own health, with secondary considerations for the well-being of family and future generations and for contributions to scientific/medical advancement. PI women expressed similar reasons, but no primary motivation was identified. Discussion: Varied altruistic perceptions of CTs participation amongst API groups may be culturally rooted. Further study is warranted, which should include other API groups and men. Improving API representation in cancer CTs may benefit from a better understanding of altruistic motivations and subsequent tailoring of interventional efforts to specific API groups. Relation to Theme: Cultural competency is necessary to bridge ethnic/racial divides. Understanding that Asian-American and Pacific Islander cultures impact their perceptions of clinical trials demonstrates a respect for their unique experiences and culture. With such respect and understanding, research can begin to envelope Asian-Americans and Pacific Islanders into the goals of quality cancer education. Learning Objectives: Identify two differences between East Asian-American women’s and Pacific Islander women’s perceptions of the most important benefits of and primary reasons for participant in clinical trials. References: 1. Byrne, M., Tannenbaum, S., Gluck, S., Hurley, J., & Antoni, M. (2013). Participation in Cancer Clinical Trials: Why Are Patients Not Participating? Medical Decision Making, 34 (1), 116-126. doi: 10.1177/0272989X13497264. 2. Friedman, D., Bergeron, C., Foster, C., Tanner, A., & Kim, S. (2013). What Do People Really Know and Think About Clinical Trials? A Comparison of Rural and Urban Communities in the South. Journal of Community Health, 38 (4), 642-651. doi: 10.1007/s10900-013-9659-z.
P39-A: Community health workers and cancer biology competencies
Bathai Edwards, Danyell Wilson, Nicole Offer, Shalini Boodram
Bowie State University, Bowie, MD, USA
Abstract: Health disparities in the treatment and outcome of cancer mirror socio-economical, ethnic, and educational backgrounds. Community Health Workers (CHWs) are at the frontline of our efforts to close these health care gaps. However, the current status of their cancer-biology training module for CHWs is unknown. If we can identify the material covered in the cancer-biology portion of published CHW training curricula, then a standardized cancer-biology module can be developed based on evidence of the best practices and recommendations. A comprehensive search of the published literature on training of CHWs was comprised of articles obtained from MEDLINE. Methods for this systematic review included identification of a topic (cancer education for CHWs); selection of articles based on specialized criteria; design and implementation of a data extraction form; and systematic data synthesis and appraisal from the selected articles to diminish bias. Two hundred and twenty-eight articles were obtained from the original MEDLINE search from which 29 followed the inclusion criteria. CHWs were trained to provide interventions for the following cancers: breast, cervical, colon, prostate, or a combination of cancers. Twenty-four articles contained evaluation methods that assessed the information learned by the CHWs, including 11 pre/post-tests, two surveys, three satisfaction ratings, two analyses of intervention, six exit/follow-up interviews, and two field evaluations. Out of the 29 articles, 12 included statistical analyses on the effectiveness of the training modules. Several states have completed or are currently establishing a centralized training module. Our systematic review will compile the evidence surrounding the current cancer biology competencies provided to CHWs. Future work will develop a concentrated syllabus that focuses on the basic biology and mechanisms related to cancer. This approach will improve CHW training and ensure that both the CHWs and their communities can attain extensive cancer education. Relation to Theme: This research project is relevant to the conference theme because it focuses on combating health disparities in diverse populations. A standardized cancer biology training method for community health workers would help to eliminate health care issues concerning ethnic minorities. Learning Objectives: The participant (Community Health Worker) shall be able to intervene and help close the health and science literacy gap of the disparaged communities they serve if they are trained and provided the proper resources concerning the basic science of cancer. References: 1. Cueva, M, R Kuhnley, LJ Revels, K Cueva, M Dignan, and AP Lanier. “Bridging Storytelling Traditions with Digital Technology.” PubMed. (2013): n. page. Print. 2. Maxwell, AE, LL Danao, RT Cayetano, et al. “Evaluating the training of Filipino American community health advisors to disseminate colorectal cancer screening.” PubMed. (2012): n. page. Print. 3. Shelton, RC, HS Thompson, L Jandorf, A Varela, B Oliveri, C Villagra, HB Valdimarsdottir, and WH Redd. “Training experiences of lay and professional patient navigators for colorectal cancer screening.” PubMed. (2011): n. page. Print.
P41-A: Building an Infrastructure and Measuring the Implementation of Advance Care Planning in the Oncology Practice Setting
Karen Stepan, Margaret Meyer
University of Texas MD Anderson Cancer Center, Houston, TX, USA
Abstract: Background/Purpose: Each year, approximately 40% of our new patients present with metastatic disease, with no prior treatment. The other 60% have had previous treatment, but it has failed. The percent of advance directives completed is relatively small when compared to the annual total number of newly registered patients and the number of hospital admissions. Approximately 20% have completed a medical power of attorney document and have had it filed it in their medical record. As a result, there is a real need to actively engage our patients and families in advance care planning and provide a systematic process for doing so. This abstract describes the development of an advance care planning program aimed at empowering and engaging patients and families in their care decisions, as well as educating patients and providers about the importance of documenting their information in the medical record in order to improve concordance between patient care preferences and the care provided. Description: As one of the institution’s strategic initiatives, the advance care planning team established a Project Charter that formed the program’s business case, mission statement, scope, metrics/targets, expected benefits, and milestones. Efforts focused on policy development; data collection; documentation; education resource development/dissemination; new social workers staffing approval/hiring; and faculty/staff training. Evaluation: Various databases were utilized to extract the data needed such as the electronic health record, the Tumor Registry, the Education Center and Quality Improvement. We also surveyed members of our Patient/Family Advisory Council to elicit feedback regarding program improvement. Usefulness: Change in ACP is achieved through the support of institutional leadership and the use of multi-level strategies. In a large oncology setting, there are many aspects to consider when planning, coordinating and implementing an institution-wide initiative, including policy, education, clinician engagement, personnel and standard measures by which to evaluate program efforts. Relation to Theme: With institutional support and visibility, the proposed abstract addresses cancer education innovation and best practices, through the development, implementation and evaluation of an advance care planning program in the oncology practice setting. The focus areas are multifaceted and include patient/family education, healthcare professional education and the psychosocial aspects of care. Learning Objectives: 1. Identify the approach used to support advance care planning in the oncology practice setting. 2. Discuss program alignment with the institution’s strategic plan/focus areas. 3. Summarize accreditation and regulatory standards/measures for the provision of advance care planning. References: 1. The American Board of Medical Specialties. (2014). MOC Part IV. (2014). Retrieved from http://www.abms.org/ 2. Houben, C.H., Spruit, M.A., Groenen, M.T., Wouters, E.F. and Janssen, D.J. (2014). Efficacy of Advance Care Planning: A Systematic Review and Meta-Analysis. JAMDA, 15(7), 477-89. 3. The Institute of Medicine. (2014). Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. Retrieved from http://iom.edu/~/media/Files/Report%20Files/2014/EOL/Key%20Findings%20and%20Recommendations.pdf 4. National Quality Forum. National Voluntary Consensus Standards: Palliative Care and End-of-Life Care – A Consensus Report. 2012. Retrieved from http://www.qualityforum.org/Publications/2012/04/Palliative_Care_and_End-of-Life_Care—A_Consensus_Report.aspx 5. The Quality Oncology Practice Initiative. QOPI® 2014 QCDR Measures: Measure 20; NQF 326. Retrieved from http://qopi.asco.org/documents/QOPIQCDR2014.pdf
P45-A: Building support for cancer family caregivers
Jo Hanson, Betty Ferrell
City of Hope Comprehensive Cancer Center, Duarte, CA, USA
Abstract: Background/Purpose: Family caregivers (FCG) play a critical role in planning and providing cancer patients’ care yet their training and support needs are often unrecognized by healthcare providers (HCP). This NCI funded Training Grant (R25) addresses gaps between the needs experienced by FCG and support provided by HCP. The purpose of this presentation is to describe an effort to improve cancer FCGs’ quality of life (QOL) provided by interdisciplinary HCP. Methods: The five year project, 2010-2015, focused on educating nationwide interdisciplinary HCP teams about cancer FCGs’ QOL issues by presenting four annual 3-day training courses. The evidence-based curriculum, presented by national experts, provided FCG QOL research findings along with practical examples of cancer-center programs that successfully support FCG. Post course, teams initiated goals in their home institutions. Pre-course and 6, 12, and 18-month outcome measures included: institutional assessments evaluating current status of FCG support; institutional surveys assessing institution readiness to change; FCG educational programs; and goal status. Results/Findings: Participants (N=397 HCP/214 teams) represented 42 states and Washington D.C. from 192 cancer-care settings. Pre-course institutional assessments rated overall FCG support at 71%. Institutional survey results found FCG support services available: 78.6% pre-course; 47.6% 6-month; 59.6% 12-month; and 67.7% 18-month. Education regarding FCG psychological well-being was the most frequent offering at all time periods, pre-course (34%) to18-month (61%). Quality of care for FCG for pediatric patient education consistently rated lowest, 13.5% average. Goals ranged from presenting FCG course information at staff meeting to public television monthly FCG-focused programs. Discussion: Intuitional Survey results show a drop from pre- to 6-month assessment of FCG services available due to teams’ better understanding after course completion of both FCG support needs and how their institution actually meets these needs. The courses provided HCP education on the support needs of FCG and provided tools to initiate projects to improve QOL for FCG.student opportunities for further cancer-related training in health professional and graduate programs. Relation to Theme: This abstract describes an educational effort for interdisciplinary healthcare providers to better understand cancer family caregiver needs and provides tools to initiate change to improve family caregivers’ quality of life. Learning Objectives: The participant shall be able to: 1. Describe a nationwide educational project for cancer healthcare providers to improve support for family caregivers. 2. Identify as least two issues impacting the role of cancer family caregivers. 3. Discuss at least two exisiting resources in cancer centers that can improve family caregivers’ quality of life. References: 1. Given BA, Given CW, Sherwood PR. Family and caregiver needs over the course of the cancer trajectory. J Support Oncol. 2012;10(2):57-64 2. Kim Y, Spillers RL, Hall DL. Quality of life of family caregivers 5 years after a relative’s cancer diagnosis: follow-up of the national quality of life survey for caregivers. Psycho-Oncology. 2012;21(3):273-281.
P47-A: Provider Weight Bias: A Phenomenological Study of Breast Cancer Survivors with Medical Obesity
Sandra Wyrick, Mel Haberman, Sterling McPherson, Phyllis Eide
Washington State University College of Nursing, Spokane, WA, USA
Abstract: Background/Purpose: Affordable, accessible health care is the expectation in the U.S. Another factor impacts patient care: Weight bias. Healthcare providers communicate forms of weight bias when they associate negative traits and assumptions with obesity, often spending less time with obese patients, engaging in less discussion, doing less treatment interventions, and being reluctant to perform preventative health screenings including cancer screenings and mammograms. Obesity is a common, serious and costly condition reaching pandemic proportion in the U.S. Obesity is associated with a higher cancer incidence, recurrence, progression, and death; every year 2.8 million people in the U.S. die as a result of being obese and in 2014, over 40,000 deaths were associated with breast cancer. Recognizing the magnitude regarding obesity and the gravity of associated health risks, the AMA declared obesity as a disease in June 2013. To facilitate the optimum care of the patients with obesity, it is imperative to more closely uncover and explore the obese patients’ experience of weight bias by health care professionals. Description: Using a descriptive phenomenological methodology, a purposive sampling of 15-20 participants is being recruited from breast cancer healthcare facilities and weight loss centers to explore and interpret the phenomenon of weight bias as experienced by breast cancer survivors with medical obesity in their interactions with oncology nurses and physicians. The transcribed data will be analyzed for emerging patterns and themes, resulting in a final descriptive statement regarding the phenomenon of weight bias in the oncological healthcare setting. Results/Findings: Study results/findings are forthcoming. Discussion: Mounting evidence demonstrates how weight bias is encountered in the interactions with health care professionals, resulting in a decreased quality of life and shorter survival rate. Given the prevalence of obesity in the U. S. and permeation of weight bias throughout the healthcare industry, meaningful remedies are needed to protect patients against weight bias. Relation to Theme: Obesity prevalence has increased among all groups regardless of age, gender, ethnicity, socioeconomic status, or race. Today a staggering 2.1 billion people worldwide is medically obese or overweight. Barriers to patient care increase and overall quality of care is jeopardized when a patient is subjected to provider weight bias. Learning Objectives: The participant shall be able to identify at least two barriers to care for the breast cancer survivor with medical obesity related to forms of provider weight bias in the oncologic healthcare setting. References: 1. Malterud, K., & Ulriksen, K. (2011). Obesity, stigma, and responsibility in health care: A synthesis of qualitative studies. International Journal of Qualitative Studies Health and Well-being, 6(4), 8404-8415. 2. Puhl, R.M., Luedicke, J., & Grilo, C.M. (2014). Obesity bias in training: attitudes, beliefs, and observations among advanced trainees in professional health disciplines. Obesity, 22(4), 1008-1015. See: http://www.ncbi.nlm.nih.gov.
P49-A: Improving treatment of breast cancer using an interactive online learning platform
Karen Overstreet1, Lois Colburn2, Deborah Susalka3
1Imedex, Raleigh, NC, USA, 2University of Nebraska Medical Center, Omaha, NE, USA, 3Imedex, LLC, Alpharetta, GA, USA
Abstract: Background: Although the treatment of breast cancer has improved, it remains the second most common malignancy among women in the US, with many at risk for recurrence. Clinicians need to be able to evaluate clinical data regarding novel targeted therapies for metastatic breast cancer (MBC) that may overcome challenges with current approaches.1-4 Oncologists rely on CME to provide quality patient care—CME helps translate the latest research to practice.5 Participation in online CME increased by 23% in recent years;6,7 > 70% of clinicians rate online CME as effective. The impact of CME is dependent on its ability to effectively leverage 4 natural learning actions: note-taking, reminder-setting, related search, and social learning.8,9 Description: We developed several interactive online CME activities that elucidate the role of novel agents for MBC, identify clinical trials that are recruiting patients, and assess applications of emerging approaches. These were designed using a unique e-learning architecture, which facilitates note-taking, reminder-setting, related search, and social learning. Multimedia components include animation and videos. Both interactivity and feedback are facilitators of CME effectiveness.10 Evaluation: Completion rates for education delivered through this platform average 2- to 3-fold higher than historical standards for online CME, and participation is associated with strongly significant knowledge change (p Usefulness: Real-time engagement reports allow planners and faculty to segment learner cohorts to identify those who need additional support and those who are ready to take action. We have augmented the initial online activities with a series of live events and another online activity to increase clinicians’ ability to evaluate novel treatments for MBC. The platform is available for educational providers to use. Relation to Theme: Breast cancer is the second most common cancer in women and is prevalent in diverse populations across the US. This session will evaluate the effectiveness of an innovative, highly interactive online platform with multimedia components for educating oncologists and oncology nurses who treat patients with metastatic breast cancer. Learning Objectives: The participant shall be able to: 1. Evaluate participant engagement data obtained using on online learning platform 2. Assess the effectiveness of e-learning regarding metastatic breast cancer delivered on an innovative platform References: 1. LEE011 in advanced BC. https://clinicaltrials.gov/ct2/show/NCT01958021. 2. Palbociclib + letrozole vs. letrozole in advanced BC. https://clinicaltrials.gov/ct2/show/NCT01740427. 3. LY2835219 + fulvestrant in BC. https://clinicaltrials.gov/ct2/show/NCT02107703. 4. Palbociclib + letrozole in advanced BC. https://clinicaltrials.gov/ct2/show/NCT02142868. 5. Robinson C, et al. J Cancer Educ. 2015; 30: 75-80. 6. ACCME 2013 Annual Report. Published July 2014. www.accme.org. Accessed April 13, 2015. 7. ACCME Annual Report Data 2013. Policy and Medicine. http://www.policymed.com/2014/07/accme-annual-report-data-2013.html. Accessed April 14. 2015.8. McGowan BS, et al. J Cont Ed Nurs. 2014: 45: 1-2. 9. Pelletier S. Medicalmeetings.com. 2013; June: 31-33. 10. Moore DE, et al. J Contin Educ Health Prof. 2009;29:1-15.
P51-A: Deployment of Questionnaire to Track Video Viewing of Cancer Screening Education at the Point-of-Care
Maria Jibaja-Weiss, Jane Montealegre, Roshanda Chenier, Glori Chauca, Ivan Valverde
Baylor College of Medicine, Houston, TX, USA
Abstract: Background/Purpose: As part of a comprehensive cancer prevention project aimed at improving colorectal (CRC), cervical (CxC), and breast cancer (BC) screening and follow-up among medically underserved patients in Houston, Texas, we developed and implemented videos designed to increase utilization of fecal immunochemical test (FIT), Pap test, and mammography screening. Here we describe our use of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to guide the implementation and evaluation of our program. Description: In Phase I, FIT and Pap videos were created and deployed targeting 3 ethnic/ linguistic patient subgroups (English, Spanish, Vietnamese). Video viewing was integrated into the patient flow at participating community health centers (CHCs) using the electronic medical record (EMR) to identify patients due for either test. Videos were played on a computer screen while patients waited in the exam room. In Phase II, 4 mammography videos were created and deployed. Additionally, the EMR was modified to allow for documentation of video viewing in order to concretely measure the “reach” and “effectiveness” of our intervention. Evaluation: A staggered deployment scheme is being used to evaluate the impact of EMR documentation on video viewing and screening [with deployment at Group 1 CHCs (n=6) preceding that of Group 2 (n=7) by 3 months]. During the initial 3-months, a total of 2,614 videos were viewed by patients – 859 mammography, 776 Pap, 979 FIT videos. There appears to be a steady increase in utilization of the tracking questionnaire. Sustainability of utilization will continue to increase as staggered deployment of videos and questionnaire continues in the additional seven CHCs. Usefulness: Preliminary findings suggest that the tracking feature is an acceptable way to track video viewing at the point-of-care with minimal clinic staff effort. Utilizing similar methodology to track patient education at the point-of-care may be developed by other organizations using EMR systems. Relation to Theme: Point-of-care videos that utilize the EMR to target cancer screening education and track video viewing are novel strategies to educate patients who may be due or past due for screening exams. Learning Objectives: Learning Objective 1: The participant should be able to describe how targeted cancer screening patient education may be integrated into the clinic flow utilizing an Electronic Medical Record (EMR). Learning Objective 2: The participant should be able to understand how the EMR may be used to track the viewing of patient education videos shown in exam room computers. References: 1. Sabatino SA, Lawrence B, Elder R, Mercer SL, Wilson KM, DeVinney B, et al. Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers: nine updated systematic reviews for the guide to community preventive services. Am J Prev Med 2012;43:97-118. 2.Rawl SM, Skinner CS, Perkins SM, Springston J, Wang HL, Russell KM, et al. Computer-delivered tailored intervention improves colon cancer screening knowledge and health beliefs of African-American. Health Educ Res 2012;27:868-85.
P53-A: Ostomy Home Skills Kit (OSHK) is Effective at Preparing Patients to Confidently Manage Their Post-Operative Recovery
Kathleen Heneghan1, Michael F McGee2, H. Randolph Bailey3, Ajit Sachdeva1, John M Daly4, Elizabeth Davis5, Janice C Colwell6
1American College of Surgeons, Chicago, IL, USA, 2Northwestern Memorial Hospital, Chicago, IL, USA, unnybrook Odette Cancer Centre, Toronto, Canada, 3Colon and Rectal Clinic of Houston, Houston, TX, USA, 4Temple University School of Medicine, Philadelphia, PA, USA, 5Davis Consulting, Chicago, IL, USA, 6University of Chicago Hospital, Chicago, IL, USA
Abstract: Background: With an increase in out-patient procedures and early discharge, patients/families have to assume a greater responsibility for their surgical recovery. The OHSK was created by a multi-society collaborative to provide pre-operative ostomates the knowledge and skills required for self care and improve post-operative stoma-related outcomes. The novel kit includes a visual text, DVD, sample stoma supplies, and mock stoma facilitating pre-operative skills training and a durable perioperative educational resource. Methods: From 2009-2013 the OHSK included a self-administered survey querying perioperative perspectives of newly discharged ostomates. A random sample of non-OHSK new ostomates was administered the same survey as a comparative group. Survey topics assessed the patient’s value of educational perioperative adjuncts/providers, stoma care confidence at discharge, quality of life, and post-operative stoma care needs assessment. Outcomes: In preparing for surgery, patients (n=317) ranked teaching value of OHSK (96%), stoma support group (89%), WOCN (87%) and surgeon (85%) favorably. In preparing for home care, patients ranked teaching value of OHSK (94%), WOCN (85%), and surgeon (71%) favorably. OHSK users had lower home problem scores (2.3 v 2.7, p Conclusion:New ostomates viewed the OSHK as the most helpful resource in preparing for self care, had less complications and used less resources then standard care. Relation to Theme: This innovative program support surgical oncology patients and their families in their efforts to provide self-care and safely transitions to the home environment. Standardized skills training provided by professionals supports a cost-effective equitable and effecient improvement. Learning Objectives: Identify the benefits of skills education delivered by a virtual coach and available to support decision making and self-care post-discharge. References: 1. Nagle D, Pare T, Keenan E, et al. Ileostomy pathway virtually eliminates readmissions for dehydration in newe ostomates. Dis Colon Rectum. 2012;55:1266-72 2. Ronco M, Iona L, Fabbro C. et al. Patient education outcomes in surgery: a systematic review from 2004 to 2010. Int J Evid Based Healthc. 2012;10:309-23. 3. Salvadalena G. Incidence of complications of the stoma and peristomal skin amoung individuals with colostomy, ileostomy, and urostomy: a systemic review. J Wound Ostomy Continence Nurs. 2008;35:596-607.
