Patient housing barriers to hematopoietic cell transplantation: results from a mixed-methods study of transplant center social workers

Preussler, Jaime M.; Mau, Lih Wen; Majhail, Navneet S.; Bevans, Margaret; Clancy, Emilie; Messner, Carolyn; Parran, Leslie; Pederson, Kate; Ferguson, Stacy Stickney; Walters, Kent; Murphy, Elizabeth A.; Denzen, Ellen M.

doi:10.1007/s00520-015-2872-9

Cited by 15 publications

(5 citation statements)

References 16 publications

(21 reference statements)

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“…We acknowledge that the response rate puts the analysis at risk for nonresponse bias. However, a response rate of 57% among health professionals is about average or higher than average as reported in the literature [15][16][17][18][19]. Despite these limitations, the findings from this study make an important contribution to defining an optimal social worker care model in HCT.…”

Section: Table 2 Themes and Representative Comments Highlighting Clinmentioning

confidence: 78%

Perceived Workforce Challenges among Clinical Social Workers in Hematopoietic Cell Transplantation Programs

Ferguson

Randall

Dabney

et al. 2018

Biology of Blood and Marrow Transplantation

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Clinical social workers are psychosocial care experts who provide interventions that aim to address the emotional, relational, financial, and logistical challenges that arise throughout the hematopoietic cell transplantation (HCT) treatment and recovery process. Interventions that contribute to better patient outcomes can include cognitive behavioral therapy and counseling for adaptation to illness, family planning for 24/7 caregiver availability and strategies to support patient activities of daily living, instruction on guided imagery and relaxation techniques for symptom management and to decrease anxiety, psychoeducation on the treatment trajectory, and linkage with financial resources. A Social Work Workforce Group (SWG) was established through the System Capacity Initiative, led by the National Marrow Donor Program/Be The Match, to characterize the current social work workforce capacity and challenges. The SWG conducted a web-based survey of HCT clinical social workers in the United States. The response rate was 57% (n = 90), representing 76 transplant centers. Survey results indicated that the clinical social worker role and scope of practice varies significantly between centers; less than half of respondents reported that their clinical social work expertise was used to its fullest potential. With an estimated 3-fold increase in HCT patient volume by 2020, the need for specialized psychosocial health services will increase. The SWG makes recommendations to build capacity for the psychosocial care of HCT patients and to more fully integrate the social worker as a core member of the HCT team. The SWG created a Blood and Marrow Transplant (BMT) Clinical Social Worker role description that can be used by transplant centers to educate healthcare professionals, benchmark utilization of clinical social workers, and improve comprehensive psychosocial health programs.

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Section: Table 2 Themes and Representative Comments Highlighting Clinmentioning

confidence: 78%

Perceived Workforce Challenges among Clinical Social Workers in Hematopoietic Cell Transplantation Programs

Ferguson

Randall

Dabney

et al. 2018

Biology of Blood and Marrow Transplantation

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“…6,7,10 Housing needs related to temporary relocation for cancer treatment have also been reported. 11 Housing could be an important source of disparity among patients with cancer. Unmet needs have been associated with missed cancer treatment appointments and delays in care.…”

Section: Corresponding Author Introductionmentioning

confidence: 99%

“You Have to Keep a Roof Over Your Head”: A Qualitative Study of Housing Needs Among Patients With Cancer in New York City

Phillips

Raskin

Harrington

et al. 2019

JOP

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PURPOSE: Housing status can become compromised in the wake of financial hardship for some patients with cancer and become a source of disparity. This qualitative study describes the types of housing issues experienced by patients with cancer and survivors of cancer in New York City. METHODS: Semistructured interviews were conducted with a volunteer sample of 21 patients with cancer or survivors of cancer treated in New York City who reported housing needs in the period after diagnosis through survivorship. Nine supplemental interviews were conducted with cancer and housing key informants. Conventional content analysis was conducted on transcripts to create a codebook describing types of housing needs. RESULTS: Patients and survivors most commonly had breast (n = 9) and blood (n = 4) cancers and ranged from recently diagnosed to many years posttreatment. Twenty-nine distinct housing-related issues were identified, which were grouped into the following six major categories: housing costs (eg, rent, mortgage), home loss, doubled up or unstable housing, housing conditions, accessibility (eg, stairs, proximity to amenities), and safety. Issues were often interrelated. Housing needs sometimes predated cancer diagnosis. Other issues newly emerged in the wake of cancer-related physical limitations and disruption to finances. Needs ranged in severity and caused patients and survivors considerable burden during a difficult period of poor health and financial strain. CONCLUSION: This study contributes depth to current understandings of housing needs among patients with cancer and survivors by providing detailed disaggregated descriptions. We recommend increasing availability of services responsive to these needs and exploring promising options such as patient navigation and legal services. Findings also highlight the importance of creative solutions addressing ecologic-level factors such as housing affordability.

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“…For some patients, a model of shared follow-up care may increase willingness to travel to a more distant center to receive cellular therapy. For others, efforts to leverage longstanding oncologist-patient relationships, provide cellular therapies at a greater number of sites over a wider geographic area, or reduce the costs of travel to and from a cellular therapy center, such as through temporary housing assistance as is sometimes offered to patients undergoing transplantation, 54 may be more effective.…”

Section: Discussionmentioning

confidence: 99%

Willingness to Travel for Cellular Therapy: The Influence of Follow-Up Care Location, Oncologist Continuity, and Race

Frosch

Namoglu

Mitra

et al. 2022

JCO Oncology Practice

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PURPOSE Patients weigh competing priorities when deciding whether to travel to a cellular therapy center for treatment. We conducted a choice-based conjoint analysis to determine the relative value they place on clinical factors, oncologist continuity, and travel time under different post-treatment follow-up arrangements. We also evaluated for differences in preferences by sociodemographic factors. METHODS We administered a survey in which patients with diffuse large B-cell lymphoma selected treatment plans between pairs of hypothetical options that varied in travel time, follow-up arrangement, oncologist continuity, 2-year overall survival, and intensive care unit admission rate. We determined importance weights (which represent attributes' value to participants) using generalized estimating equations. RESULTS Three hundred and two patients (62%) responded. When all follow-up care was at the center providing treatment, plans requiring longer travel times were less attractive ( v 30 minutes, importance weights [95% CI] of –0.54 [–0.80 to –0.27], –0.57 [–0.84 to –0.29], and –0.17 [–0.49 to 0.14] for 60, 90, and 120 minutes). However, the negative impact of travel on treatment plan choice was mitigated by offering shared follow-up (importance weights [95% CI] of 0.63 [0.33 to 0.93], 0.32 [0.08 to 0.57], and 0.26 [0.04 to 0.47] at 60, 90, and 120 minutes). Black participants were less likely to choose plans requiring longer travel, regardless of follow-up arrangement, as indicated by lower value importance weights for longer travel times. CONCLUSION Reducing travel burden through shared follow-up may increase patients' willingness to travel to receive cellular therapies, but additional measures are required to facilitate equitable access.

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Patient housing barriers to hematopoietic cell transplantation: results from a mixed-methods study of transplant center social workers

Cited by 15 publications

References 16 publications

Perceived Workforce Challenges among Clinical Social Workers in Hematopoietic Cell Transplantation Programs

Perceived Workforce Challenges among Clinical Social Workers in Hematopoietic Cell Transplantation Programs

“You Have to Keep a Roof Over Your Head”: A Qualitative Study of Housing Needs Among Patients With Cancer in New York City

Willingness to Travel for Cellular Therapy: The Influence of Follow-Up Care Location, Oncologist Continuity, and Race

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