Understanding and Improving Knowledge of Cancer Survivorship Care Among College Providers

Abstract

This study aimed to assess college providers' basic knowledge of the health risks of young adult cancer survivors (YAS) and related care guidelines and to determine whether an educational in-service is an effective platform for increasing college health providers' knowledge about survivorship care at a large university health center. During phase 1, staff from college health centers and office of disabilities in the Philadelphia area (n = 40 staff members from 24 colleges/universities) completed a needs assessment on their experiences with YAS and preferences for education and care coordination. During phase 2, a 1-h educational in-service, informed by results of the survey, was provided to 18 health center medical providers. While most providers indicated that YAS are at risk for chronic health conditions because of cancer treatment, nearly all were unfamiliar with the content of published long-term follow-up guidelines for cancer survivorship. Over half did not have knowledge of cancer survivorship services in their area. All respondents were interested in more education on cancer survivorship care. Attendees of the in-service increased their knowledge of survivorship follow-up guidelines, awareness of local survivorship resources, and comfort with caring for YAS at posttest relative to baseline. The in-service was highly acceptable to providers and feasible to implement. College providers had little baseline knowledge of cancer survivorship guidelines, but were motivated to obtain more information. Through an educational in-service, college health providers may be better equipped to provide acute and longitudinal survivorship care to a vulnerable population who are at risk for inadequate engagement in risk-based follow-up care.

A Scoping Review Exploring Access to Survivorship Care for Childhood, Adolescent, and Young Adult Cancer Survivors: How Can We Optimize Care Pathways?

“…This reflects challenges explained in the literature, which shows how young survivors are increasingly expected to manage their own care while navigating personal and social challenges as well as challenges within their living environments. 24 , 25 , 28 These survivors have also expressed the necessity for developmentally appropriate care that recognizes their need for autonomy while also recognizing the potential need for parental involvement. 35 …”

“…This reflects challenges explained in the literature, which shows how young survivors are increasingly expected to manage their own care while navigating personal and social challenges as well as challenges within their living environments. 24,25,28 These survivors have also expressed the necessity for developmentally appropriate care that recognizes their need for autonomy while also recognizing the potential need for parental involvement. 35 Some novel survivorship care delivery models have emerged in recent years to address the dual challenges of the AYA developmental period, and the complexity of continuing to engage AYA survivors of child and adolescent cancer in the critical importance of ongoing surveillance for cancer-related late-effects, years after this seems most salient.…”

“…25 At the provider level, primary care providers (PCPs) may lack awareness of the complexities of survivorship care, including survivorship guidelines, surveillance and treatment needs, and consequently, may not refer survivors to recommend screening and management protocols. [26][27][28] The presence of system-level barriers in the delivery of survivorship care reflects the abrupt transition of pediatric cancer patients to adult healthcare services and the lack of comprehensive guidelines governing the provision of survivorship care. 24,29 Addressing these obstacles is critical to improving the quality of survivorship care for patients, as they can significantly impact the continuity and effectiveness of care across the cancer survivorship trajectory.…”