P55-A: A Chronic Care Ostomy Self-management Program for Cancer Survivors
Ruth McCorkle1, Marcia Grant2, Christopher Wendel3, Nancy Tallman, Martha Cobb4, Mark Hornbrook5, Elizabeth Ercolano1 , Virginia Sun2, Judith Hibbard6, Robert Krouse3
1Yale University, New Haven, CT, USA, 2City of Hope/Beckman Research Institute, Duarte, CA, USA, 3University of Arizona College of Medicine, Tucson, AZ, USA, 4University of Arizona College of Nursing, Tucson, AZ, USA, 5Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA, 6University of Oregon, Eugene, OR, USA
Abstract: Background/Purpose: Cancer survivors with ostomies experience extensive changes in health-related quality of life (HRQOL). Patients have limited access to long-term support and are forced to use trial-and-error to improve self-management. Challenges include skin care problems, difficulties with social interactions, and knowledge of new equipment. Description: This is a longitudinal one-group design pilot study of a five-session ostomy self-care curriculum that addresses challenges reported by patients. The program is based on the Chronic Care Model to improve HRQOL and self-management for cancer survivors with ostomies. Multiple instruments were administered to examine outcomes at baseline, post-intervention, and at six-month follow-up (Patient Activation Measure, Self-Efficacy, Hospital Anxiety and Depression Scale, Ways of Coping, Group Health Association of America Satisfaction with Ostomy Care Survey, and the City of Hope Quality of Life – Ostomy). Changes from pre- to post-intervention and pre-intervention to follow-up were evaluated with paired t-tests. Text responses were coded and evaluated for important themes and recommendations. Evaluation: Thirty-eight subjects participated in the study. Most had a history of rectal cancer (60.5%) or bladder cancer (28.9%). Participants rated the overall program high (4.4-4.8 on 5-point scale). Text feedback indicated that participants enjoyed the group forums, wanted more participants, and more hands-on training. Interaction with other ostomates and new supplies were felt to be especially beneficial. Scores on multiple surveys were shown to be improved and sustained, including Patient activation (p=0.0004), Self-Efficacy (p=0.006), Total HRQOL (p=0.01), physical well-being (p=0.005), and social well-being (p=0.002). Survivor anxiety was significantly reduced by follow-up (p=0.047). Barriers to participation included distance to travel, difficulty with transportation, and ongoing medical issues. Usefulness: This self-management ostomy program can help cancer survivors with ostomies adapt to their stoma, especially with hands-on experience with equipment. Initiating this program in the community setting would be beneficial to many cancer survivors. Relation to Theme: The purpose of this study was to improve the quality of life of cancer patients with ostomy utilizing an innovative curriculum designed from a substantial cancer survivor input. Our goal was to include cancer. Learning Objectives: The participant shall be able to: 1. Identify three patient preferences for the content and methods used in an ostomy training curriculum. 2. Identify two barriers in the implementation of a cancer curriculum for cancer survivors with ostomies. References: 1. Leyk M, Ksiaz’ek J, Habel A, Dobosz M, Kruk A, Terech S. The influence of social support from the family on health related-quality of life in persons with a colostomy. J Wound Ostomy continence Nurs 2014;41(6):581-587. 2. Altuntas YE, Kement M, Gezen C, Eker HH, Aydin H, Sahin F, Okkabaz N, Oncel M. The role of group education on quality of life in patients with a stoma. Eur J Cancer Care 2012;21(6):776-781.
P57-A: Hard copy durable patient cancer education materials: do they still matter?
Darryl Schuitevoerder, John Vetto, Jeanine Fortino
Oregon Health and Science University, Portland, Oregon, USA
Abstract: Background: Traditional hard copy information materials are still present in our cancer clinics. While their actual impact on patient care often goes un-assessed, it is important to understand their role in today’s electronic age where information can easily be obtained from various sources. It has remained the practice in our melanoma clinic to provide an information booklet to all of our new patients. The purpose of this study was to evaluate how useful this booklet was, as well as determine the current resources our patients use to gather cancer information. Methods: All patients referred to the clinic in the previous 3 years were pooled from our prospective, IRB approved, melanoma sentinel node database. Of these 205 patients a valid email address was listed for 147. A ten-question survey was emailed to all of these patients, who were not told ahead of time that their experience with the booklet would be studied. Results: 77 of the 147 (52%) patients polled responded. 58 (75%) remembered receiving the booklet at their initial consultation. 44 (76%) of those patients rated it as extremely or very useful, and no patients reported the booklet as not useful at all. 88% of respondents found the information to be clear and helpful. 64% remembered the provider reviewing the material with them and nearly all of these patients found that helpful. When asked to rank the importance of the various resources for obtaining cancer information, providers were ranked as most important, followed by the information booklet and Internet information sites. Internet blogs and friends and family were rated as the least important sources of information. Discussion: Even in the current electronic age, our results indicate that information shared by providers, including the hard copy education booklet, were the most important sources of information for our newly referred melanoma patients. Relation to Theme: 1. The participant should be able to recognize that both the durable material itself and the discussion of the material with the provider are valuable to cancer patients. 2. The participant shall be able to identify sources of information for cancer patients and their relative value. Learning Objectives: The participant shall be able to identify factors associated with cancer support group membership among individual who have also engaged in psychoeducational services. References: 1 Angioli R, Plotti F, Capriglione S, Aloisi A, Aloisi ME, Luvero D, Miranda A, Montera R, Gulino M, Frati P. The effects of giving patients verbal or written pre-operative information in gynecologic oncology surgery: a randomized study and the medical-legal point of view. Eur J Obstet Reprod Biol. 2014;177:67-71. 2. McCaw BA, McGlade KJ, McElnay JC. Online health information – what the newspapers tell their readers: a systematic content analysis. BMC Public Health. 2014;14:1316-24.
P59-A: Laughter for Health: Integrating Simulated Laughter, Yogic Breathing and Stretching Exercises into Patient Care
University of Texas MD Anderson Cancer Center, Houston, TX, USA
Abstract: Backgroung/Purpose: A laughter therapy program for patients and caregivers can be implemented into cancer centers. Laughter for Health, also known as “Laughter Yoga”, is a group exercise that teaches participants how to incorporate simulated laughter into life. Patients and their caregivers learn breathing, stretching and mirthful laughter techniques. Literature suggests that participants may obtain physiological and psychological health benefits of laughter using wordless childlike play and joyful laughter. Description: The University of Texas MD Anderson Cancer Center has been offering patients and caregivers Laughter for Health since 2007. Weekly sessions include an introduction and history, possible health benefits and contraindications, rhythmic clapping/chanting, and laughter/breathing exercises. The one-hour class ends with affirmation or guided imagery meditation followed by patients’ verbal feedback immediately after the class. Evaluation: Immediate verbal and written feedback is collected after the session via email solicitation. The majority of the participants shared they felt more relaxed and calm immediately after the class. The instructor observation of repeat participants has revealed that laughter has helped them to be happy and distract their mind from thinking about cancer. A patient stated, “I have not laughed the way I did during today’s session in such a long time and really I left the session feeling so good, relaxed and happy.” Usefulness: Integrating laughter in patient care may help patients reduce anxiety and stress and attain these potential health benefits of laughter. Educators can develop a similar program by training laughter yoga facilitators and implement Laughter for Health practice in any healthcare settings. Cancer centers can integrate a laughter therapy program into their patient care as a positive patient experience opportunity. This can create a platform for conducting robust studies to investigate the potential health benefits of laughter. Relation to Theme: This presentation is to show how incorporating a laughter therapy into patient care might be beneficial to patients from all walks of life. Educators can be trained to develop and implement a laughter program at any medical settings with no cost to patients. Learning Objectives: The participants shall be able to describe a new mind/body/spirit activity that can be introduced into any healthcare settings to enhance patients and caregivers feelings of well-being. References: 1. Bennett, P. N., Parsons, T., Ben-Moshe, R., Weinberg, M., Neal, M., Gilbert, K., Rawson, H., Ockerby, C., Finlay, P. and Hutchinson, A. (2014), Laughter and Humor Therapy in Dialysis. Seminars in Dialysis, 27: 488–493. doi: 10.1111/sdi.12194. 2. Mora-Ripoll, R. (2010), The Therapeutic Value of Laughter in Medicine. Alternative Therapies in Health & Medicine, 16(6), 56-64.
P61-A: Psychosocial needs of long-term cancer survivors: results from a national sample of psychoeducational program attendees
Allison Harvey, Marni Amsellem, Rhea Suarez
Cancer Support Community, Washington, DC, USA
Abstract: Background: The number of cancer survivors has been growing at a rate much faster than our understanding of their long-term psychosocial service utilization and how to most effectively meet these needs. Because a significant segment of individuals utilizing services through the Cancer Support Community (CSC) are long-term survivors, the CSC sought to better understand psychosocial needs and utilization of services in this population. Methods: Between 2009-2014, 10,573 individuals attending nationwide Frankly Speaking About Cancer psychoeducational workshops completed post-workshop evaluations (75% response rate). Respondents reported on cancer information-seeking, emotional support utilization and treatment side effects. In all, 6,324 respondents were diagnosed with cancer; of those 36.1% were diagnosed within the past year, 24.0% between 2-5 years ago, and 22.8% 5+ years ago. The current analyses focused on respondents diagnosed at least two years ago (n=2,066; 46.9% of survivors). Results: Survivors were Caucasian (80.0%), female (80.7%), and averaged 60.3 years old (s.d.=11.2). Half (51.1%) had breast cancer; 35.5% had metastatic disease. Long-term survivors reported both significant needs and widespread support utilization, relying on family and friends (64.8%), support groups (55.6%), other patients (30.7%), and patient support organizations (29.5%) to help them cope with cancer. They seek cancer information from their healthcare team (84.5%), the Internet (53.8%), support groups (51.6%), workshops (41.6%), and medical literature (41.2%). More than one-third (37%) reported that this was their first psychoeducational workshop, and 53.1% are currently in support groups. Notably, 38% endorsed ‘connecting with others undergoing similar issues’ as an important aspect of attending the psychoeducational workshop. Discussion: Results support the notion of a ‘gap’ in meeting needs of cancer survivors. They suggest that even years later, comprehensive information and supportive services are highly relevant in meeting the psychosocial needs of cancer survivors, and delivery via multiple modalities may be most optimal. Relation to Theme: This abstract relates directly to the conference theme of “Cancer Education in Diverse Populations” generally addressing the psychosocial needs of long-term cancer survivors, a historically underserved population in terms of meeting their specific needs, despite the fact that the numbers of this group are rapidly growing. Learning Objectives: 1. The participant shall be able to identify common informational and supportive needs of cancer survivors who are at least 2 years from diagnosis and who have elected to attend a cancer psychoeducational workshop. 2. The participant will better understand support utilization patterns in this population. References: 1. Kent, E., Arora, N., Rowland, J., et al. (2012). Health information needs and health-related quality of life in a diverse population of long-term cancer survivors. Patient Education and Counseling, 89(2), 345-352. 2. Burki, T.K. (2015). Unmet needs of cancer survivors. Lancet Oncology, 16(3), e106. doi: 10.1016/S1470-2045(14)71203-3.
P63-A: A Psycho-educational group for young adults (YA) on treatment: Impact on knowledge, distress, and satisfaction.
Lina Mayorga1, Jeanelle Folbrecht2, Kayla Fulgniti2, Renee Ortiz2, Natalie Kelly2, Marisol Trujillo2, Jo Ann Namm2
1City of Hope National Medical Center, Rosemead, CA, USA, 2City of Hope National Medical Center, Duarte, CA, USA
Abstract: Background/purpose: Adolescents and Young Adults (AYAs) face unique challenges in emotional, social and cognitive development while undergoing oncology treatment, resulting in distress and falling behind in meeting developmental milestones. While literature documenting distress and treatment outcomes in the AYA population is well established, intervention development and efficacy research is still in its infancy. The purpose of this study was to examine the feasibility and impact on distress of a 6 week psycho-educational program for young adults during oncology treatment. Methods:A six week psycho-education program was provided for patients on treatment between the ages of 18 and 30. Topics identified in the literature as areas of need were included: symptom management, coping, self-image, and relationships. Attrition (attendance) and distress (HADS) were measured to determine the feasibility and effectiveness of the program. (Replaced New Methods)22 enrolled and 12 completed the program. Of 12 that completed, they attended 4.17 (SD 1.28) sessions. For the 12 who completed, HADS at pre was 13.58 (SD 7.984, range 0-26). HADS at post was 11.67 (SD 8.003, range1-27). On a correlated t test, the change was significantly different F(1,11) = 5.95, p= .03. There was no significant relationship between number of groups attended and change in HADS scores. Results: Twenty patients were enrolled in the program. Preliminary data showed a wide range of HADS scores prior to the program with moderate decreases in HADS scores for those that attended the sessions. Attrition rates demonstrated that regular group attendance was difficult for many patients. Conclusion: Effective psychosocial treatment interventions for AYAs during treatment remain challenging. This study demonstrated that a psycho-education social group designed to address area of need particular to the AYA population can reduce levels of distress. Challenges with group attendance while on treatment, however, limit the impact on those on treatment. Findings could prove helpful in further developing educational among AYA patients. Relation to Theme: Despite advances in treating cancer, AYA’s comprise of the age group minimal gain in survival rates in the US. Psychosocial, developmental, and emotional issues are significant contributors to this trend, and identifying effective methods of intervention & education are necessary to see improvements in treatment outcomes for this population. Learning Objectives: 1. The participant shall be able to learn about the effectiveness and feasibility of a psycho-educational group for on treatment young adults, including patient satisfaction. 2. The participant will be able to learn about the effectiveness and feasibility of utilizing the HADS to measure changes in depression and anxiety in AYA’s in a 6 week psycho-educational group. References: 1. Zebrack B, Isaacson S. Psychosocial care of adolescent and young adult patients with cancer and survivors. Journal of Clinical Oncology. 2012; 30(11):1221-1226. 2. Zebrack B, Mathews-Bradshaw B, Siegel S. Quality cancer care for adolescents and young adults: A position statement. Journal of Clinical Oncology. 2010;28(32):4862-4867. 3. Furlong W, Rae C, Greenberg ML, et al. Surveillance and survival among adolescents and young adults with cancer in Ontario, Canada. International Journal of Cancer. 2012; 1313(11):2660-67.
P65-A: Patient-Reported Benefit of Survivorship Care Plans (SCP) with Clinical SCP Visits
Emily Jo Rajotte, K Scott Baker, Karen Syrjala
Fred Hutchinson Cancer Research Center, Seattle, WA, USA
Abstract: Background/Purpose: In its 2006 report the Institute of Medicine (IOM) recommended that all cancer survivors receive follow-up care after treatment to monitor and manage long-lasting effects of their cancer therapy. A key component of this innovative approach to prevention of late effects and recognition of ongoing health needs is the receipt of a treatment summary and follow-up care plan, collectively called a survivorship care plan (SCP). The goal of this research is to evaluate the perceptions of cancer survivors who receive an SCP with a Survivorship Clinic visit to review the plan with the patient and address related concerns. Methods: Prior to their Survivorship Clinic appointment the team prepares an SCP for each patient. At the visit, a survivorship nurse practitioner reviews the SCP with the patient. Together they make a plan for routine health prevention and surveillance, lifestyle changes and community resource use to target the patient’s needs, along with referrals to specialists if necessary. At 12-months after the Survivorship Clinic visit patients complete an online survey to evaluate the impact of the SCP. Results/Findings: Between September 2013 to April 2015, 50 patients completed the survey, 72% female, 76% white, non-Hispanic, and 20% breast cancer survivors. About half (52%, n=26) reported that they shared their SCP with their providers such as primary care. Nearly two-thirds (66%, n=33) reported the SCP was very helpful in knowing what recommended tests they needed, and 44% (n=22) indicated it was very helpful in assisting them with making healthy lifestyle choices. Half (52%, n=26) indicated the SCP made it easier to discuss survivorship issues with their health care team. Discussion: Results suggest that SCPs provided in the context of a consultative Survivorship Clinic are successful in guiding the coordination of care, facilitating care transitions and encouraging self-management of health by cancer survivors. Relation to Theme: The Survivorship Clinic at SCCA is an innovative program that educates patients on complex survivorship issues and psychosocial aspects of care and thus is directly related to the conference theme of Innovations in Cancer Education. Learning Objectives: The participant shall be able to design and implement a patient-reported outcomes evaluation of Survivorship Care Plans. References: 1. Stricker, C. T.; Jacobs, L. A.; Risendal, B.; Jones, A.; Panzer, S.; Ganz, P. A.; Syrjala, K. L.; McCabe, M. S.; Baker, K. S.; Miller, K.; Casillas, J.; Rosenstein, D. L.; Campbell, M.; Palmer, S. C., Survivorship care planning after the institute of medicine recommendations: how are we faring? Journal of cancer survivorship : research and practice 2011, 5 (4), 358-70. 2. Palmer, S. C.; Jacobs, L. A.; DeMichele, A.; Risendal, B.; Jones, A. F.; Stricker, C. T., Metrics to evaluate treatment summaries and survivorship care plans: a scorecard. Supportive care in cancer 2014, 22 (6),1475-83.
P67-A: Building a Diverse Patient Action Team to Facilitate Institutional Culture Change
Jomary Colon, Nikia Clark, Christy Widman, Deborah Erwin, Willie Underwood
Roswell Park Cancer Institute, Buffalo, NY, USA
Abstract: Background: The Minority Patient Action Team (PAT) is a group of diverse racial and ethnic minority patients from Roswell Park Cancer Institute (RPCI) in Buffalo, NY organized as a pilot program. Their role was to provide insight on their cancer experience and assist in enhancing quality patient care and community resources. Methods: A mailing was sent to all minority cancer patients from RPCI who received treatment in the last 5 years and were at least one year out of treatment. We utilized cancer registry data to invite participation in PAT. As our outreach team is vested in the local cancer community, we wanted to reach a new pool of volunteers with direct cancer patient experience. Results: There were 12 members of the PAT; 7 were African American and 5 were Hispanic representing a variety of cancers and ranged in age from 32-68. Members were offered a stipend for participation and met 12 times between November 2014 and May 2015 guided by two race concordant facilitators. One member was a monolingual Spanish speaker. PAT members vetted outreach materials, participated in cancer related presentations and lectures, worked with our internal employee base sharing perspectives and also participated in community events. At the culmination, PAT helped craft a document to be shared with incoming minority cancer patients entitled “’Now I Know…’ Helpful Tips from a Patient’s Perspective.” Other recommendations were made to further enhance the minority patient’s cancer experience. Discussion: All members of the PAT became involved in other activities at the cancer center as a result of their experience on the team. We continue to call on these volunteers for new projects as needed. Patients offer expertise on quality and experience that cannot be replicated elsewhere. Next steps will explore additional opportunities for the PAT to build a culturally sensitive cancer environment. Relation to Theme: Our abstract is unique in that it deals with diverse populations as cancer patients and as the expert on quality care. We are focusing on minority perceptions relating to cancer care and education. Learning Objectives: The participant will be able to identify best practices for developing a diverse cancer patient team including curriculum and outcomes. References: Frank, L., Basch, E., & Selby, J. V. (2014). The PCORI perspective on patient-centered outcomes research. JAMA, 312(15), 1513-1514. Clauser, S. B., Gayer, C., Murphy, E., Majhail, N. S., & Baker, K. S. (2015). Patient Centeredness and Engagement in Quality-of-Care Oncology Research.Journal of Oncology Practice, JOP-2015.
P69-A: Awareness and Attitudes of Cypriot Men on Prostate Cancer and Screening
Evi Farazi, Loukas Anastasiou, Zoe Roupa
University of Nicosia, Nicosia, Cyprus
Abstract: Background/Purpose: Prostate cancer is the most common form of cancer in men in Cyprus. It is best treated if diagnosed early and accurately. Screening for prostate cancer using prostate specific antigen (PSA) test or digital rectal exam can help identify individuals with suspected cancer, which can be ultimately diagnosed through biopsy. The aim of this project was to assess the level of awareness, perception and screening behavior for prostate cancer among Cypriot men. The objectives were to measure the level of awareness, knowledge and attitudes of Cypriot men about prostate cancer and to identify factors that influence these. Methods: A survey was delivered to 600 Cypriot men in the general population residing in the different districts of Cyprus, using convenience proportional quota sampling. The survey was based on a structured, validated questionnaire in English that was translated to Greek and included a variety of questions on demographics (age, education, district etc), prostate cancer risk factors, symptoms, the general knowledge and awareness of Cypriot men regarding prostate cancer and screening. The survey was delivered between middle of February and end of April 2015. Analysis of the results was achieved using descriptive and analytical statistics in software package SPSS version 21. Results/Findings: Results revealed a medium level of awareness of Cypriot men regarding prostate cancer. Factors that affect the level of awareness were identified, such as age, family history, educational level, urbanization and previous exposure to screening for prostate cancer. Discussion: These results could be used to design specific health education programs to inform and increase the level of awareness about prostate cancer by targeting men of younger ages, men living in rural areas as well as men of low educational level. This will ultimately lead to a reduction in the burden of prostate cancer in Cyprus. Relation to Theme: The abstract presents results related to a prostate cancer awareness study in the specific population of Cyprus, revealing needs in cancer education and thus adding to the conference theme regarding cancer education in diverse populations. Learning Objectives: The participant shall be able to describe factors that affect the level of awareness of Cypriot men regarding prostate cancer and screening. The participant shall be able to compare the results of this study to similar studies in other populations, and thus develop ideas for designing cancer education programs to target the appropriate individuals and improve prostate cancer awareness in diverse populations. References: 1) Atulomah O, Olanrewaju F, Amosu M and Adedeji O. (2010). Level of Awareness, Perception and Screening Behavior Regarding Prostate Cancer Among Men in a Rural Community of Ikenne Local Government Area, Nigeria. Libertas Academica, 2, 11-20. 2) Oranusi, C., Mbieri, U. & Nwofora, A. (2012) Prostate cancer awareness and screening among male public servants in Anambra State, Nigeria. African Journal of Urology. 18(2), 72-74.
P71-A: Peer Relationships of Cancer Survivors in College
Jennifer So1, Tonya Pan2, Sandy Bohan3, Shelley Condon3, Megan Clifford3, Jacob Melendez3, Kristen Wells3, Georgia Robins Sadler1, Vanessa Malcarne3
1UCSD Moores Cancer Center, San Diego, CA, USA; 2San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; 3San Diego State University, San Diego, CA, USA
Abstract: BACKGROUND: For young individuals with cancer, peer relationships are especially significant. Sharing and connecting with peers is critical to the development of individuals’ social skills and social support. However, young individuals with cancer may focus more on their cancer needs and treatment rather than on building relationships with healthy peers. Cancer can influence an individual’s peer support system and impede peer interactions. This study investigated the peer relationships of young cancer survivors in college. METHODS: Twenty young cancer survivors (13 women, 7 men), attending college in the United States, consented to a one-on-one, semi-structured interview conducted via video chat. Participants ranged in age from 18 to 30 years, and were diagnosed between the ages of 1.5 and 22 years. Verbatim transcripts of interviews were analyzed using the content analysis method. RESULTS: Three thematic domains emerged regarding peer relationships: (1) characteristics, (2) challenges, and (3) impact of self-image. Participants often described supportive relationships with peers who were caring, whereas non-supportive relationships involved peers who were disrespectful and skeptical. Participants noted challenges to engaging socially with peers that impeded building relationships, such as having cancer-related health concerns and issues that limited social activity. An important factor impacting the quality of peer relationships was the participants’ self-image in relation to their peers. Those who felt comfortable with their cancer identity were able to better connect with peers than participants who felt abnormal compared to their peers. DISCUSSION: The results of this study provide insight into the quality of peer relationships of young adult cancer survivors, as well as the factors that contribute to establishing and maintaining those relationships. These findings may educate college staff and inform their efforts to aid other young cancer survivors during this important developmental time to build beneficial social connections with peers. Relation to Theme: Young cancer survivors are a diverse population that needs to be further investigated in order to improve cancer education targeted to them. Their cancer experiences on peer relationships can help bring insight and improve their quality of life during and after their cancer treatment. Learning Objectives: The participant shall be able to identify aspects of peer relationships specific to cancer survivors in college. References: Kent, E. E., Parry, C., Montoya, M. J., Sender, L. S., Morris, R. A., & Anton-Culver, H. (2012). ‘You’re too young for this’: Adolescent and young adults’ perspectives on cancer survivorship. Journal Of Psychosocial Oncology, 30(2), 260-279. doi:10.1080/07347332.2011.644396. Howard, A. F., Tan de Bibiana, J., Smillie, K., Goddard, K., Pritchard, S., Olson, R., & Kazanjian, A. (2014). Trajectories of social isolation in adult survivors of childhood cancer. Journal of Cancer Survivorship, 8(1), 80–93. doi:10.1007/s11764-013-0321-7
P73-A: Nueva Luz: Empowerment of Latina Breast Cancer Survivors through an English and Spanish survivorship educational intervention
Lina Mayorga, Gloria Juarez
City of Hope National Medical Center, Duarte, CA, USA
Abstract: PURPOSE:Evaluate the effectiveness of an English/Spanish psychosocial education intervention to assist Latina breast cancer survivors transition into survivorship. METHODS: Eight English and Spanish speaking Latina breast cancer survivors with stage I, II, or III breast cancer participated in a digitally-recorded interview. The program evaluation focused on the content, format, cultural congruency and linguistic appropriateness. Also, which aspects of the program were most beneficial and which were least beneficial from the participant’s perspective. RESULTS: Findings indicate that the Nueva Luz program was helpful in determining content modifications; participants had specific suggestions on information that maybe revised, added or omitted. Participants evaluated the delivery methods and the bilingual notebook with the printed education materials. Participants preferred the customized tailored approach, the combination of the face-to-face sessions along with the bilingual notebook and the opportunity to ask question. The printed materials helped reinforce verbal communication and to practice what was taught. The education format and content suited their needs and prompted them to make changes and change their outlook. CONCLUSIONS: Our pilot findings suggest that it is feasible and acceptable to conduct a psychosocial intervention with this underserved population. The combination of written bilingual information with one-on-one customized tailored approach provided by a bilingual health care provider can be effective in helping Latina breast cancer survivor’s transition successfully into survivorship. The educational intervention empowered participants to take more of an active role in their care and becoming a motivating force within their families to provide encouragement and support to take charge of their own health as well. Participants learned to be more proactive in their care including improvement of patient-provider communication and participating in decisions about their care. Implications: The “Nueva Luz” program needs to be further tested for efficacy in a larger randomized clinical trial. With further research and development “Nueva Luz” the potential to fill a Relation to Theme: Latinos currently are the largest ethnic minority and comprise 15% of the United States population (1). As the number of Latinos and breast cancer survivors continues to grow, the need to develop education programs that are culturally congruent and linguistically appropriate for non-English speaking and limited English proficient ethnic minorities. Learning Objectives: 1. Participants will learn about Findings the one-on-one tailored approach that is a feasible and acceptable method of providing a bilingual psychosocial intervention for Latinos. 2. Participants will learn about the effectiveness of using printedbilingual information along with the verbal instruction from a bilingual and culturally competent health care provider can be effective in helping Latina breast cancer survivor’s transition successfully into survivorship, improve QOL and contribute to better patient outcomes References: 1. Pew Hispanic Center. Statisitical Portrait of Hipsanics in the United States. 2010. 2. Badger T, Segrin C, Meek P, Lopez AM, Bonham E, Sieger A. Telephone interpersonal counseling with women with breast cancer: symptom management and quality of life. Oncol Nurs Forum. 2005; 32(2):273–9. doi: 10.1188/05.onf.273-279. PubMed PMID: 15759065. [PubMed: 15759065] 3. Badger TA, Segrin C, Hepworth JT, Pasvogel A, Weihs K, Lopez AM. Telephone-delivered health education and interpersonal counseling improve quality of life for Latinas with breast cancer and their supportive partners. Psychooncology. 2012 doi: 10.1002/pon.3101. PubMed ID: 22573418. 4. Meneses K, Benz R. Quality of life in cancer
P77-A: Mammography advanced training school: improving the image quality and an accurate diagnosis of breast cancer
Thiago Silva, Silvia Maria Sabino, Gisele Ribeiro, Edmundo Mauad
Barretos Cancer Hospital, Barretos, São Paulo, Brazil
Abstract: Breast cancer remains the leading cause of cancer mortality among women worldwide, with the mortality rates in developing countries showing an increased trend due to a lack of resources for implementation of organized screening programs, accurate diagnosis and effective treatment. Mammography is the gold standard for detection of breast cancer and its optimal quality is essential for successful diagnosis at early stage. However, a Brazilian study reported that 60% of the mammographic examinations conducted by the public health systems and private clinics exhibited some degree of failures. With expertise based on the European model of population-based organized screening, the Barretos Cancer Hospital started in 2012 the first Brazilian training program for radiographers to ensure the clinical quality of the mammography. Radiographers selected for the 80 hours training course submitted 15 days before the course starts a portfolio containing 50 examinations conducted by them for review by the clinical quality control team. Through the evaluation of 18 mammographic positioning quality items stipulated by the European Guidelines it is produced a customized practice-oriented training for each student, based on their most frequent positioning failures. Since 2012 it was trained 217 radiographers from different States of Brazil. The mean of failures reported per exam was 3.4 at the beginning of the course and 1.2 at the end. The average rate of decrease of failures per exam was 62% (p=0.001). The most common positioning-related failures reported were absence of the pectoral muscle at cranio-caudal incidence (88%) and pectoral muscle to nipple level (46.5%) and non-visualization of infra-mammary angle (46.5%) at Medio-lateral oblique. This experience has shown that these trained professionals become able to perform mammography with higher diagnostic quality, reversing the current national framework, where the majority of mammograms performed have errors that make it difficult to provide an accurate diagnosis. Relation to Theme: With the prominent increase of breast cancer incidence worldwide and the large gaps in image quality coupled with deficiencies in radiological services, it is necessary to offer some training programs to improve the quality of the mammography, contributing to the reduction of breast cancer mortality rates in different population. Learning Objectives: The students shall be able to perform mammography with high diagnostic quality, increasing the rate of early diagnosis of breast cancer with all the screened women being benefited. Thus, it is expected that the training could be useful to promoted critical thinking on the technicians’ part; to reduce the waste of resources and unnecessary exposure of patients to radiation; to improve the final quality of mammography services offered in a Breast Cancer Screening Program; to develop a managing tool for quality in mammography in developed developing countries. References: Brnic Z, Blaskovic D, Klasic B, et al: Image quality of mammography in Croatian nationwide screening program: comparison between various types of facilities. Eur J Radiol 81(4): e478-485, 2012. Everton KL, Mazal J and Mollura DJ: White paper report of the 2011 RAD-AID Conference on International Radiology for Developing Countries: integrating multidisciplinary strategies for imaging services in the developing world. J Am Coll Radiol 9(7): 488-494, 2012. Avramova-Cholakova S, Lilkov G, Kaneva M, et al: Eight years of quality control in Bulgaria: impact on mammography practice. Radiat Prot Dosimetry. 2015 Jul;165(1-4):359-62.
P79-A: Breast density legislation education for patients and providers: are we reaching them?
New Mexico State University, Las Cruces, NM, USA
Abstract: Background/Purpose: Legislative efforts in 24 states require notification after mammograms to women with heterogeneously and extremely dense breast tissue (50% of all women) with information about breast density, supplemental screening options, and recommended physician conversations. Despite state laws, education for patients or healthcare professionals about legislation and communication may be a challenge. The purpose of this study was to examine online information from three breast density information resource websites to further understand cancer education and state legislation. Methods: Two breast density resource websites from California (CA) and Michigan (MI) and one advocacy breast density resource website were selected and reviewed using content analysis for ten variables including readability, usability, provider, patient, and legislative resources. Results: Mandated breast density patient notification letters from mammography service providers with CA or MI standardized wording showed similar reading grade levels (8.2 CA and 8.4 MI). The MI provider information included an online CME program. The CA provider information included a provider communication flowchart. The MI and advocacy website included English and Spanish patient education brochures. The advocacy website included segments for patient stories. All websites included selected states with legislation. The CA website was organized through the CA Breast Density Information Group including breast radiologists and breast cancer risk specialists in the state (breastdensity.info). The MI website was organized through the state Department of Health and University of Michigan Health System (midensebreasts.org). The advocacy website was organized as a nonprofit organization for patient education (areyoudense.org). Discussions: Online breast cancer education has potential to direct discussions for health professionals and imaging professionals to increase breast density awareness and decrease fears of patients. Efforts may strengthen and support provider-patient relationships about screening and modifiable and non-modifiable risk factors regardless of breast density. Relation to Theme: The abstract provides new information for health care professionals and patient/family education regarding breast cancer prevention, breast density legislation, online information-seeking, and improved provider-patient communication. Learning Objectives: The participant shall be able to discuss the breast density state legislation patient notification process with supplemental screening options. References: Slanetz PJ, Freer PE, Birdwell RL. Breast-Density Legislation — Practical Considerations. N Engl J Med 2015; 372:593-595. Rhodes DJ, Breitkopf CR, Ziegenfuss JY, Jenkins SM, Vachon CM. Awareness of Breast Density and Its Impact on Breast Cancer Detection and Risk. J Clin Oncol 2015;. doi: 10.1200/JCO.2014.57.0325 Khong KA, Hargreaves J, Aminololama-Shakeri S, Lindfors KK. Impact of the California Breast Density Law on Primary Care Physicians. Radiology 2015;12:256-260.
P81-A: The Patient Shark Tank: Amplifying the Voice of the Patient and Caregiver in Innovation
CANCER101, New York, NY, USA
Abstract: Background: There is an evolution underway where we are beginning to understand the value of partnering with patients to revolutionize healthcare. With an emphasis on healthcare innovation, there is an explosive growth of tools, resources, health technologies, and other platforms designed to serve patients and their caregivers. However, with virtually little oversight within the industry, “good ideas” often evolve into innovations to address a perceived issue, yet very few patients have been involved in the design or development of the innovation. Description: To amplify the voice of the patient and caregiver—and empower them to partner with innovators, the Patient Shark Tank® was created in 2011. Imagine an ecosystem where a patient’s/caregiver’s perspective and expertise could be heard loud and clear in the design, the development or even enhancement of any solution that’s designed to serve them, whether its new technology, a mobile app, a new policy or product being developed, patient education and/or research design. An innovator (any person or organization) that has created a patient centric solution pitches their concept or initiative to a panel of patients/caregivers who ask targeted questions based on their experiences to understand how the innovation uniquely addresses their needs and provides direct perspective and feedback. Evaluation: A 12 part scorecard was co-designed with patients, which patient/caregiver panelists use to assess the innovations. This allows for standardization in evaluation, as well. The 12 part scorecard distills into a 3 part score that is depicted on a Patient Shark Tank seal the innovator receives. Usefulness: The insights allow the innovator to either go back to the drawing board, charge forward with the patients’ perspectives and even re-pitch once they’ve refined. Over 150 innovations have been evaluated globally across academic medical centers, hospitals, pharmaceutical, insurance and technology companies, as well as start-ups. Relation to Theme: WIth an emphasis on Innovation and the use of technology in healthcare, this abstract correlates with the theme by showcasing the value and importance of obtaining patient and caregiver perspective in the design, development and enhancment of innovatons designed to serve them. Learning Objectives: Embrace the impact of patient perspective in innovations designed to serve them. Incorporate a participatory co-design process into the design and development of solutions for patients and their caregivers. References: References
P83-A: Improving oral chemotherapy patient education: It’s not just any pill
Clare Sullivan1, Christine Cleary1, Carole Dalby1, Catherine (Kitty) Hooper1, Kaitlin Chesnulevich2, Patricia Rizzo1, Christine Lilienfeld1, Thomas Kochanek3
1Dana Farber Cancer Institute, Boston, MA, USA; 2Londonderry Cancer Center, Londonderry, New Hampshire, USA; 3Patient Family Advisory Council, Boston, MA, USA
Abstract: Background: The care of the patient receiving oral chemotherapy is complex. Unlike infusion chemotherapy, the patient and caregiver assume more risk and responsibility managing their care at home. Specific education regarding medication, prompt management of side effects and adherence strategies are fundamental. To improve safety and quality, consistent with the ASCO/ONS Chemotherapy Administration Safety Standards, Dana-Farber Cancer Institute (DFCI) implemented an adherence program with a unique initiative to improve oral chemotherapy education materials. Description: The goal of the initiative was to educate a culturally diverse audience, with evidenced based information, reinforcing critical safety points to reduce overall risk factors. In conjunction with a process improvement plan, a focus group of patients and clinicians revised DFCI web content, developed four video vignettes and created print materials with a critical message: It’s not just any pill. Oral chemotherapy is a serious drug that requires extra caution. The teaching materials and videos are available on the DFCI external website in five languages. Evaluation: Success is measured through Press-Ganey feedback relative to treatment education, social media analytics and teaching material analytics. In collaboration with a communications specialist with social media expertise, our analytics show the videos were viewed in 25 countries, representing all continents. Usefulness: The print materials with safety and adherence strategies include a link to the videos and are merged electronically to all oral chemotherapy drug sheets. Animated videos have many advantages for the health care community seeking cost effective, efficient and innovative approaches to cancer education. The cost and labor is significantly less than the traditional camera interviews and revisions and dubbing into multiple languages is convenient. Video feedback: Educating patients with cancer is stressful, but the commonality of the stick figures, with the voice and music generate a positive message regarding chemotherapy safety. Videos: Bronze Award Digital Health Media- 2015. Relation to Theme: This poster abstract relates to the conference theme because it is an innovative approach to educating patients and the public to the attentiveness needed with oral chemotherapy. The use of animated videos using stick figures was relatable to diverse ethnic and socioeconomic backgrounds served at Dana-Farber Cancer Institute and beyond. Learning Objectives: The participant will identify a unique-process improvement initiative applicable to any clinical setting regarding oral chemotherapy education. The participant will identify at least two advantages animated videos bring to cancer care education. References: Moore, S., Brandt, M., (2010). Adherence to Oral Therapies for Cancer, Helping Your Patient Stay on Course Toolkit. ONS. Weingart, S.N., Li, J.W., Zhu, J., Hasset, M.J. (2012, January). US Cancer Center Implementation of ASCO/Oncology Nursing Society Chemotherapy Administration Safety Standards. Journal of Oncology Practice, 9(1), 7-12
P2-B: Adapting Targeted Cancer Screening Videos for a Homeless Patient Population
Jane Montealegre, Roshanda Chenier, Glori Chauca, Ivan Valverde, Maria Jibaja-Weiss
Baylor College of Medicine, Houston, TX, United States; Baylor College of Medicine, Houston, TX, USA
Abstract: Background/Purpose: Clinics that serve the homeless population often face budgetary constraints and competing health issues that impede their ability to deliver cancer screening education to their patients. We adapted a series of cancer screening educational videos for implementation at the point-of-care within a network of publicly-funded homeless clinics. Description: Our team previously developed educational videos for cervical (CxC), colorectal (CRC), and breast cancer (BC) screening that have been integrated into the clinical workflow of a large safety net healthcare system. Briefly, the bilingual videos (English and Spanish) use theory-based messaging, are shown to individual patients in the exam room, and are targeted to individuals due/past due for screening by querying the electronic medical record. An advisory board was established to oversee the adaptation/implementation of the videos at 10 homeless clinics. New content was developed for the CRC videos to reflect the single-sample stool test employed by the clinics; content for the CxC and BC videos remained the same. Project staff made 2 site visits to each clinic to assess logistical and technical considerations needed to integrate the videos within each unique clinical setting. Evaluation: Implementation of the videos will begin in July 2015. Deployment will follow a staggered design, with group 1 clinics (n=5) beginning first, followed by group 2 clinics (n=5) three months later. Evaluation indicators include the proportion of eligible patients who view the videos and receipt of a screening test among patients who watch the videos. Usefulness: Educational videos to promote cancer screening can be adapted for a homeless patient population. A staggered deployment scheme will allow the evaluation of the impact of the targeted videos on screening test utilization. Given the particular needs of the homeless population, once created these adapted videos may be utilized by other organizations who serve this underserved population. Relation to Theme: Implementation of culturally and linguistically appropriate cancer education point-of-care (POC) videos in homeless clinics is imperative for addressing health disparities in this population. The patients are empowered by learning the importance of early screening and detection, as Learning Objectives: After this presentation, each participant will be able to understand the process of educational video implementation to promote cancer screening for homeless patient populations. References: 1. Chau, S. Chin, M., Chang, J., et al. (2002). Cancer risk behaviors and screening rates among homeless adults in Los Angeles County. Cancer Epidemiology, Biomarkers & Prevention, 11, 431-438. 2. Jandorf, L., Fatone, A., Borker, P. et al. (2006). Creating alliances to improve cancer prevention and detection among urban medically underserved minority groups: The East Harlem partnership for cancer awareness. CANCER Supplement,107(8), 2043-2051.
P4-B: Making Impacts on Health Disparities through Innovative Community Benefit Programming
Nancy Clifton-Hawkins, Annette Mecurio
City of Hope, Duarte, CA, USA
Abstract: Background: The changes in the landscape of health care in the United States has caused a shift in way that non-profit hospitals develop and report on community health improvements activities. Rather than acting in silos non-profit hospitals need to think in community-based collaborative relationships to address the root causes of health inequities in their local service area. Description: City of Hope is not only a National Cancer Institute designated Comprehensive Cancer Center, it is also a non-profit hospital charged with the privilege of addressing the cancer inequities of the vulnerable population living within its service area. With the non-profit status, comes the responsibility of ensuring that all efforts at address the root causes of cancer related health disparities are specifically drawn from a tri-annual community health needs assessment. The challenges for delivering such programming is the ability to dive deep and change the institutional think surrounding the way that such an institution interactions not only with the community but within the institution to cross professional boundaries to develop and deliver programs that make an impact on the lives of individuals living within our culturally rich region. Moving away from random programs to more strategic collaborations and reporting these findings will be the key to appropriately addressing needs, head on, and demonstrating sustainable changes. Evaluation: We will share findings of the shifts in staff perception of their capacity and responsibility for addressing the disparities in cancer inequities through strategic community benefit programming. Usefulness: Sharing strategies to address cancer related disparities within thewithin the context of changing health care environment will assist participants in creating sustainable community health improvement activities that make impact in local vulnerable populations. Relation to Theme: Non-Profit Comprehensive Cancer Centers are poised to make significant impact in addressing issues along the continuum of cancer care for vulnerable communities. Utilizing the parameters of the Affordable Care Act, hospitals in the United States can effectively assess needs and plan programming to address the disparities that cancer patients face. Learning Objectives: 1. Define the concepts of Community Benefit and its relationship to the Affordable Care Act. 2. Recall at least two ways to effectively address the cancer disparities among vulnerable populations in hospital service area. 3. Share challenges that may impede non-profit hospital from effectively engaging with local community. 4. Develop at least one strategy for creating a collaborative relationship with internal and external stakeholders. References: 1. GD Nelson, CH Mueller, TK Wells, CL Boddie-Willis, and CH Woodcock. (2015) Hospital Community Benefits after the ACA: State Law Changes and Promotion of Community Health. The Hilltop Institute. Retrieved from: http://www.hilltopinstitute.org/publications/HospitalCommunityBenefitsAfterTheACA-StateLawChangesIssueBrief10-Feb2015.pdf. May 10, 2015. 2. S Robbins. (2015) 26 CFR 601.201. Rulings and Determination letters. Rev. Proc. 2015-21. Retrieved from: http://www.irs.gov/pub/irs-drop/rp-15-21.pdf May 10, 2015.
P6-B: Women and Tobacco Use: Discrepancy in the Knowledge, Belief and Behavior towards Tobacco Consumption among Urban and Rural Women in Chhattisgarh, Central India.
Ram Tiwari, Anjali Gupta
Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
Abstract: Background: Tobacco consumption has become pandemic, and is estimated to have killed 100 million people in the 20th century worldwide, 700,000 out of the 5.4 million deaths due to tobacco use were from India. Era of Global modernization has led to an increase in the involvement of women in tobacco consumption in the low income and middle-income countries. Tobacco consumption by females are known to have grave consequences. Objective: to assess: 1) the tobacco use among urban and rural women; 2) the discrepancy in the knowledge, belief and behavior towards tobacco consumption among urban and rural women in Durg-Bhilai Metropolitan, Chhattisgarh, Central India. Methods: Study population consisted 2000 of 18-25 year old young women from Durg-Bhilai Metropolitan, Central India, from both urban and rural areas. Data was collected using a pretested, anonymous, extensive face to face interview by a female investigator to assess the tobacco use among women and the discrepancy in the knowledge, belief and behavior towards tobacco consumption among urban and rural women. Results: The prevalence of tobacco use was found to be 47.2%. Tobacco consumption among rural women was 54.4% and in urban women was 40%. Majority of the women from urban areas (62.81%) were smokers whilst rural women (77.40%) showed preponderance toward smokeless tobacco use. Urban women had a better knowledge and attitude towards harms from tobacco and its use than the rural women. Women in rural areas had higher odds (1.335) of developing tobacco habit that the urban women. Discussion: Increased tobacco use by women poses very severe hazards to their health, maternal and child health, and their family health and economic well-being. Due to the remarkably complex Indian picture of female tobacco use, an immediate and compulsory implementation of tobacco control policies laid down by the WHO FCTC is the need of the hour. Relation to Theme: India is a predominantly rural country with much emphasis of the health care in the urban areas. Since tobacco use is on the uprise amongst women in India, our study focus on the discrepancy of tobacco use among the urban and rural women in central india. Learning Objectives: The participant shall be able to identify the burden of tobaccoo use amongst rural population and ways to handle and improve the situation in keeping with the socioenvironmental model. References: 1. Akansha Singh, Namita Sahoo (2013). Urban–rural differentials in the factors associated with exposure to second-hand smoke in India. BMJ Open,Nov 25,3(11). 2. Danawala SA, Arora M, Stigler MH (2014). Analysis of motivating factors for smokeless tobacco use in two Indian states. Asian Pac J Cancer Prev, 15(16) ,6553-8.
P8-B: Determining Cancer Nursing Core Competencies for Priority in a Sub-Saharan African Context
Rebecca Sipples1, Patrice Nicholas2, Deborah Kirk-Walker1, Rebecca Petersen3
1University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA, 2Brigham and Women’s Hospital/MGH Institute of Health Professions School of Nursing, Boston, MA, USA, 3National Register of Health Service Psychologists, Boston, MA, USA
Abstract: Background/Purpose: Established cancer nursing core competencies are available in the U.S., Australia, and other settings. In sub-Saharan Africa (SSA), where there exists a burgeoning cancer crisis, cancer nursing core competencies specific to cancer care in this region are not currently available. In response to the increasing burden of cancer, the purpose of this study was to determine cancer nursing core competencies to optimize cancer care in SSA. Methods: We conducted a literature search for cancer nursing core competencies in SSA and reviewed four established cancer nursing core competency standards in use internationally. We selected 50 competencies in 6 domains to include on a survey of international experts who rated the competencies by level of importance. Results/Findings: The survey response rate was 39% (n=26). Of the 6 domains of competencies, the Palliative and End of Life Care (palliative) domain was rated significantly higher than the remaining 5 domains. Nearly all of the 50 competencies were considered important. Competencies pertaining to symptom and pain management, identification and treatment of oncologic emergencies, and palliative and end-of-life care were most strongly endorsed by the experts. No significant difference was found in perceived level of importance of the competencies based on gender. Experts who were older and more professionally experienced ranked competencies in all domains except palliative as less important than the younger, more experienced cohort of experts. Discussion/Conclusions: We identified 50 cancer nursing core competencies for potential future use in SSA. Results indicated competency domains and individual competencies that may be of more or less importance for inclusion in future educational and training interventions. Using the competencies as a guide, educators can design innovative educational and training programs and cancer-specific curricula for nurses in an effort to empower this group to significantly contribute to efforts to address the burgeoning cancer crisis in SSA. Relation to Theme: Our work involves advancing cancer nursing in SSA; a region facing a burgeoning cancer epidemic in the setting of an ongoing cancer workforce shortage. Our efforts in SSA emphasize advancing cancer nursing education that encompasses care across the cancer continuum. Ongoing educational planning will support opportunities for international collaboration. Learning Objectives: The participant shall be able to identify three cancer nursing competency areas that may be most important to include in future cancer nursing educational opportunities for nurses in SSA. The participant shall be able to identify the competency domain considered most important by cancer experts for inclusion in future cancer nursing educational opportunities for nurses in SSA. References: 1. Kinfu, Y., Dal Poz, M. R., Mercer, H., & Evans, D. B. (2009). The health worker shortage in Africa: Are enough physicians and nurses being trained? Bulletin of the World Health Organization, 87(3), 225-230. 2. Strother, R. M., Fitch, M., Kamau, P., Beattie, K., Boudreau, A., Busakhalla, N., & Loehrer, P. J. (2012). Building cancer nursing skills in a resource-constrained government hospital. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 20(9), 2211-2215. doi:10.1007/s00520-012-1482-z; 10.1007/s00520-012-1482-z
P10-B: Community-Campus Partnerships: Increasing the Benefits and Decreasing the Challenges
Fe Seligman1, Sandy Bohan2, Monica, Cabiles1, Jeanne Marie Marasigan1, Vanessa Malcarne2, Georgia Robins Sadler3
1Operation Samahan, Inc., National City, CA, USA, 2San Diego State University, San Diego, CA, USA, 3University of California San Diego, Moores Cancer Center, San Diego, CA, USA
Abstract: Background: Community-campus partnerships (CCP) can help to reduce the nation’s cancer disparities. The Asian Pacific Islander (API) community faces unique challenges in addressing their cancer disparities because of the community’s diversity; successful CCPs can help address these disparities. Methodology: This CCP began with a network of API community leaders determined to identify and reduce their community’s cancer disparities. The API Community Health Network conducted a community health assessment, concluding that campus partners could help the Network develop robust research to design and test community-specific solutions. Faculty members from two nearby universities were invited to join the Network to help address diverse issues relevant to cancer. The community partner describes the benefits anticipated from a CCP, the strategies used to attain and amplify those benefits, the anticipated challenges that were minimized or avoided entirely, and the actual challenges that were overcome. Results/Findings: The community partner began with high expectations, which were quickly tempered by the reality of learning about and conducting a research project, as well as recognition of the technological and the logistical challenges. The needs for depth of training, plus rigorous adherence to IRB standards and scientific protocols, were further daunting. Treatment as a full-fledged, respected research partner was highly rewarding and kept the community partner fully engaged. Learning research methods was also rewarding and validated the community’s views of their leaders concerns. The campus partners’ cultural competency and unwavering commitment to the community was critical to sustaining the community partner’s engagement. Discussion: CCPs will more likely succeed if campus partners assume responsibility for understanding the benefits and challenges of a CCP from the community partner’s perspective. The community partner can increase the odds of success by a willingness to openly share their perspectives and resources with the campus partners, while gaining essential research skills to benefit their community. Relation to Theme: Community-campus partnerships offer effective strategies for reducing the nation’s health disparities. This poster demonstrates the challenges and benefits of community-campus partnerships from the community partner’s perspective. It will also discuss the challenges that are commonly experienced from the community partner’s perspective and ways those challenges can be minimized. Learning Objectives: Participants will learn about the benefits and challenges that accompany community-campus partnerships and how to avoid the pitfalls of such partnerships, while increasing the benefits to them and their community. References: 1. Kagawa-Singer M, Valdez Dadia A, Yu MC, Surborne A. Cacner, culture, and health disparities: Time to chart a new course? CA Cancer J. Clin. 2010; 60 (1):12-39. 2. Sadler GR, Ryun L, Nguyen T, Oh G, Paik G, Kustin B. Heterogenity within the Asian Community. Int J Equity Health. Dec 29 2003; 2(1):12.
P12-B: Physician-based Human Papillomavirus Vaccine Intervention for Male University Students: A Pilot Study
Marielle Gross1, Cuc Tran2, Alex Lee3, Kayla Sutherland4, Alexis Santos5, Xiao Wu6, Jacqueline Castagno7, Robert Amdur8
1Johns Hopkins University School of Medicine, Department of Gynecology and Obstetrics, Baltimore, MD, USA, 2Emerging Pathogens Institute of University of Florida, Gainesville, FL, USA, 3University of Florida, Department of Health Outcomes and Policy, Gainesville, FL, USA, 4The Ounce of Prevention Fund of Florida, Tallahassee, FL, USA, 5University of Florida, Gainesville, FL, USA, 6University of Florida, Department of Statistics, Gainesville, FL, USA, 7University of Florida, Department of Obstetrics and Gynecology, Gainesville, FL, USA, 8University of Florida, Department of Radiation Oncology, Gainesville, FL, USA
Abstract: Background: Only 6.8% of American males 13-17 received HPV vaccines as recommended in 2012, yielding a sizable adult population needing “catch-up” vaccination. Education is a barrier, but data on form and effectiveness of interventions remains limited. We investigate physician-based educational interventions for college males. Methods: 57 unvaccinated college males 18-21 were consented and randomized into three 20-minute intervention groups: (G1) Control-arm with education limited to CDC’s HPV factsheet, (G2) PowerPoint lecture by male radiation oncologist with head-and-neck cancer expertise, (G3) same lecture followed by face-to-face discussion with male oropharyngeal cancer patient. Pre and posttests measured comprehension, barriers and intention to vaccinate. Vaccination status at 6 months was assessed from student health records. One-way student t-test was used to analyze data. Results: 41 males (71.9%) attended. Only 5/41 (12.1%) were aware of prior vaccination opportunities. Pretest comprehension was poor: 82.9% believed their lifetime-risk of HPV infection was low, and 36.6% thought HPV is treated with antivirals. Group 2 (0-6/13; p-value 0.0037), Group 3 (3-10/17; p-value 0.006), and Group 2+3 (3-16/30; p-value. At 6 months, one from G2 and two from G3 received ≥1 HPV vaccines, but data were not significant. Total vaccination was significantly increased in G2+3 (0-3/30; 10%; p-value 0.041). Discussion: A 20-minute presentation by an oncologist +/- interactive cancer patient is feasible means for educating college males about HPV vaccination. Pilot testing demonstrated >5-fold increased intention to vaccinate, 40% appointment interest and 10% confirmed vaccination rate. In its pilot iteration, this low-cost intervention demonstrated modest clinical benefit and potential to impact a healthcare-resistant population, indicating further investigation of this strategy. Relation to Theme: We evaluate a novel strategy for HPV vaccine education that utilizes a head-and-neck oncologist and a male patient with relatable HPV-cancer experience to deliver a tailored message to stimulate vaccination in young adult males, the population with the lowest rate of HPV vaccination to date and a strong propensity for avoiding proactive preventive healthcare. Learning Objectives: The participant shall be able to identify at least two knowlege gaps in young adult males’ understanding of HPV infection. He or she will also be able to describe the difference between the effectiveness of a standard written educational format (the control) and that of a brief physician-led seminar with regard to intention to vaccinate and actual vaccination. References: 1. Fu, Linda, et al. Educational interventions to increase HPV vaccination acceptance: A systematic review. Vaccine. Volume 32, Issue 17, 7 April 2014, Pages 1901–1920. 2. Katz, Mira L, et al. Human papillomavirus (HPV): college male’s knowledge, perceived risk, sources of information, vaccine barriers and communication. Journal of Men’s Health. Volume 8, Issue 3, October 2011, Pages 175–184. 3. Kester, Laura M., et. al. The effects of a brief educational intervention on human papillomavirus knowledge and intention to initiate HPV vaccination in 18–26 year old young adults. Gynecologic Oncology. Volume 132, Supplement 1, March 2014, Pages S9–S12.
P14-B: Title: Smoking Cessation and the Surgical Patient: Multifaceted Interventions Aimed at Improved Patient Care Outcomes.
Kathleen Heneghan1, Nancy Strand1, Ajit Sachdeva1, Frederick Greene2, John Daly3
1American College of Surgeons, Chicago, IL, USA, 2Levine Cancer Institute, Charlotte, NC, USA, 3Temple University School of Medicine, Philadelphia, PA, USA
Abstract: Purpose: Smoking significantly increases all surgical complications and increases the risk of cancer reoccurrence and secondary cancers when compared to non-smokers. Considering nearly 20% of patient undergoing surgery are smokers; surgery is often the first line of treatment for many cancers; and lung cancer causes more deaths than colorectal, pancreatic and prostate cancers combined, the surgical teams role in smoking cessation interventions is critical. 1,2 Smokers are more likely to quit when advised by a health professional and remain smoke free when they quit prior to surgery. Unfortunately, the literature identified only 13% of surgeons always counsel their patients to quit.4 The purpose of this study is to determine the effectiveness of utilizing a multifaceted performance improvement model to increase the frequency and quality of smoking cessation communication offered by surgical professionals. Methods: Triangulation methodology identified professional practice smoking cessation interventions and barriers. Multifaceted interventions were implemented by the American College of Surgeons to increase smoking cessation interventions and quit rates prior to surgery. Results: Focused discussion with 13 surgical specialty councils and survey data supported a need for surgical smoking cessation resources and professional education. Only 4% of surgeons always provide smoking cessation intervention to patients and 69% were not aware of coding for reimbursement. Multifaceted interventions included a smoking cessation position statement, publications, education programs, marketing and surgery specific patient resources. Professional courses ratings were high (4.5/5) and quit smoking patient resources are one of the most frequently accessed sites from the ACS website. Conclusions: Multifaceted approach and evidence based consumer messages on smoking cessation, plus counseling and coding education supported rapid uptake and implementation. 4 Warner, DO, Sarr MG, Offord KP, et al. Anesthesiologists, general surgeons, and tobacco interventions in the perioperative period. Anesth Analg. 2004: 99(6): 1766-1773. Relation to Theme: Continued smoking in cancer survivors increases the risk of recurrence, secondary cancers and death.5 All of the efforts to support health care reform will be meaningless unless we challenge patients to take responsibility for their own health and to reduce habits that contribute to illness and recovery. Learning Objectives: 1. Know the effects of smoking on surgical outcomes. 2. Learn effective smoking cessation strategies, counselingmethods and proper coding of interventions. 3. Apply smoking cessation counseling at all non-emergent patient consults. 4. Identify methods for measuring the effectiveness of perioperative smoking cessation interventions. References: 1. Kamath AS, Sarrazin MV, Vander Weg, MW, et al. Hospital Costs Associated with Smoking in Veteran’s Undergoing General Surgery. J AM Coll Surg. 2012; 214: 901-908. 2 American Cancer Society. Cancer Facts and Figures, 2015. 3 U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the U.S. Surgeon General, 2004. 4 Warner, DO, Sarr MG, Offord KP, et al. Anesthesiologists, general surgeons, and tobacco interventions in the perioperative period. Anesth Analg. 2004: 99(6): 1766-1773.
P16-B: Strategies to Retain Hard-to-Reach Participants in Community-Based Participatory Research
Sabrina Ford, Cristian Meghea, Karen Patricia Williams
Michigan State University, East Lansing, MI, USA
Abstract: Background/Purpose: Diverse racial and ethnic populations must be included in research studies in order to address health disparities. Retaining hard-to-reach populations including poor, underserved, and racial/ethnic groups in longitudinal studies can be quite difficult. Using innovative retention strategies that address culture and community are imperative.1 The objective of this report is to identify and describe strategies for successful retention rates among a unique groups of hard to reach racial/ethnic participants.2 Methods: We analyzed follow-up rates between two different experimental cohorts utilizing the Kin KeeperSM Cancer Prevention Intervention model. The aim of Study A examined the capability of the Kin KeeperSM education curriculum to increase health literacy in breast and cervical cancer. The aim of Study B was to measure changes in breast and cervical cancer screening after receiving the Kin KeeperSM education. Participants in both studies included Black, Latina, and Arab women between the ages of 21-75 from the Detroit Metropolitan area. Retention rates were analyzed and compared over 12 months for both cohorts. Results: We found strong retention rates for both cohorts with each having a unique set of cultural differences. The overall follow up rate was 82% for Study A and 88% for Study B. However, Black women had higher retention rates in Study A whereas Arab women had higher rates in Study B. Discussion: We found that each study had its own cultural, community, and geopolitical challenges that required adjustments and adaption of retention strategies. Despite these challenges, we were able to maintain consistent participation for each study. We attribute high retention rates to trusted cultural connections and the flexibility to modify retention strategies without compromising the research design. Relation to Theme: This abstract describes retention strategies for an ethnically diverse, underserved populaton of Black, Latina, and Arab women enrolled in a breast and cervical cancer education program. Learning Objectives: Learning Objectives: The participant will be able to identify at least three strategies to retain study participants in community-based participatory research. 1. Specific to race/ethnicity. 2. Cultural and community challenges. 3. Change in community stakeholders References: 1. Kwiatkowski K, Coe K, Bailar JC, Swanson GM (2013) Inclusion of minorities and women in cancer clinical trials, a decade later: Have we improved? Cancer, 119:2956-2963. 2. Carroll, JK, Yancy, AK, Spring, B, Figueroa-Moseley, C, Mohr, DC, Mustian, KM, et al. (2011) What are successful strategies for underserved populations? Examining physical activity intervention in primary care and community settings. Trans Behav Med, 1:234-251. 3. Sheppard, VB, Mays, D, LaVeist, T, Tercyak, KP. (2013) Medical Mistrust and self-efficacy influence black women’s level of engagement in BRCA1/2 genetic counseling and testing. J Natl Med Assoc, 105:17-22.
P18-B: Rare but Serious: Identification & Referral of Low-Income Women at High Risk for Hereditary Breast Cancer – A Tale of Two Studies
Rena Pasick1, Galen Joseph1, Susan Stewart2, Robin Lee, Celia Kaplan
1University of Calfornia San Francisco, San Francisco, CA, USA, 2University of Calfornia at Davis, Davis, CA, USA
Abstract: Background: Hereditary breast and ovarian cancer is rare but serious. However, genetic counseling and testing have mainly been utilized by educated, affluent white women. Strategies are needed to effectively identify low income women at risk and to connect them with genetic counseling. Methods: We conducted two studies with different approaches. This report compares the lessons learned from an efficient sustainable public health intervention to a culturally tailored woman to woman approach for African American women. Study 1 was a National Cancer Institute-funded randomized delayed control study (2007-12) to assess family history among callers to California’s statewide toll-free phone service where low-income women obtain referrals to free breast and cervical screening. Callers with a family history appropriate for genetic counseling (GC) were randomized to immediate invitation to make a GC appointment or were sent a brochure asking them to call for an appointment. Study 2, (Susan G. Komen for the Cure, 2010-15) was a feasibility study to ascertain if a train the trainer strategy where Health Ministry Leaders conducted “Family History” church-based workshops could effectively identify high-risk women and refer them to counseling and testing? Results: The intervention in Study 1 was efficient at identifying and referring low-income women to GC. Women in the intervention group were more likely than controls to receive counseling during the intervention period (38.6% vs. 4.5%, p=0.0001). The faith-based intervention met numerous challenges in development and implementation. Still, 21 church-based events were conducted generating 419 completed family history screeners; 81 (19%) were eligible for GC, and 45 (55%) contacted a genetic counselor. Discussion: Low-income women at risk for HBOC can be identified outside of medical settings and referred to GC. Trust and the ability to communicate complex information in clear simple terms were critical in both cases, as was the availability of free GC. Relation to Theme: This presentation aligns perfectly with conference themes by comparing two intervention studies, both designed to address disparities in access to genetic risk services by low-income ethnically diverse populations. Benefits and challenges in different strategies to identify high-risk women are compared. Implications for best practices will be discussed. Learning Objectives: The participants will learn how to overcome barriers to trust in the identification of high-risk women and their referral to genetic counseling. The participants will understand that creative and tailored strategies are needed so that low-income women have the same opportunity to avoid hereditary breast cancer as those more affluent. Participants will consider the pros and cons of efficiency versus highly personalized, culturally tailored approaches. References: 1. Awareness and Preferences Regarding BRCA1/2 Genetic Counseling and Testing Among Latinas and Non-Latina White Women at Increased Risk for Hereditary Breast and Ovarian Cancer. Journal of Genetic Counseling, 20(6), 625-638 2. Armstrong K, Micco E, Carney A, Stopfer J, Putt M. Racial differences in the use of BRCA1/2 testing among women with a family history of breast or ovarian cancer. JAMA. 2005;293(14):1729-36. 3. Halbert, Chanita Hughes, et al. “Recruiting African American women to participate in hereditary breast cancer research.” Journal
P20-B: The role of incarceration and reentry on colorectal cancer screening amongst formerly incarcerated African American and Latino men in New York City
Cristina Villagra, Suky Martinez, Anibal Cortes, Vir Patel, Lina Jandorf
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Abstract: Background/Purpose: Like incarceration, colorectal cancer (CRC) mortality rates in New York City (NYC) currently show significant racial disparities. To compound the problem, individuals recently released from prison return disproportionately to a few minority neighborhoods that are among the same communities with the lowest rates of CRC screening. However, little is known about how incarceration and reentry may exacerbate the potentially acute need for CRC screening amongst them. We hypothesized that CRC screening behaviors among this population would be affected by a multitude of factors including cancer screening knowledge, masculinity, medical mistrust, and discrimination. Methods: A total of 28 individual interviews were conducted (21 with recently released men and 6 with their case managers at reentry service sites in NYC from May to October 2013 The interviews were designed to examine how the experience of incarceration and reintegration relates to CRC screening attitudes and practices, their knowledge and attitudes towards preventive services, and frequency of CRC screening among the participants. The participants were eligible for the study if 1) former incarcerated males; 2) self-identified as black or Latino; 3) were 50 years of age or older; 4) released from prison or jail within the last six months; and 5) were English or Spanish speaking. Results: Of the 21 clients, 16 had completed a screening colonoscopy. Most of the participants, 76%, had a history of multiple incarcerations. We found several themes and perceptions regarding barriers in completing a CRC screening. Among the non-completers, medical mistrust, navigating healthcare system, invasiveness of the procedure, lack of knowledge regarding CRC, nutrition, education level and fears of demasculinization were some of themes related to barriers. Discussion: Counseling practices and educational interventions which include health messaging may reduce medical mistrust and improve CRC knowledge. This may increase screening colonoscopy utilization among formerly incarcerated males. Relation to Theme: The abstract relates to the aims of the conference as it describes research conducted to better understand barriers and facilitators to colorectal cancer screening among formerly incarcerated males in New York City. The knowledge gathered in this study will help us develop a future appropriate educational intervention. Learning Objectives: The participant shall be able to: 1. Identify key beliefs that exist about screening colonoscopy among formerly incarcerated minority males. 2. Identify the role of barriers and facilitators among formerly incarcerated males to completing a colonoscopy to screen for colorectal cancer. References: 1. Ahalt C, Binswanger IA, Steinman M, Tulsky J, Williams BA. Confined to ignorance: The absence of prisoner information from nationally representative health data sets. J Gen Intern Med. 2012;27(2):160-166. doi: 10.1007/s11606-011-1858-7 [doi]. 3. Morenoff JD, Harding DJ. Incarceration, prisoner reentry, and communities. Annu Rev Sociol. 2014;40:411-429. doi: 10.1146/annurev-soc-071811-145511 [doi]. 4. Maschi T, Morrisey MB, Leigey M. The case for human agency, well-being, and community reintegration for people aging in prison: A statewide case analysis. J Correct Health Care. 2013;19(3):194-210. doi: 10.1177/1078345813486445 [doi].
P22-B: Parent Perspectives of HPV Vaccination in Western New York State
Martin Mahoney1, Frances G Saad-Harfouche1, Christy Widman2, Annamaria Masucci1, Deborah Erwin1
1Roswell Park Cancer Institute, Buffalo, NY, USA, 2Roswell Park Cancer Institute, Hamburg, NY,USA
Abstract: Background: Vaccines are available for the prevention of multiple types of human papillomavirus (HPV) with the potential to prevent clinical outcomes ranging from genital warts to abnormal pap smears to anogenital precancers/cancers. Although routinely recommended for adolescents, uptake of vaccine remains suboptimal and considerably below the Healthy People 2020 objective of 80%. Our objective was to understand perceptions, as well as potential barriers and opportunities to enhance HPV vaccination uptake among parents. Methods: This project used a self-administered survey administered to parents (n=54) in Western New York state. Surveys were distributed to persons who attended HPV vaccine education sessions (n=3) offered through school PTO groups and a workplace parent networking group. Results: Participants were primarily non-Hispanic whites (87%) and female (83%); nearly one-half the sample (48%) was age 31-40. The majority of respondents didn’t cite a regular source of internet-based HPV vaccine information. Influences for getting HPV vaccine for their children included child’s age, likelihood of sexual activity, recommendation from their doctor and guidelines from professional societies. Most felt a need for increased promotional messaging on HPV vaccine with content focusing on cancer prevention. Close to one half of parents felt HPV vaccine should be mandated as a requirement for school. Discussion: This data will be important to identify perceptions, as well as myths and knowledge deficits which can be addressed in the design of future educational programs targeting parents of adolescents as a strategy to increases rates of HPV vaccine. Relation to Theme: The data presented in this abstract relate directly to the theme pertaining to opportunities for cancer education delivered to diverse populations to reduce HPV related cancers. Learning Objectives: The participant shall be able to identify barriers and hindrance to HPV vaccine uptake from a parent’s perspective as well as possible solutions to impact vaccine rates. References: 1. Dunne, E. F., Markowitz, L. E., Saraiya, M., Stokley, S., Middleman, A., Unger, E. R., & Iskander, J. (2014). CDC Grand Rounds: reducing the burden of HPV-associated cancer and disease. MMWR Morb Mortal Wkly Rep,63(4), 69-72. 2. Rubin, R. (2015). Why the “No-Brainer” HPV Vaccine Is Being Ignored. JAMA,313(15), 1502-1504.
P24-B: Program Evaluation of a Culturally-Tailored CRC Education Program for Hispanics
Rebecca Palacios, Janet Sanchez, Mario Gutierrez Casale, Christina Vaquera, Mayra Rodriguez, Karoline Sondgeroth, Erin Beeman
New Mexico State University, Las Cruces, NM, USA
Abstract: Background/Purpose. Whereas Hispanics in the U.S. show favorable outcomes for colorectal cancer (CRC) when compared to all other racial ethnic groups, Hispanics residing along the U.S. Mexico Border exhibit disparities in both CRC incidence and mortality. Several risk factors may account for these late CRC stage diagnoses and mortality rates. For example, our own research found that across all ages, Hispanics in the border region had significantly lower levels of CRC knowledge and were less likely to engage in physician-patient CRC interactions than NHWs. Additionally, Hispanics aged 50+ exhibited lower CRC screening rates than NHWs. The Inflatable Colon CRC Educational tour was recently adapted to address Hispanics’ cultural barriers to CRC screening and prevention. The purpose of this study was to evaluate the effectiveness of the culturally adapted IC-CRC educational tour for Hispanics. Methods. We compared the Culturally Adapted IC-CRC Educational Tour to the older IC-CRC Educational Tour which simply consisted of a description of CRC and its different stages. We randomly assigned participant clusters to one of the two tours described above. Study participants included Hispanic adults, who had never been screened/diagnosed for CRC, were at least 50 years old, and lived in the border region (e.g., Dona Ana, NM and El Paso, TX counties). Outcome measures were assessed via self-report at posttest and at 2 and 4-month follow-ups. Participants received incentives for participating in the different assessment phases. Results/Findings. Group differences were identified for CRC screening and prevention . The mediating effects of cultural barriers, such as fatalism, fear, familism and machismo are also reported. Discussion. Culturally adapted educational programs benefit from addressing more than simple language barriers. It is important to address culturally-related beliefs acting as barriers to cancer screening and prevention. Relation to Theme: Culturally adapted educational programs designed to address cancer health disparities in Hispanic populations, an underserved population, are directly relevant to the conference theme focus on cancer education in diverse populations and disparities. Learning Objectives: 1. Participants shall be able to identify cultural barriers to cancer screening and prevention in Hispanics. 2. Participants shall be able to identify techniques used to adapt the IC-CRC tour for Hispanics. References: 1. Coronado, G. D., Farias, A., Thompson, B., Godina, R., & Oderkirk, W. (2006). Attitudes and beliefs about colorectal cancer among Mexican Americans in communities along the US-Mexico border. Ethn Dis, 16(2), 421-427. 2. Jandorf, (2010). Understanding the barriers and facilitators of colorectal cancer screening among low income immigrant Hispanics. Journal of immigrant and minority health, 12(4), 462.doi:10.1007/s10903-009-9274-3 3. Fernandez, (2008). Colorectal cancer screening among Latinos from US cities along the Texas–Mexico border. Cancer causes & control, 19(2), 195.doi:10.1007/s10552-007-9085-6
P26-B: What is culturally respectful online cancer education with and for Alaska Native people?
Melany Cueva1, Katie Cueva2
1Alaska Native Tribal Health Consortium, Anchorage, AK, USA, 2Institute of Social and Economic Research, University of Alaska, Anchorage, AK, USA
Abstract: Background: Alaska’s village-based healthcare providers – Community Health Aides and Practitioners (CHA/Ps) – requested cancer information for themselves and their communities. However, Alaska’s geographic and economic challenges limit the amount of in-person education available for CHA/Ps. In response, a research team at the Alaska Native Tribal Health Consortium received an award from the National Cancer Institute to create a culturally-respectful distance-delivered cancer education course for Alaska’s CHA/Ps. Methods: A multi-faceted approach has been undertaken to understand what culturally-relevant online cancer education might look and feel like. Ten health educators engaged in supporting Alaska Native community wellness participated in a two-hour focus group. Three existing cancer education online learning modules created with, and for, Alaska’s CHA/Ps, were completed between March 2013 and December 2014 by 178 predominantly female (78%), Alaska Native/American Indian (76%), CHA/Ps (94%) who offered feedback. A Key Stakeholder Survey (70 respondents) and 12 in-depth interviews were conducted with prompts on prior experiences with online learning, suggestions for the proposed culturally-responsive online cancer education course, current access to technology, comfort with technology, past and potential participation in cancer education courses, and demographic information. Another approach included a review of published peer-reviewed literature. Results: Emerging themes for culturally-respectful distance-education have included incorporating personal stories, pictures, local statistics, traditional values, and being respectful of individual learners. The focus group of healthcare educators shared that relationships, stories, laughter/humor, valuing the learners, and being attentive to emotions were culturally-respectful educational practices. The majority of online learners felt the existing modules were culturally respectful (92%), with write-in comments sharing themes that culturally respectful aspects included stories, pictures, relationships, and Alaska-specificity: “I really enjoyed the personal stories and aspect of other communities.” “Sometimes stories and relationships are more important than facts and data.” Discussion: This multi-faceted approach provides a foundation for online cancer education course development. Relation to Theme: This presentation will share our preliminary understandings of what culturally respectful online education with and for Alaska’s Community Health Aides/Practitioners that is grounded within Alaska Native cultural attributes looks and feels like to support meaningful cancer education. Learning Objectives: 1. Describe findings on what culturally-respectful distance education with, and for, Alaska Native people might look and feel like 2. List a variety of research methodologies used to begin understanding what is included in culturally-respectful online cancer education with, and for, Alaska Native people. References: 1. Wilson S. (2008). Research is ceremony: Indigenous research methods. Halifax: Fernwood Publishing. 2. Kovach M. (2010). Indigenous Methodologies: Characteristics, Conversations, and Contexts. Toronto: University of Toronto Press.
P28-B: Assessing and Addressing Barriers to Genomic Cancer Risk Assessment (GCRA) in Latin America through Innovative Pairing of Clinical Training and Genomic Tools
Jeffrey Weitzel1, Josef Herzog1, Cynthia Villareal-Garza2, Danielle Castillo1, Rosa Alvarez2, Sharon Sand1, Tanya Chavez1, Kathleen Blazer1
1City of Hope, Duarte, CA, USA, 2Instituto de Cancerologia – Tec Salud, San Pedro Garza Garcia, N.L., Mexico
Abstract: Background/Purpose: Access to genetic/genomic cancer risk assessment (GCRA) is standard of care in most developed countries, but is not available in most Latin American populations. A series of initiatives were employed to assess the landscape, develop and pilot a strategy for vertical integration of GCRA among underserved populations in Latin America. Methods: A roundtable forum with 16 Latin American physicians representing Mexico, Peru, Brazil, Colombia and Puerto Rico was conducted to assess the state of GCRA services and barriers to implementation in these countries. The roundtable was conducted in Spanish, moderated by bilingual cancer genetics clinicians, recorded, transcribed, translated and thematically analyzed. Of 35 Latin American clinicians who participated in City of Hope GCRA training, 16 (representing 6 sites in Mexico, Peru, Colombia and Puerto Rico) joined the Cancer Genetics Community Research Network (CCGCRN), wherein a common prospective registry protocol is deployed, and an economical BRCA screening tool (HISPANEL) was introduced to support GCRA services. Quality/content of GCRA process and sensitivity of the HISPANEL were assessed. Results/Findings: Roundtable findings pointed to the need for a multi-level approach that provides GCRA training and cost-effective genetic testing, and an evidence-based foundation for the development of policy, infrastructure and resources to implement and sustain GCRA services in Latin America. Initial site assessments demonstrate successful initiation of GCRA services and facilitate ongoing support to address barriers. To date >880 patients have been accrued to the CCGCRN registry at collaborating sites in Latin America. Preliminary evaluation of the HISPANEL genomic tool in Mexico suggests clinical sensitivity of 68-77%, at a cost of ~$20 per case (Villarreal-Garza, Alvarez-Gómez et al. Cancer 2014). Discussion: Innovative pairing of multi-modal GCRA training and Relation to Theme: This abstract describes how an innovative multi-level dissemination and implementation initiative is combining genetic/genomic cancer risk assessment (GCRA) education/training (see abstract #52), an affordable genomics test, and collaboration with an international cancer genomics research network, is identifying and addressing the need for GCRA services in Latin America. Learning Objectives: 1. Identify the need for and barriers to the integration of genomic technologies and services for genetic/genomic cancer risk assessment (GCRA) in Latin America 2. Explore how the vertical integration of multi-modal GCRA training with practice support, affordable genomic screening resources and participation in a collaborative cancer genomics research network offer an innovative approach to address disparities in access to GCRA for cancer prevention and control in Latin America. 3. Recognize how international research collaborations contribute to an ethnically/racially diverse evidence base to support the development of policy and infrastructure toward sustainable GCRA services in Latin America. References: 1. Lara-Medina, F., et al., Triple-negative breast cancer in Hispanic patients: high prevalence, poor prognosis, and association with menopausal status, body mass index, and parity. Cancer, 20 2. Curran, G.M., et al., Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care, 2012. 50(3): p. 217-26. 3. Wandersman, A., et al., Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation. Am J Commun Psychol, 2008. 41(3-4): p. 171-81.
P30-B: Leveraging the Resources of an Innovative Clinical Cancer Genetics Training Program to Address Disparities in Cancer Prevention and Control in Latin America
Kathleen Blazer, Bita Nehoray, Ilana, Solomon, Mariana Niell-Swiller, Christina Ryback, Gloria Nunez, Sharon Sand, Lily Van Tongeren, Jeffrey Weitzel
City of Hope, Duarte, CA, USA
Abstract: Background/Purpose Genetic/genomic cancer risk assessment (GCRA) identifies and prescribes personalized screening and prevention care for individuals and families with increased cancer risk, often prior to disease onset, when early detection or prevention strategies are most effective. GCRA is standard of care in most developed countries, but is not available in most of Latin America. Documented barriers include lack of affordable genomic tools, limited knowledge about GCRA among key stakeholders, and absence of clinicians trained for GCRA. City of Hope is leveraging the robust training resources of its Clinical Cancer Genetics Community of Practice (CCGCoP) to address the need for GCRA education and training in Latin America. Description The CCGCoP is a flexible, multi-modal program of distance didactics, face-to-face case-based workshops and continuing practice support. A program priority is training clinicians in underserved areas across the U.S. and internationally. Spanish-language workshops and materials and distance support tools have been incorporated to train Latin American MD and PhD clinicians developing GCRA programs in their countries. Evaluation Of 51 international participants to date, 35 are from Latin America, representing academic and clinical practices in Mexico, Brazil, Peru, Chile, Argentina, Colombia and Uruguay. Preliminary findings demonstrate significant increases in GCRA professional self efficacy and skills. Alumni feedback and ongoing assessments reflect the value and effectiveness of CCGCoP training and practice support, and documents the need for a completely Spanish-language version of the program. Usefulness CCGCoP alumni are currently providing GCRA services at approximately 22 sites in Latin America. CCGCoP training now serves as an essential component of an implementation and dissemination project that also includes affordable genomic testing, clinical site visits and a collaborative research network. Near-term goals include developing a full Spanish language curriculum and train-the-trainer program to support the ultimate goal of decreasing cancer related health disparities through sustainable GCRA services in Latin America. Relation to Theme: This abstract relates to each element of the theme for the 2015 AACE conference. The abstract describes how an innovative multi-modal training program to promote practitioner-level competence in genetic/genomic cancer risk assessment (GCRA) is expanding its outreach to address significant disparities in access to GCRA services in Latin America. Learning Objectives: 1. At the conclusion of this presentation, participants shall be able to: 2. Identify barriers to implementing genetic cancer risk assessment (GCRA) services in Latin America that can be addressed by educating and training medical professionals 3. Recognize how the CCGCoP, an innovative distance-mediated training model, is addressing the need for clinicians with GCRA training in Latin America 4. Discuss how the CCGCoP model can be enhanced to support sustainable GCRA training resources in Latin America 5. Explore how the benefits and limitations of this model can inform innovative approaches to cancer education and training in other underserved populations. References: 1. Lara-Medina F, Perez-Sanchez V, Saavedra-Perez D, et al. Triple-negative breast cancer in Hispanic patients: high prevalence, poor prognosis, and association with menopausal status, body mass index, and parity. Cancer 2011; 117: 3658-69. 2. Dia Mundial contra el cáncer (Datos Nacionales). http://www.inegi.org.mx/inegi/contenidos/espanol/prensa/aPropositom.asp?s=inegi&c=2825&ep=82 (accessed Jul 9 2011). 3. Greenup R, Buchanan A, Lorizio W, et al. Prevalence of BRCA mutations among women with triple-negative breast cancer (TNBC) in a genetic counseling cohort. Ann Surg Oncol 2013; 20: 3254-8. 4. Ray, M.L., et al., Using a training-of-trainers approach and proactive technical assistance to bring evidence based programs to scale: an operationalization of the interactive systems framework’s support system.
P34-B: The use of teach back in an outpatient clinical setting
Ann Breen, Patricia Estrada, Zara Asch
Seattle Cancer Care Alliance, Seattle, WA, USA
Abstract: The Institute of Medicine encourages healthcare organizations to utilize literacy strategies, including patient feedback, to ensure that communications are accurately understood (Brach, C. 2012). A challenge in cancer education is assessing patients’ understanding of the information presented to them. It is imperative that patients understand instructions because care is inexorably shifting away from institutions towards the home. Patients have an increased responsibility for managing their medications and monitoring side effects. In a quality improvement effort at a National Comprehensive Cancer Network (NCCN) center the Patient Education Department created an anonymous survey to assess to what degree staff knew about and implemented Patient Education standards, to identify whether there was adequate institutional support for educational intervention, and to engage staff. The project’s long-term goal is to mobilize staff to adopt best practices such as the teach back technique. The anonymous survey queried staff knowledge regarding basic education and literacy principles such as teach back and utilization of appropriate grade level for written materials. Data gathered from 80 participants demonstrated that only 30% of respondents reported implementation of the teach back technique. The teach back technique was not consistently used, only 21% use it 75-100% of the time. The majority of survey respondents (62%) recognized literacy problems and understood that written materials should be at a 5th-8th grade reading level. The Patient Education Department presented survey results to staff in order to increase teach back utilization. This feedback initiated a conversation about the use of teach back during high risk education sessions. The conversation will continue as more data is collected through chart audits and presentations to clinicians. This initial survey can serve as a template and be used to begin a similar process at other institutions. The findings can act as a tool of change for improved teaching. Relation to Theme: Clinicians need tools to confirm that patients understand what they have been told because the risk for misunderstanding increases when diverse populations are served. Teach back provides corrective feedback so that clinicians know that patients understand what has been taught in order to improve home safety and adherence. Learning Objectives: 1. The participant shall be able to understand the importance of developing a health literate organization. 2. The participant shall be able to develop a survey to assess the clinicians use of teach back to establish a baseline. References: 1. Brach, C., et al. 2012. Ten attributes of a health literate health care organization. National Institute of Medicine. 2. Coleman, C. 2011. Teaching health care professionals about health literacy: A review of the literature. Nursing Outlook 59(2):70-78.
P36-B: Barriers to Completing Delayed Breast Reconstruction following Mastectomy
Aleksandra Ogrodnik1, Ted James2
1Danbury Hospital, Danbury, CT, USA; 2Fletcher Allen Health Center, Burlinton, VT, USA
Abstract: Background- Rates of breast reconstruction following mastectomy vary widely, and little is known about why women who originally express an interest in breast reconstruction do not receive it. Improved documentation of clinical decision making is one of the potential benefits of the electronic health record, and may serve as a tool to enhance patient-centered, clinical outcomes research. The goals of this study were to explore patterns in delayed reconstruction (DR), identify possible barriers to follow-through and to determine the adequacy of electronic health record documentation to provide information pertaining to decision-making for breast reconstruction. Methods- A retrospective electronic medical record review of women undergoing mastectomy from 2008 to 2012 in a single academic medical center in rural New England. Data included patient demographics, cancer stage, co-morbidity index, post-mastectomy reconstruction status, as well as documented decision-making regarding reconstruction. Results: Of 367 women who had undergone a total mastectomy, 219 women were identified who did not receive immediate reconstruction. Of these women, 24.6% expressed no interest in DR, 21.9% expressed interest in DR but were still pending the procedure, and 5.9% had completed DR. 47.5% lacked any documentation of decision-making regarding breast reconstruction. Median follow-up was 34 months. Reasons for not following through with DR included poor-timing (25%), indecision (17%), desired method of reconstruction not available at treating facility (10%), persistent obesity (8.3%), continued smoking (4%), and reason not specified (35%). Discussion: Many women do not receive breast reconstruction despite expressing an interest in the procedure. Reasons were multi-factorial and consisted of both patient- and provider-related factors. Documentation regarding decision-making for breast reconstruction was inconsistent. Further exploration of potential barriers to breast reconstruction and opportunities to enhance clinical decision-making may serve to improve patient experience and satisfaction following mastectomy. Relation to Theme: We aimed to explore potential barriers to post mastectomy breast reconstruction in a rural population, and to find opportunities to enhance patient-physician clinical decision-making. With that knowledge, we may improve education of patients regarding reconstruction options as well as their experience and satisfaction following mastectomy. Learning Objectives: The participant shall be able to: 1. Identify at least three barriers to follow-through with post-mastectomy breast reconstruction in women who expressed interest in the procedure. 2. Describe strategies to improve the adequacy of electronic health record documentation to provide information pertaining to the decision-making process for breast reconstruction. 3. Identify opportunities to enhance clinical decision-making regarding post-mastectomy breast reconstruction, which may serve to improve patient experience and satisfaction following mastectomy References: 1. Christante D, Pommier SJ, Diggs BS, et al. Using complications associated with postmastectomy radiation and immediate breast reconstruction to improve surgical decision making. Arch Surg 2010;145:873-878 2. Henry M, Baas C, Mathelin C. Why do women refuse reconstructive breast surgery after mastectomy? Gynecol Ostet Fertil 2010;38:217-223 3. Alderman AK, Hawley ST, Morrow M, et al. Receipt of delayed breast reconstruction after mastectomy: do women revisit the decision? Ann Surg Oncol 2011; 18:1748-1756 4. Brennan ME, Spillane AJ. Uptake and predictors of post-mastectomy reconstruction in women with breast malignancy –systematic review. Eur J Surg Oncol 2013;39:527-541
P38-B: Using Unobtrusive Measures When Data Collection Options Are Limited
John Tat1, Jonjei Ku2, Jihye (Erica) Kim2, Jessica Phan2, Seung Dae Park2, Georgia Robins Sadler2
1The Scripps Research Institute, La Jolla, CA, USA, 2University of California San Diego Moores Cancer Center, La Jolla, CA, USA
Abstract: Background/Purpose: Resources to support cancer control efforts are exceedingly limited, making it essential that deployed programs are evidence-based and optimally effective. However, there are situations when robust program evaluation is either non-viable, non-affordable, or not warranted. Unobtrusive measures, first described by Eugene Webb, et al., can sometime offer researchers an inexpensive way to evaluate cancer control interventions. This presentation will provide an overview of the types of unobtrusive measures evaluators can consider and a review of the unobtrusive measures used in scientific evaluations. Methods: This educational presentation will discuss how unobtrusive measures can be used as a proxy for assessing related behaviors. This charactistic makes them relatively inexpensive and easy-to-use since they can usually be made without the consent of those being observed or are the consequences of people’s actions. This presentation will show how to select and collect unobtrusive data for program development, monitoring, and evaluation. Examples demonstrating the use of unobtrusive measures will be drawn from the scientific literature. Results/Findings: Learners will discover that unobtrusive measures can be used by themselves, as well as in combination with qualitative and/or quantitative measures. They can contribute critical insights during all phases of program development and evaluation. Identifying examples of unobtrusive measures used in for-profit and non-profit marketing strategies can help health educators identify innovative measures for social marketing purposes. Usefulness: Researchers concerned with piloting new programs or replicating evidence-based cancer control programs must remain vigilant in their assessment of their programs’ effectiveness. The use of unobtrusive measures can help accomplish the goals of ongoing program evaluation and enhancement. The number and variety of changes that can be unobtrusively monitored are considerable. Besides providing early warning signs of a program’s diminishing effectiveness, unobtrusive measures can also be valuable guides in helping cancer control educators to identify ways to enhance programs. Relation to Theme: Unobtrusive measures provide innovative and inexpensive tools to evaluate whether evidence-based cancer education programs are still effective at closing at health information disparity gaps, especially in niche communities, once they have been adopted for long-term community use. Learning Objectives: 1. The participant shall be able to describe unobtrusive measures and identify how those measures could be used in the creation and evaluation of cancer education programs. 2. The participant shall be able to interpret the data gathered from the unobtrusive measures and use them to guide the creation, evaluation, and improvement of cancer education programs. References: 1, Webb, E. J., Campbell, D. T., Schwartz R. D., & Sechrest L. Unobtrusive Measures: Nonreactive Research in the Social Sciences. 1966, Chicago, IL: Rand McNally. 2. Yin R. K. Qualatative Research from Start to Finish. 2011, New York City, NY: The Guilford Press. 3. Rubin, A. & Babbie, E. R. Research Methods for Social Work. 2014. Belmont, CA: Brooks/Cole, Cengage Learning.
P40-B: Development of Patient Navigation Competencies and a Free Evidence-Based Online Training
Anne Willis, Mandi Pratt-Chapman, Shaira Morales, Monique House
George Washington University Cancer Institute, Washington, DC, United States
Abstract: Background/Purpose: The goal of the program is to create standardization across the profession of patient navigator by establishing consensus-based competencies and implementing a free competency-based online training. Patient navigation has grown quickly and lacks clear professional standards and role delineation. Patient navigator activities vary significantly across sites, leading to the underuse of these professionals and patient navigators operating out of scope of practice. A 2013 survey found that 45% of respondents identified role clarity as a major challenge for navigators. Although competencies exist or are being developed for nurse and social work navigators, a gap exists for non-clinically licensed patient navigators. Description: We used a mixed-methods approach for this project that includes: development of a framework of functional domains, focus groups with navigators (n=21), 4), development of competencies, review of competencies by 22 national experts, a survey of health care professionals involved in patient navigation (n=525) to validate the competencies and development of a free, interactive evidence-based online training for Oncology Patient Navigators launched in May 2015. Evaluation: Evaluation results will be presented related to: knowledge change from pre- and post-assessments; assessments of whether new skills were learned, whether knowledge base was enhanced, whether content is useful and relevant to professional development and whether new strategies/skills/information will be applied; and knowledge quizzes to assess competency. Usefulness: This project will help create standardization for the field of patient navigation during a time where the profession is rapidly growing. This multi-stage process for developing evidence-based training for health care professionals can be implemented across professions or institutions, especially for health care professionals for which no standard scope of practice exists. The program focuses specifically on Oncology Patient Navigators and may be relevant to patient navigators working in other disease areas. Relation to Theme: Patient navigation is an evidence-based intervention developed for addressing cancer health disparities. Patient navigators remove barriers to access care, which disproportionally affect the medically underserved. Learning Objectives: The participant shall be able to: 1. Explain the need for standardization for patient navigators 2. Describe methods for developing the Core Competencies for Oncology Patient Navigators 3. Discuss the development of a free online training for Oncology Patient Navigators 4. Describe outcomes from the Oncology Patient Navigator: The Fundamentals training References: 1. Mead CD, Wells KJ, Arevalo M et al. Lay Navigator Model for Impacting Cancer Health Disparities. Journal of Cancer Education. 2014;29(3):449-457. 2. Wells KJ, Battaglia TA, Dudley DJ, et al. Patient navigation: State of the art or is it science? Cancer. 2008;113(8):1999-2010. doi:10.1002/cncr.23815.
P42-B: Competencies for research training in cancer prevention: Making it happen
Carrie Cameron1, Jessica Faupel-Badger2, Melinda Yates1, Shine Chang1
1University of Texas MD Anderson Cancer Center, Houston, TX, USA, 2National Institute of General Medical Sciences, Bethesda, MD, USA
Abstract: Background/Purpose: In 2013, to address the question, “Why aren’t we further along in preventing cancer?”1 we proposed introducing a competency-based curriculum in cancer prevention research training that fosters skills needed for success in team science.2 Several unique characteristics were cited, including the broad diversity of the disciplines contributing to cancer prevention research, the challenges of developing specialized scientific expertise while also maintaining an interdisciplinary perspective, and the need to communicate meaningfully to advocate with scientists in other disciplines as well as the public to achieve public health impact.3,4 We now focus on creating and testing educational experiences designed to develop these competencies in three specific categories: increasing awareness and knowledge of the breadth of the field of cancer prevention, leadership, and interdisciplinary communication (IDC). Description: Using active, team-based strategies5,6, we devised a semester-long team-based activity for students in the survey course “Topics in Cancer Prevention.” This activity placed students of diverse scientific backgrounds into teams, charging them with developing a mock cancer prevention grant proposal incorporating different disciplines. The culmination of the project was a live mock study section in which teams presented their proposals orally to a panel of faculty judges. Throughout the semester, sub-activities designed to increase the competencies of leadership, disciplinary learning, and IDC were included. Evaluation: Undergraduate, graduate, and postdoctoral students from two iterations of the course provided qualitative feedback in several assessments of the perceived overall pedagogical value of the project as well as of the particular learning activities in increasing these competencies. Usefulness: Updated, relevant teaching strategies are needed in graduate research education. Team-based learning strategies applied to real-life challenges facing trainees can accelerate their career growth as productive cancer prevention researchers. Relation to Theme: This works centers on developing an innovative competency-based curriculum for the cancer prevention research workforce. The competencies address the skills necessary for productive multidisciplinary collaborations and for moving research forward at all stages of the translational research continnuum. Learning Objectives: 1. Participants will be able to identify barriers to competency development in research education. 2. Participants will be able to give examples of active learning strategies that help stimulate competency development. References: 1. Fineberg HV. JAMA. 2013;310:85-90. 2. Faupel-Badger J, Cameron C, Chang S. J Cancer Education. 2013. 3. Colditz GA, Wolin KY, Gehlert S. Science Translational Med. 2012;4(127):127rv124. 4. James AS, et al. J Cancer Education. 2014. 5. Chickering AW, Gamson ZF. New Directions for Teaching and Learning. 1991;47:63-69. 6. Sibley J, Parmelee DX. New Directions for Teaching and Learning. 2008;116:41-53.
P46-B: Motivating Cancer Education Program Participants Towards Careers in Cancer Research, Prevention and Treatment
David Hein, La Creis Kidd
University of Louisville, Louisville, KY, USA
Abstract: Background: The University of Louisville Cancer Education Program is designed to recruit, educate and motivate outstanding undergraduate and health professional students to pursue further training and careers in cancer research, prevention, and treatment. Our minority student recruitment goals were set to exceed the published percentages at the University of Louisville. During the first four years we have recruited 2 Hispanic, 21 Asian/Pacific Islander and 21 African American students which already exceeds our five year goal for minority student recruitment. For all students, we evaluated student perspective on their level of interest in cancer research and training before and after completing the program; quality of mentoring received from their faculty and lab mentors; quality of the program curriculum; and the overall program experience. Methods: A blinded and electronic survey of the students was performed to assess experiences. The evaluation likert scale consisted of scores of 1-5, which corresponded to qualitative values of poor to excellent. The students also offered written responses to survey questions. Results: In the 2014 student cohort (n = 36), interest level in cancer research increased significantly (p = 0.0138; two-tailed Wilcoxon signed rank test) after completion of the NCI cancer education program (4.39±0.69) compared to scores from the same students at baseline (3.94±1.04). A majority of the students perceived the quality of the faculty mentor (91.4%), lab mentor (85.7%), program curriculum (80.0%), and overall program (88.5%) experience as good to excellent. Each student presented their research at local/national meetings and many submitted and/or published their work in peer-reviewed journals. Many have applied to health professional or graduate schools to pursue further cancer research and training. Discussion: The University of Louisville Cancer Education Program motivates both students and their faculty mentors to engage in cancer research and enhances student opportunities for further cancer-related training in health professional and graduate programs. Relation to Theme: We will describe the educational and research methods currently utilized in the Cancer Education Program at the University of Louisville. We will report on the ethnic diversity of our participants and how our program has performed versus explicit goals. We expect this information will be useful to other cancer education programs. Learning Objectives: The participant shall be able to appreciate the usefulness of faculty/participant engaged research projects in motivating health professional and undergraduate students to pursue further training or careers in cancer research, prevention, or treatment. References: 1. Egger ME, et al: Adenovirus-mediated FKHRL1/TM sensitizes melanoma cells to apoptosis induced by temozolomide. Hum Gene Ther Clin Dev. 2014, 25(3):186-95.2. Shah PP, et al: Ubiquilin1 represses migration and epithelial-to-mesenchymal transition of human non-small cell lung cancer cells. Oncogene. 2014 Apr 21. [Epub ahead of print] 3. Saurabh K, et al: Dissecting the In Vivo Leukemogenic Potency of Bclxl. Journal of Leukemia. 2014, 2(5):1-6. 4. Zeiderman MR, et al: Targeting of BRAF resistant melanoma via extracellular matrix metalloproteinase inducer receptor. J Surg Res. 2014 Jul;190(1):111-8.
P50-B: A Cost Effective Approach: Using Social Media to Promote a Cancer Prevention Video
Donna Branson, Jeff Yancey, Garrett Harding, Lisa Anderson
Huntsman Cancer Institute, Salt Lake City, UT, USA
Abstract: Background/Purpose: The purpose of this presentation is to share results of a Facebook advertising campaign in the promotion of a cancer prevention video. The effectiveness of Facebook in generating views of the video will be compared to other media platforms including radio advertising and website banner advertising. Description: In January 2015, the Patient and Public Education Department at Huntsman Cancer Institute used Facebook to promote a cancer prevention video focused on increasing radon awareness. Three primary media platforms were used to promote the video including: radio ads, website banner ads, and Facebook. Evaluation: Data from the media campaign will be shared with the audience and will include a comparison of the cost of each media platform and its effectiveness in getting people to watch the video. The cost for the radio ads and website banner ads totaled $25,000 while the costs for the Facebook campaign totaled $400. The data shows that the Facebook advertising generated 8 times as many views as the web banner and radio ads at a significantly lower cost. Usefulness: This presentation will be useful for health professionals interested in using social media for cancer prevention education. The cost of Facebook advertising was considerably less than radio and website banner advertising and produced a greater number of views. Relation to Theme: Theme: This abstract relates to the conference theme by showing how social media can be used cost effectively to target populations with cancer prevention education. Learning Objectives: Objectives: 1. The participant shall be able to list three elements of a successful social media campaign. 2. The participant shall be able to compare the costs of traditional advertising and boosting through social media. References: 1. PEW Research Center (2014). Pew Research Center’s Internet Project Omnibus Survey, January 23-26, 2014. Retrieved from http://www.pewinternet.org/fact-sheets/social-networking-fact-sheet/ 2. Tuong, W., Larsen, E. R. & Armstrong, A.W. (2014). Videos to influence: a systematic review of effectiveness of video-based education in modifying health behaviors. Journal of Behavioral Medicine, 37(2), 218-33. doi: 10.1007/s10865-012-9480-7.
P52-B: Development of an Education Resource for Post-Prostatectomy Prostate Cancer Patients who Require Radiotherapy
Ewa Szumacher1, Merrylee McGuffin1, Aaron Cumal1, Eirena Calabrese2, Deb Feldman-Stewart3, Julie Burnett2, Janet Ellis1, Eli Lechtman4, Lisa Di Prospero1, Christopher Townsend1, Tamara Harth1
1Sunnybrook Health Sciences Centre, Toronto, Canada, 2Sunnybrook Odette Cancer Centre, Toronto, Canada, 3Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, Canada, 4University of Toronto, Toronto, Canada
Abstract: Background: Radiotherapy (RT) after radical prostatectomy is indicated to prevent local recurrence, improve biochemical control and disease-free survival. Most prostate cancer patients do not receive adequate information about post-prostatectomy radiotherapy. Providing needed information would improve patient care options. Method: One-on-one interviews with patients and health-care providers produced a list of potentially important questions. The importance of addressing each of the questions was then assessed in a survey of recently treated patients (response options: essential/important/not important/avoid). The survey also asked how the answer to each essential/important question would be used (its purpose: to help understand, decide, plan, other). The resource was developed in collaboration with mdBriefCase and will be hosted onMEDSchoolForYou.ca. The project was supported by the Sunnybrook peer reviewed GU Trust Fund. Results: Forty genitourinary radiotherapy healthcare experts across Canada (urologists, radiation oncologists, radiation therapists, and nurses) and ten prostate cancer patients were interviewed. Seventy-three essential questions were identified covering the emergent themes, such as diagnosis and staging, treatment options, potential benefits and risks, side effects, psychological issues, health promotion, and sexual health. Thirty-one patients then completed the survey. All questions were deemed essential/important to at least some patients. Thus, answers were generated for all questions. The content (answers) was evaluated by seven patients and ten healthcare providers using the Purpose-based Information Assessment (PIA).Most (6/7) patients would recommend this material (4/7) and believe this material should be available before seeing their doctor. ‘Helping understand prostate cancer and its treatment’ was the most frequently identified purpose for information, followed by “helping to make a decision’, and ‘Helping patients discuss their situation with others’ was important least frequently. Most patients liked the graphics and design. All pts agreed that ‘the material used common, everyday language” and (6/7) agreed that the material was appropriate length Relation to Theme: This reaserch project is investigating a developemnet of new online education tool that ,we hope ,would help patients and their caregivers in decison-making proces for radiation treatment for prostate cancer. Learning Objectives: 1.Development and presentation of an online education resource about post-prostatectomy radiotherapy for patients and healthcare providers. 2. To evaluate the content and the format of the resource based on patients feedback References: 1. Lin GA, Aaronson DS, Knight SJ, Carroll PR, Dudley RA. Patient Decision Aids for Prostate Cancer Treatment: A Systematic Review of the Literature. CA: A Cancer Journal for Clinicians. 2009 Nov 6;59(6):379–90. 2. Thompson IM, Valicenti RK, Albertsen P, Davis BJ, Goldenberg SL, Hahn C, et al. Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO Guideline. J Urol. 2013 Aug 1;190(2):441–9. 3. Odette Cancer Centre – Centres of Excellence – Sunnybrook International [Internet]. sunnybrook.ca. [cited 2014 Nov 15]. Available from: http://sunnybrook.ca/international/content/?page=int-centre-occ
P54-B: International Patient Orientation Video Series
Lorene Payne, David Diep, Cesar, Palacio, Martha Coleman
MD Anderson Cancer Center, Houston, TX, USA
Abstract: Background/Purpose: Patients traveling from foreign countries encounter special challenges in seeking cancer care: preparation, expectations, records, and travel logistics are only the start. Compounding those hurdles are language and culture. In 2014 over 30,000 hours of interpretation was provided to our patients. The top three languages were Arabic, Spanish and Russian. In 2014 about 2000 (5%), of new patients to our institution were international. The top five countries were: #1 Saudi Arabia, #2 United Arab Emirates, #3 China, #4 Qatar and #5 Mexico. The purpose of an international orientation program was to prepare that patient population to receive care in this country. Description: Videos were created detailing preparations for receiving medical care in a foreign country. Institutional departments collaborating in the project included Language Assistance, International Center and Patient Education. Topics included the practical: travel arrangements, obtaining and sharing pathology samples and reports, airport and hotel accommodations, etc. Also covered were institutional expectations: consents, clinical team members, wait times, etc. These common concerns were presented in a 7 minute general video. Additionally, there are cultural aspects: eye contact, direct patient communication including diagnosis and prognosis, and equality in treatment, among others. To present these cultural aspects, three video addendums were recorded in Arabic, Spanish and Chinese. The general video was re-recorded in each of the three languages, including the cultural component. The final results are one English version of the general video for all international patients, and three translated versions with their cultural addendums in the native language. The videos are available on our institution’s web pages. Evaluation: The goals of this project are to improve patient satisfaction of the international patient experience and to decrease the staff time needed for orientating these patients on arrival. Usefulness: Any institution with an international population can benefit from creating preparatory videos specific to their institution. Relation to Theme: International patients comprise a special population in that they have unique needs and concerns which can be ameliorated through education. Learning Objectives: The participant shall be able to identify special needs of the international patient and understand how orientation videos, in their native languages, can be used as a tool to meet those needs. References: Literature review results in no scholarly articles specific to international patient orientation. 1. Cunningham, B., et. al. (2014) Perceptions of Health System Orientation: Quality, Patient Centerdness, and Cultural Competency. Medical Care Research and Review, 71(6) 559-579. DOI: 10.1177/107755814557891. 2. Kosunen, Elise. (2013). 18th Nordic Congress of General Practice 2013 – Focus on Patient Orientation. Scandanavian Journal of Primary Healthcare 31:6. DOI: 10.3109/02813432.2013.762173 3. Thompson, Stephen J. (2013) The overseas patient trap: Systems face language, cultural differences tending to health tourists’ needs. Modern Healthcare online, February 2, 2013. retrieved April 29, 2015 from http://www.modernhealthcare.com/article/20130202/MAGAZINE/302029993.
P56-B: Formalized Oncology Patient Education in an Academic Medical Center: A Shared Governance Model of Multidisciplinary Care Through Connection, Cultivation, and Collaboration
Tabatha Callander Ferrell1, Melissa Otoya2, Suzanne Doyle1, Cindy Westley3, Donna Lash1
1Emily Couric Clinical Cancer Center at the University of Virginia, Charlottesville, VA, USA, 2University of Virginia Cancer Center, Charlottesville, VA, USA, 3University of Virginia Health System, Charlottesville, VA, USA
Abstract: Background/Purpose: Cancer patients use many resources: surgery, medical & radiation oncology, nursing, pharmacy, counseling, nutrition, etc. Barriers exist in an academic medical center and can result in teams working within silos-unaware of materials provided by other areas. Our objective was to conduct a massive inventory of materials provided by our care teams inclusive of all modalities. We requested materials from orientation through survivorship & end-of-life. The goals were: to collect materials in use; ensure they are current and appropriate; identify gaps; develop processes to assess, create, and maintain materials; and determine best-practice for standardization. Description: Phase I –Collect materials from care teams regardless of format, legibility, source. Process was not punitive. Phase II – Organize data in comprehensive database. Phase III – Analyze patient & staff feedback, and database to identify areas where we were meeting the needs of our patients and determine gaps. Phase IV – Identify & Prioritize Quality Improvement Projects. Phase V – Finalize Quality Initiatives; establish standards of practice. Evaluation: Feedback from patients, nurses, providers, patient education committee, and members of the Academic Medical Center drive this project. Metrics will be compiled and evaluated. Routine resources used, i.e., Chemotherapy and You will be identified as standard of care. Resources used inconsistently or that are lacking, i.e., Fertility & Sexuality will be developed. A Patient & Family Education Training Manual will be compiled to train new staff and ensure consistency with established standards. Usefulness: The project standardizes materials to ensure continuity across the continuum of care. Areas within our institution may benefit as we collaborate to update their materials that we use; thus, bridging the existing divide among departments within the institution. The project will be shared with the Health System Patient & Family Education Subcommittee and the ICEC to serve as a model for overcoming barriers within a Health System to improve patient & family centered care. Relation to Theme: This project closely examines current resources within our health system. We will expand resources for underserved population to include Spanish-speaking patients and develop information for underserved populations including those with low literacy levels. Processes we develop ensure that we continue to identify needs, update materials, and share within the institution. Learning Objectives: The participant shall be able to: 1. Learn a process by which multidisciplinary teams can collaborate within oncology care teams and within the health system to share resources. 2. Identify two barriers of academic medical centers and ways to work within the confines. 3. Create standards of practice to encourage and engage collaboration to develop and maintain patient education materials. 4. Increase awareness and importance of staff education about the resources used on each team in order to provide cross training for nursing coverage. 5. Examine the Patient & Family Education Training Manual created as a result of this project. References: 1. Portz D. Implementation of an evidence-based education practice change for patients with cancer. Clinical journal of oncology nursing. 2014-10;18 Suppl:36-40. 2. Kim HS, Shin SJ, Kim CS, et al. Randomized controlled trial of standardized education and telemonitoring for pain in outpatients with advanced solid tumors. Support Care Cancer 2013 Jun; 21(6): 1751–1759.
P58-B: Healthcare provider (HCP) independent information services: How users of the Cancer Information Service (CIS) of the German Cancer Research Center appraise and process the information provided
Andrea Gaisser, Evely Kludt, Susanne, Weg-Remers
German Cancer Research Center, Heidelberg, Baden-Württemberg, Germany
Abstract: Background and purpose. Patient-centered information and communication can favorably impact quality of life and self-efficacy of cancer patients. Considering respective shortcomings, it is one goal of the German National Cancer Plan that quality information and counseling services be available for all patients as an additional cornerstone of patient-centered care. The CIS aims at filling a gap here, offering information and communication in accordance with “good health information practice” and fostering patient participation. A survey of users of the CIS telephone service looked at satisfaction with and impact of the service provided. Methods. A total of 3658 callers, among them 1997 cancer patients, were surveyed with a mailed questionnaire that covered satisfaction with information and communication provided, self-rated impact in cognitive and emotional domains, and health information and participation preferences. The descriptive analysis presented focuses on cognitive endpoints (understanding of situation and options, orientation) and on the impact on certain affective domains (anxiety, assurance regarding medical care and health services). Results. Information and participation preference was high among surveyed patients with 87 and 84% full agreement in the items “want all information” and “want to participate in decisions”. For comprehensibility and individual tailoring of information provided respondents rated (very) good in 85 and 67%%, respectively. Over 60% stated better orientation regarding health services, understanding of options and assessment of previous information. 59% and 43%, respectively, felt more assured regarding their medical care and less anxious. Perceived high gain in orientation and knowledge translated favorably to these QoL-related domains. Also, the information provided supported doctor-patient-communication and triggered action on part of patients. Discussion. CIS information and communication was mostly perceived helpful. Results and observed impact support that independent information services such as the CIS can effectively complement information and communication through HCP´s and other sources – provided they ensure high quality performance. Relation to Theme: The survey results should further underscore the value and importance of patient-centered communication and information provision in cancer care. They also support the potential of independent information services for cancer patients meeting the standards of good health information and communication practice as a complementary resource of patient empowerment and self-efficacy. Learning Objectives: Participants shall be able to recognize the potential of HCP independent cancer information and counseling services using the example of the German CIS. References: 1. Bunge M, Mühlhauser I, Steckelberg A (2010). What constitutes evidence-based patient information? Overview of discussed criteria. Patient Educ Couns 78(3):316-28 2. Husson O et al (2011) The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol 22(4):761-72 3. Klemperer D, Lang B, Koch K et al (2010) Gute Praxis Gesundheitsinformation. Z Evid Fortbild Qual Gesundh wesen 2010; 104: 66–8 4. Perocchia RS et al (2011) Patient-centered communication in cancer care: the role of the NCI’s Cancer Information Service. J Cancer Educ 26(1):36-43
P60-B: Social and Academic Adjustment to College among Young Adult Cancer Survivors: A Qualitative Study
Konnor McMillen1, Tonya Pan2, Sandy Bohan3, Dena Kaufman3, Megan Clifford3, Kristen Wells3, Georgia Robins Sadler1, Vanessa Malcarne3
1University of California, San Diego Moores Cancer Center, Chino Hills, CA, USA, 2San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA, 3San Diego State University, San Diego, CA, USA
Abstract: BACKGROUND: Transitioning from high school to college is challenging both academically and socially. College students with a history of cancer might have a harder time adjusting to academic and social demands due to treatment-related effects. The purpose of the study was to explore young adult cancer survivors’ perceptions of their academic and social adjustment to college. METHOD: Twenty students, 13 women and 7 men, currently attending college in the U.S., age 18 years or older, with a personal history of cancer participated in a one-on-one, semi-structured interview about their cancer related experiences in college. As part of the interview, participants were asked about their academic and social adjustment to college. An Interpretative Phenomenological Analysis approach was used to analyze the data. RESULTS/FINDINGS: Academically, of the 20 participants, 11 believed they adjusted well, six reported they adjusted poorly, and three indicated they struggled at first, but have since adjusted fairly well. Three of the six academically poorly adjusted participants specified challenges related to cancer treatment interfering with academic performance. Academically well-adjusted participants reported that inspiration from their cancer experience, teachers’ understanding and help, and maturing from their cancer experience contributed to their adjustment. Socially, 10 participants believed they are well adjusted, and nine reported poor adjustment. Socially well-adjusted participants indicated involvement in college through sports teams, clubs, or cancer-related organizations helped them adjust. Of the 12 students who reported academic and/or social adjustment problems, 7 left school for cancer-related treatment. CONCLUSION: These findings provide additional insights into ways to improve the survivorship experience among young adults with cancer. This study highlights the challenges to academic and social adjustment that cancer survivors face in college. Universities can use these findings to both evaluate existing services and inform the development of new services to help cancer survivors adjust academically and socially to college. Relation to Theme: Young adult cancer survivors are an underrepresented population in the field of psychosocial cancer research. Minimal research has explored cancer survivors’ adjustments to college. The present qualitative study provides insight into how these students have adapted to the social and academic demands of college. Learning Objectives: The participant should be able to identify two aspects of college life to which cancer survivors struggle to adjust. Also, participants should be able to identify common themes stated by study participants. References: 1. Shultz, K., Ness, K., et al. (2007) Behavioral and Social Outcomes in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. Journal of Clinical Oncology, 25. Retrieved from http://jco.ascopubs.org/content/25/24/3649.full.pdf+html 2. Gurney, J. G., Krull, K. R., et al. (2009) Social Outcomes in the Childhood Cancer Survivor Study Cohort. Journal of Clinical Oncology, 27. Retrieved from http://jco.ascopubs.org/content/27/14/2390.short
P62-B: Cancer support groups: factors associated with current support group membership in individuals diagnosed with cancer attending psychoeducational programs
Allison Harvey, Marni Amsellem, Rhea Suarez
Cancer Support Community, Washington, DC, USA
Abstract: Background: For those with cancer, membership in a cancer support group fosters a sense of connection and is often associated with positive mental health outcomes. Not all individuals who could benefit from groups join—even among individuals who utilize other psychoeducational services. To better understand what influences group membership, the Cancer Support Community (CSC) investigated characteristics of individuals who join groups among attendees of CSC’s Frankly Speaking About Cancer (FSAC) psychoeducational workshops. Methods: Between 2009-2014, 10,573 FSAC workshop nationwide attendees completed post-workshop evaluations (75% response rate). Evaluations assessed a variety of respondent characteristics, including current participation in a support group. Current analyses focused on respondents diagnosed with cancer (n=6,324). Results: Respondents tended to be Caucasian (80.0%), female (80.7%), and averaged 60.3 years old (s.d.=11.2). Half (51.1%) had breast cancer, 36.1% were diagnosed within the past year, and 35.5% had metastatic disease. 52.2% were currently in a support group. Individuals with metastatic cancer and who were diagnosed 6-24 months ago were more likely to be support group members (χ²=59.6, 21.7, respectively, p = Discussion: The current analyses revealed factors associated with participation in support groups among those diagnosed with cancer who seek out psychoeducational services. Results suggest meaningful differences, which may have implications for outreach strategies to increase the delivery of psychosocial support. Relation to Theme: This abstract most strongly relates to the theme of meeting needs of diverse populations in cancer education because of an intriguing finding revealing racial differences in support group membership, that while African-Americans represent a small portion of workshop respondents, they are proportionally more likely to attend support groups. Learning Objectives: The participant shall be able to identify factors associated with cancer support group membership among individual who have also engaged in psychoeducational services. References: 1. Kent, E. E., Alfano, C. M., Smith, A. W., Bernstein, L., McTiernan, A., Baumgartner, K. B., & Ballard-Barbash, R. (2013). The roles of support seeking and race/ethnicity in posttraumatic growth among breast cancer survivors. Journal of Psychosocial Oncology, 31(4), 10.1080/07347332.2013.798759. doi:10.1080/07347332.2013.798759 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3812815/ 2. Forsythe, L. P., Kent, E. E., Weaver, K. E., et al. (2013). Receipt of Psychosocial Care Among Cancer Survivors in the United States. Journal of Clinical Oncology, 31(16), 1961–1969.
P64-B: Characteristics of Positive and Negative Cancer Disclosure Experiences: A Qualitative Analysis
Shelley Condon1, Tonya Pan2, Sandy Bohan1, Megan Clifford1, Jacob Melendez1, Kristen Wells1, Georgia Robins Sadler3, Vanessa Malcarne1
1San Diego State University, San Diego, CA, USA, 2San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA, 3UCSD Moores Cancer Center, San Diego, CA, USA
Abstract: BACKGROUND: Cancer survivors are faced with the choice of sharing their cancer story with others. The characteristics of cancer disclosure experiences that cause survivors to label them as positive or negative have not been fully explored. The current study identified themes underlying positive and negative cancer disclosure experiences from the perspective of young cancer survivors in college. METHOD: Twenty young cancer survivors (13 women and 7 men) with ages ranging from 18 to 30 years old (M = 21) attending college in the United States participated in this study consisting of individual, semi-structured interviews conducted over video chat. As part of a larger qualitative study surrounding cancer disclosure, participants were asked, “What has been your best experience of sharing your cancer story?” and “Have you had any bad experiences sharing your cancer story?” The constant comparative method was used to qualitatively analyze participants’ responses. RESULTS/FINDINGS: One participant explained that all disclosure experiences were similarly met with shock from others; the other nineteen participants described their most positive experience sharing their cancer story. Their responses yielded three common themes: disclosure positively impacted others, disclosure elicited positive responses from others, and disclosure fostered supportive environments, such as at cancer-related events. Eleven participants described a negative experience sharing their cancer story. Their responses yielded three common themes: disclosure was met with disbelief from others, disclosure elicited negative responses from others, and disclosure seemed unimportant to others. CONCLUSION: An interesting finding was that more participants were able to provide a positive experience sharing their cancer story compared to a negative experience. A common theme across both positive and negative experiences was reactions from others. Interventions to support young adult cancer survivors in college could benefit by targeting both cancer survivors and Relation to Theme: Young cancer survivors are an underrepresented population in psychosocial cancer research. Their unique perspective on experiences of disclosure can be used to bring a necessary awareness of the realities of survivorship in college and to improve cancer education for survivors as well as their support systems. Learning Objectives: The participant shall be able to identify and explain the positive and negative characteristics of cancer disclosure experiences. References: 1. Thompson, A. L., Long, K. A., & Marsland, A. L. (2013). Impact of childhood cancer on emerging adult survivors’ romantic relationships: A qualitative account. The Journal of Sexual Medicine, 10(1), 65-73. 2. Hilton, S., Emslie, C., Hunt, K., Chapple, A., & Ziebland, S. (2006). Disclosing a cancer diagnosis to friends and family: A gendered analysis of young men’s and women’s experiences. Qualitative Health Research, 19(6), 744-754.
P66-B: Discerning cancer patients’ preferred method of communicating experience at a regional cancer centre
Susan Boyko, Anthony Zagar
Northeast Cancer Centre, Sudbury, ON, Canada
Abstract: Background/Purpose: The Northeast Cancer Centre located in Sudbury Ontario, Canada, serves a sparsely populated but vast geographic area. Our rural and remote population has a higher percentage of older adults, Aboriginal and Francophone people, and lower rates of high school completion than other regions in Ontario. Description: We participated in a pilot of a provincial patient experience survey that invited cancer patients to tell us about their degree of satisfaction with services received within 48 hours of their visit to the centre. The survey was designed to gather patient feedback on-line. Patients were reluctant to participate in the on-line survey and response rates were poor. We adjusted our recruitment strategy several times using a continuous rapid learning cycle or Plan-Do-Check-Adjust (PDCA) methodology. We utilized both passive and active recruitment methods systematically, changing a single parameter at a time and re-evaluating our processes at each step to demonstrate the limitations of assuming that all patients and families are prepared/prefer to utilize electronic devices and the internet for communication. Based on our experience, the provincial research body amended the pilot protocol to include the use of a paper version of the survey. This gave patients an alternative option for participation if they were reluctant or unable to complete the survey online. Evaluation: Overwhelmingly, patients preferred to complete the survey on paper and did so. Not only is patient preference important when cancer patients receive information and education from a healthcare professional; equal emphasis should be placed on how patients prefer to communicate with us. When we facilitate the patient’s preferred communication style, we are better able to receive feedback that will improve patient care and shape patient education practice. Usefulness: This information will be incorporated in future patient education and process improvement initiatives with patients and families. Relation to Theme: Regional cancer centres that serve rural and remote areas should continually seek and assess culturally appropriate communication strategies that will meet the information and education needs of their diverse population. It is through the thoughtful and inclusive selection of processes that disparities in care can be overcome. Learning Objectives: Discuss the importance of discerning how diverse rural populations prefer to communicate their health care experience. Describe the use of continuous rapid learning cycles to identify and assess processes that can better support the communication of patients and families with healthcare professionals. References: Dennis, P. (2006). Getting the Right Things Done: A Leader’s Guide to Planning and Execution. Cambridge, MA USA: The Lean Enterprises Institute, Inc. Gauthier-Frohlick, D., Boyko, S., Conlon, M., Damore-Petingola, S., Lightfoot, N., Mackenzie, T., Mayer, C., Reed, E., & Steggles, S. (2010). Evaluation of cancer patient education and services. Journal of Cancer Education. 25(1):43-8. Government of Canada, Statistics Canada. (October 24th, 2012). Focus on Geography Series, 2011 Census. Retrieved from http://www12.statcan.gc.ca/census-recensement/2011/as-sa/fogs-spg/Facts-pr-eng.cfm?Lang=eng&GC=35. Rural Ontario Municipal Association. (October 2012). A Voice for Rural and Northern Ontario. Retrieved from http://www.roma.on.ca/ROMA-Docs/Reports/2011AVoiceforRuralNorthernOntario2011Oct.aspx
P68-B: The Relationship of Health Locus of Control to Clinical Trials Knowledge among Hispanic Americans
Jose Valdez1, Sarah Mills2, Rina Fox2, Vanessa Malcarne1, Georgia Robins Sadler3
1San Diego State University, San Diego, CA, USA; 2SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; 3UCSD Moores Cancer Center, San Diego, CA, USA
Abstract: Background: Hispanic Americans (HAs) remain underrepresented in cancer clinical trials. Reasons for this are poorly understood, though beliefs about health may be an important factor. Health locus of control (HLC) describes the extent to which individuals believe they and other agents have control over their health. The Multidimensional Health Locus of Control (MHLC) Scales is a measure that evaluates four types of HLC: Internal HLC, Powerful Others (e.g., healthcare professionals) HLC, Chance HLC, and God HLC. HLC beliefs have previously been linked to cancer-related health outcomes, such as screening practices and attention to health-related information; however, no studies have examined the relationship between HLC and clinical trials knowledge in HAs. Thus, the goal of this study was to examine the relationship between HLC beliefs and clinical trials knowledge in HAs. Methods: Self-identified HAs (N = 327) completed the MHLC Scales and the Clinical Trials Knowledge questionnaire, a measure of knowledge about clinical trials. Pearson product-moment correlations were used to examine the relationships among HLC and clinical trials knowledge among HAs. Results: Endorsement of Internal HLC among participants was positively associated with clinical trials knowledge (r = .12; p = .04). Endorsement of Powerful Others HLC was negatively associated with clinical trials knowledge (r = -.21; p p > .05) to clinical trials knowledge. Discussion: In sum, greater endorsement of internal control and lesser endorsement of powerful others control were associated with higher clinical trials knowledge among HAs. Individuals with high Internal HLC beliefs may seek information about clinical trials. However, individuals with high Powerful Others HLC may rely on their physicians’ knowledge, and know less about clinical trials themselves. These individuals’ belief in powerful others underscores the important role that healthcare professionals can play in transmitting clinical trials information. Relation to Theme: This abstract addresses the theme of cancer health disparities. Hispanic Americans (HAs) are underrepresented in cancer clinical trials. This may be a result of limited knowledge. This abstracts identifies which HAs have low levels of clinical trials knowledge by examining how locus of control beliefs relate to clinical trials knowledge. Learning Objectives: The participant shall be able to understand the relationships between health locus of control beliefs and clinical trials knowledge among Hispanic Americans. The participant shall be able to identify barriers to clinical trials knowledge among Hispanic Americans. References: Grotz, M., Hapke, U., Lampert, T., & Baumeister, H. (2011). Health locus of control and health behavior: Results from a nationally representative survey. Psychology, Health, & Medicine, 16, 129-140. Wallington, S. F., Luta, G., Noone, A. M., Caicedo, L., Lopez-Class, M., Sheppard, V., Spencer, C., & Mandelblatt, J. (2012). Assessing the awareness of and willingness to participate in cancer clinical trials among immigrant Latinos. Journal of Community Health, 37, 335-343.
P70-B: Cancer Impact, Disruption, and Late Effects of Treatment among Young Adult Cancer Survivors
Dena Kaufman1, Tonya Pan2, Sandy Bohan1, Konnor McMillen3, Megan Clifford1, Kristen Wells1, Georgia Robins Sadler3, Vanessa Malcarne1
1San Diego State University, San Diego, CA, USA; 2San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; 3UCSD Moores Cancer Center, San Diego, CA, USA
Abstract: BACKGROUND:Cancer diagnosis and treatment do not only affect patients physically but also psychologically. The purpose of this study is to explore young adult cancer survivors’ perceptions of how their cancer experience and treatment have disrupted, impacted, and are still affecting their lives. METHOD: Twenty college students, aged 18-30 years with a personal history of cancer, were recruited via flyers, cancer organizations, and cancer-and-college related Web sites to take part in an individual interview. The semi-structured interviews were conducted via video chat. Interviews were transcribed verbatim and analyzed using the content analysis method. Three domains emerged from students’ discussions on the implications of their cancer experience and treatment: impact, disruption, and late effects. These domains were further subcategorized by physical and/or psychological characterizations. RESULTS/FINDINGS: The most notable impacts of students’ cancer experience were psychological. These included a change in personality traits, a new sense of strength, and an increased motivation to help others manifested in charity work and career aspirations. Many students expressed the disruption in their lives imposed by cancer in terms of their daily existence – physical capacity and activity, employment, college, and social life. Late effects commonly reported were both physical, such as bone and joint issues, and psychological, such as concentration difficulties and memory loss. CONCLUSION: This study highlights the various physical and emotional effects of cancer on young adult cancer survivors. Notably, participants described a mix of positive and negative outcomes from their cancer experience. These findings can be used to educate and prepare children and adolescents undergoing cancer treatment for the possible implications of their cancer on their early adulthood. This information can be used in future research to assist with developing a guide for cancer patients currently undergoing treatment to be aware of the possible consequences of the cancer experience. Relation to Theme: Undergoing a cancer diagnosis and treatment at a young age is uniquely challenging. Efforts for extensive research must be made to understand the trials and tribulations associated with cancer experiences during and after treatment. The current study elaborates on how survivors’ psychological and physical abilities are affected by cancer-related treatments. Learning Objectives: The participant should be able to identify the common disruptions to life associated with cancer treatment among cancer survivors in college. In addition, participants should be able to indicate personal changes, such as psychological or physical, from the study participants’ responses. References: Castellano‐Tejedor, C., Eiroa‐Orosa, F., Pérez‐Campdepadrós, M., Capdevila, L., de Toledo, J. S., & Blasco‐Blasco, T. (2015). Perceived positive and negative consequences after surviving cancer and their relation to quality of life. Scandinavian Journal Of Psychology, 56(3), 306-314. doi:10.1111/sjop.12199. McClellan, W., Klemp, J. R., Krebill, H., Ryan, R., Nelson, E., Panicker, J., & Stegenga, K. (2013). Understanding the functional late effects and informational needs of adult survivors of childhood cancer. Oncology Nursing Forum, 40(3), 254-262. doi:10.1188/13.ONF.254-262
P72-B: A Qualitative Analysis of Body Image in Young Adult Cancer Survivors
Jacob Melendez1, Tonya Pan2, Sandy Bohan1, Megan Clifford1, Shelley Condon1, Kristen Wells1, Georgia Robins Sadler3, Vanessa Malcarne1
1San Diego State University, San Diego, CA, USA; 2San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; 3UCSD Moores Cancer Center, San Diego, CA, USA
Abstract: BACKGROUND: Body image is the cognitive understanding of one’s body and how one perceives their physical image. It is a prevalent issue among cancer survivors because treatments can cause changes to a patient’s appearance. Young cancer patients often have to cope with these changes amidst otherwise normal physical changes and social pressures. The present study examines the development and evolution of body image in the lives of young adult cancer survivors. METHODS: Twenty young adult cancer survivors (13 women and 7 men) 18 to 30 years old (M = 21 years) attending college in the United States participated in individual, semi-structured interviews conducted over video chat. Time elapsed from initial cancer diagnosis to time of interview varied from 6 months to 20 years (M = 8 years). Themes of body image were analyzed using the constant comparative method. RESULTS: Three thematic domains were discovered that relate to cancer-related body image: 1) concern, 2) emotional impact, and 3) evolution. Some participants did not have body image concerns because they were too young to remember changes or did not experience visible changes due to treatment. Others expressed a concern that their appearance differed markedly from peers who never had cancer. Participants revealed body image insecurities and unhappiness because of cancer-related physical changes. However, participants described evolving self-image as time passed from the time of treatment, such as increased confidence and pride in their appearance. DISCUSSION: Many cancer survivors became more comfortable with appearance changes over time, and lessons drawn from their experience may help other survivors who have difficulty resolving body image issues. Further study should explore how to facilitate the progression toward a positive body image, and inform interventions specifically targeting cancer patients and survivors who have difficulty resolving their body image issues. Relation to Theme: Young cancer survivors are an underrepresented and understudied population in psychosocial cancer research. Their perspectives on body image can contribute to the awareness of the important issue of body image uniquely faced by young cancer survivors in college. Learning Objectives: The participant shall be able to describe the changing process of body image in young cancer survivors. The participant will be able to identify different ways in how physical changes can affect the thoughts and self-perspectives of cancer survivors in college. References: Hopwood, P., Fletcher, I., Lee, A., & Ghazal, S. (2000). A body image scale for use with cancer patients. European Journal of Cancer, 37(2001), 189-197. Collins, K., Liu, Y., Schootman, M., Aft, R., Yan, Y., Dean, G., & Jeffe, D. (2010). Effects of breast cancer surgery and surgical side effects on body image over time. Breast Cancer Res Treat Breast Cancer Research and Treatment, 126, 167-176.
P74-B: Challenges in Developing Pediatric Cancer Care in Southern Vietnam: Overcoming Barriers Through International Collaboration and Education
Lindsey Mette, Chatchawin Assanasen
University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
Abstract: Background: Though a leading cause of death, cancer, particularly childhood cancer, is rarely a public health priority in resource-limited countries. Globally, 60% of children have inadequate access to effective cancer diagnosis, therapy and supportive care measures. Consequently, relapse and treatment-related fatal outcomes contribute significantly to the lower survival rates compared to developed countries. Geographically and politically, Southern Vietnam remains isolated with limited access to modern research collaborations and methodologies. Description: Extrapolated incidence and survival data estimate survival rates as low as 5% for Vietnamese pediatric cancers. As the definitions of underserved populations have blurred in relation to global communities, the University of Texas Health Science Center at San Antonio (UTHSCSA) and the Kids with Cancer Foundation of Vietnam evaluated clinical and educational challenges with healthcare delivery in Vietnam. Visiting Vietnamese hospitals, UTHSCSA faculty identified gaps in care and academic-based infrastructure through interviews with local hospital administrators, educators, physicians, and nursing staff, as well as reviewed local institutional data. Observerships at UTHSCSA for Vietnamese pediatric oncologists facilitated mentorship and clinical education. Evaluation: Barriers identified in southern Vietnam included the lack of common treatment regimens amongst institutions, a nonexistent central cancer registry, underutilization of reference laboratories and inability to ship specimens internationally. Educational aspects of the program are observed by measuring programmatic changes for each hospital, including the development of a regional leukemia treatment protocol and supportive care measures. Stronger critical thinking skills in physicians were observed, as well as improved communication between physicians and partner institutions. Academic posters by Vietnamese and UTHSCSA physicians have been presented at professional society meetings. Usefulness: Despite a growing number of young, capable physicians interested in pediatric cancer, no formal training programs exist for this subspecialty. Through professional collaboration, gradual development of infrastructure has enabled cooperative partnerships, advanced academic medicine, and identified opportunities to improve patient care. Relation to Theme: Our work in global cancer education and training has provided infratructure and expertise to resource-limited pediatric oncology hospitals in Vietnam. The aspects of this program are easily transferrable to other resource-limited countries. Learning Objectives: The participant shall be able to identify opportunities for collaboration and educatio in resource-limited countries References: Singh E, Ruff P, Babb C, Sengayi M, Beery M, Khoali L, et al. (2015). Establishment of a cancer surveillance programme: the South African Experience. Lancet Oncology, 16(8), e414-21. Samudio A, Figueredo D, Lasssaletta A, Zelada O, Peris A, Bogado Yinde L, et al. (2015). Building a national pediatric cancer center and network in Paraguay: lessons for addressing challenges in a low-income country. Journal of Pediatric Hematology Oncology, 37(5), 383-90.
P76-B: A Literature Review on Parental Acceptance and Uptake of the HPV Vaccine among African-Americans and Latinos in the United States
Kayoll Galbraith1, Julia Lechuga2, Coretta M. Jenerette1, LTC Angelo D. Moore (Ret.)3, Mary H. Palmer1, Jill Hamilton4
1School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 2The University of Texas at El Paso, El Paso, TX, USA; 3Moore & Moore Healthcare Consulting, LLC., Cumberland, NC, USA; School of Nursing, 4Johns Hopkins University, Baltimore, MD, USA
Abstract: Background: In the United States, the burden of cervical cancer disproportionately affects African-American women and Latinas compared to non-Hispanic white women. Fortunately, cervical cancer is preventable through HPV vaccination however studies show disparities in HPV vaccine acceptance and uptake among African-Americans and Latinos compared to non-Hispanic whites. The purpose of this systematic literature review is to condense the research findings of studies conducted with African-Americans and Latinos on factors associated with HPV vaccine acceptability and uptake. Methods: Standards for conducting an integrative review described by Whittemore, and Knafl and Cooper were used. Studies in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO were searched. Results: Awareness about HPV and the HPV vaccine varied by demographic characteristics of parents. For Latino parents, acculturation to U.S. culture and awareness were associated. Among African-Americans, higher socioeconomic status was indicative of increased awareness. Sexuality-related concerns, concerns about safety and low perceived risk emerged as barriers to vaccination among both ethnic minority groups. Among Latinos, vaccine acceptability was associated with the vaccine’s cancer prevention benefits and a provider’s recommendation. Among African-Americans however, acceptability varied more widely and acceptance was associated with awareness, perceived risk of acquiring HPV, religion, and a provider’s recommendation. Few intervention studies have been developed to increase HPV vaccine acceptance. Importantly, few studies assessed the influence of culture on HPV vaccine acceptance and uptake. Discussion: This review highlights important factors that facilitate African-American and Latino parents’ HPV vaccine acceptance. It also highlights specific areas of concern about HPV vaccinations among African-American and Latino parents, which, act as barriers to HPV vaccine acceptance and uptake for their adolescent girls. Future research should be informed by culture-centered theories as this is the first step to inform the development and implementation of culturally-grounded interventions to address these populations’ concerns. Relation to Theme: This abstract describes potentially new areas that healthcare professionals and researchers could focus on to develop culturally-grounded educational interventions about the HPV vaccine for African-American and Latino parents of adolescent girls. This abstract identifies similarities and differences in barriers and facilitators to HPV vaccine acceptance among African-American and Latino parents that future educational interventions could target. Learning Objectives: 1) The participants should be able to identify at least two distinct barriers to HPV vaccine acceptance among African-American and Latino parents. 2) The participants should be able to identify at least two common facilitators of HPV vaccine acceptance among African-American and Latino parents. 3) The participants should be able to describe ways in which the information in this presentation could be useful in practice and research to encourage higher HPV vaccine acceptance among African-American and Latino parent parents. References: Hamlish T, Clarke L, Alexander KA. Barriers to HPV immunization for African American adolescent females. Vaccine. 2012; 30(45):6472-6476. Yaqub O, Castle-Clarke S, Sevdalis N, Chataway J. Attitudes to vaccination: a critical review. Soc Sci Med. Jul 2014;112:1-11. Lechuga J, Vera-Cala L, Martinez-Donate A. HPV Vaccine Awareness, Barriers, Intentions, and Uptake in Latina Women. Journal of Immigrant and Minority Heath/ Center for Minority Public Health. 2014.
P78-B: Developing a Curriculum emphasizing Oral medical examination for improvement of patient care in a diverse population
University of Texas Scjhool of Dentistry at Houston, Houston, TX, USA
Abstract: Background: Good care by a dentist or dental hygienist must emphasize the complete assessment of a patient and not the narrow view of the patient as a set of teeth to be fixed. Medical history and recording of vital signs must therefore be a starting point followed by a thorough head and neck examination.Oral cancers make up 3% of all cancers in the United states.It is more frequent than the better known cervical cancers and Hodkin’s lymphoma.Healthy people 2020 protocol OH-14.2 seeks to increase the proportion of adults receiving annual oral and pharyngeal cancer screening.It then becomes important to emphasize this in the training of dental professionals. Description: An IRB was obtained and 51 dental and dental hygiene students were recruited in a 5 month study to perform head and neck and intra oral examinations on new dental patients.The students recorded any abnormal findings and the site of findings.The faculty invesitigator performed the same examination on the patient at this same visit termed visit 1.This was followed by clinical and written instructions when lesions were missed by the subjects. At a later date,visit 2,the same student repeated the same examination on another patient and the results were analyzed. Evaluation: In the 5 month study,several incidental findings were noted.4 were referred for biopsies and two were diagnosed as Squamous cell carcinoma in situ,this highlighting the advantage of early detection.Students in the study also showed a decrease in the number of missed findings on visit 2 .emphasizing the importance for a clinical course in oral medical evaluation as an adjunct to the classroom didactics.The study also addressed “over diagnosis”,whereby normal anatomical features were marked as lesions. Usefulness: The study ultimately led to a proposal for a clinical elective in the curriculum to bridge the gap between didactics in oral diseases and clinical practice and early cancer detection. Relation to Theme: The dental school caters to individuals from varied socioeconomic groups,some with complex medical conditions and many without dental insurance.Our dental and dental hygiene students are being exposed to oral cancer examinationand education as standard of care in this diverse population group. Learning Objectives: The participant shall be able to appreciate the importance of a curriculum that stresses oral soft tissue examination as part of routine dental examination in a diverse population. The participants will also understand the importance of early detection of oral lesions,the common sites for these lesions and the various ways in which they present. References: Zini A, Czerninski R, Sgan-Cohen HD. Oral cancer over four decades: epidemiology, trends, histology, and survival by anatomical sites. J Oral Pathol Med. 2010 Apr; 39(4):299-305. Dodd VJ, Schenck DP, Chaney EH, Padhya T. Assessing Oral Cancer Awareness Among Rural Latino Migrant Workers.J Immigr Minor Health. 2015 May 28. [Epub ahead of print]
P80-B: Cancer Genetic Counseling by Videoteleconferencing along the Texas-Mexico Border
Lindsey Mette1, Anna Maria Pulido Saldivar1, Natalie Poullard1, Ivette Torres1, Sarah Seth1, Brad Pollock2, Gail Tomlinson1
1UT Health Science Center at San Antonio, San Antonio, TX, USA; 2University of California Davis, Davis, CA, USA
Abstract: Background: Breast and colorectal cancers are two common cancers for which genetic risk assessment and counseling are available. However, these services are often limited to major metropolitan areas and not frequently accessed by underserved populations. Multiple ethnic and racial disparities exist with regards to identification of high-risk individuals, screening, and treatment outcomes; these socioeconomic factors are frequently seen in minority and new immigrant populations. Description: We provided cancer genetic risk assessment and counseling via telemedicine, as well as navigation to breast and colorectal cancer screening, education, and outreach to the South Texas-Mexico border region. This population shares many of the barriers identified in other minority populations, including lack of resources and health insurance, distrust of the medical system, and family and employment obligations that preclude access to care. Evaluation: In order to determine the acceptability of this alternate service model, program participants were mailed a 20-item questionnaire to assess their level of satisfaction with the program. With a completion rate of 34%, the overall level of satisfaction was very high (4.715 on 5.0 scale), and nearly half reported decreased concerns about developing cancer after genetic counseling. Usefulness: These findings demonstrate the acceptability of a cancer genetic risk assessment program heavily reliant on telemedicine in an underserved minority community. Despite the challenges previously noted in the literature about serving minority populations and barriers to cancer genetic risk assesment for Hispanics, we were able to provide these services in line with traditional genetic counseling services while maintaining a high level of participant satisfaction. Relation to Theme: Identification of hereditary predisposition to cancer is an important aspect of cancer prevention. As the demand for trainend genetic counselors grows, those in rural, remote, or medically underserved areas are often without access to genetic counseling. Telegenetics offers a solution to this gap in access to care. Learning Objectives: The participant will identify opporutnities for employing telemedicine modalities to overcome disaprities in access to specialized healthcare services References: Buchanan AH, Datta SK, Skinner CS, Hollowell GP, Beresford HF, Freeland T, et al. (2015). Randomized trial of telegenetics vs. in-person cancer genetic counseling: cost, patient satisfaction and attendance. Journal of Genetic Counseling, epub ahead of print. DOI: 10.1007/s10897-015-9836-6. McDonald E, Lamb A, Grillo B, Lucas L, Miesfeldt S. (2014). Accepatability of telemedicine and other cancer genetic counseling models of service delivery in geographically remote settings. Journal of Genetic Counseling, 23(2), 221-8.
P82-B: Feasibility of a multi-component intervention for health education in cancer prevention
Meghan Strom1, Matthew Cox2, Jaejoon Song2, Courtney Karam2, Susan Peterson2, Karen Basen-Engquist2
1University of Arizona, Tuscon, AZ, USA; 2MD Anderson Cancer Center, Houston, TX, USA
Abstract: BACKGROUND Behavioral interventions to increase PA and improve diet have been moderately effective and researchers still do not have a clear understanding on which aspects of these programs are most effective as adherence to recommendations remains low. HEALTH4 MD Anderson is a 16-week pilot cancer prevention behavioral intervention to improve PA and diet. METHODS HEALTH4 MD Anderson was designed using a Multi-phase Optimization STrategy (MOST) to test multiple combinations of remotely-delivered technology-based interventions for improving implementation and maintenance of healthy behaviors. Feasibility was assessed using online questionnaires that measured adherence to the intervention and satisfaction. Effectiveness was measured via changes in PA as well as diet self-efficacy (DSE) or the confidence to change diet. Participants (N=25) were eligible by any of these criteria: body mass index (BMI) of >25; RESULTS Participants (age 41.8 years ± 10.4) had a baseline mean BMI of 31.8 ± 8.2.Mean satisfaction score was 3.98 ± 0.17 out of 5; 98% were satisfied (in high agreement) with their program and 92% adhered to assigned intervention group components. DSE remained high at 8 weeks (19.11 ± 0.77) but decreased from baseline (20.42 ± 0.41). There were no statistically significant changes at this interim point in DSE or PA (p>0.05), although the feasibility was attained. DISCUSSION Our preliminary results indicate high levels of adherence and satisfaction with the HEALTH4 MD Anderson program. HEALTH4 MD Anderson may be a promising intervention strategy for improving weight management and PA. Relation to Theme: The research in HEALTH4 MD Anderson introduces a new method for testing interventions for cancer prevention applicable to both survivors and the general population that was well received in preliminary pilots. It is cancer education from both the researcher and participant perspective which integrates technology into interventions. Learning Objectives: The participant shall be able to summarize the MOST intervention design and identify the four intervention components used in HEALTH4 MD Anderson. References: McClure JB, Derry H, Riggs KR, Westbrook EW, St. John J, Shortreed SM, Bogart A, An LC. Questions about quitting (Q2): design and methods of a Multiphase Optimization Strategy (MOST) randomized screening experiment for an online, motivational smoking cessation intervention. Contemp Clin Trials. 2012; 33(5): 1094-102. Fong D, Ho, J., Hui, B., Lee, A., Macfarlane, D., et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012 2012-01-31 23:59:03;344. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74. PubMed PMID: 22539238. Epub 2012/04/28.