Creating sustainable infrastructure to support cancer survivors by identifying and addressing social risk factors and reducing health inequities

Creating sustainable infrastructure to support cancer survivors by identifying and addressing social risk factors and reducing health inequities [PDF]

Speakers: Hannah Arem (MedStar Health Research Institute), Lisa Simms Booth (Smith Center for Healing and the Arts), Oluwabukola Oluwole (MedStar Health Research Institute), Tallulah Anderson (2for2 Boobs), Jacqueline Beale (MedStar Health Research Institute)

Through this session speakers included multilevel perspectives on the potential for social risk factor screening and referral processes to support racial equity. Participants were encouraged to consider how implicit bias and racism impacts patient experiences in both hospital and community settings. Cancer survivors experience long-term challenges after completion of cancer treatment including financial toxicity, social isolation, and difficulties establishing a new normal. There is little published research on how to integrate social risk factor screening and referral processes to assess and address these needs into cancer survivorship care, and in particular to achieve racial equity. To this end it is critical to incorporate diverse perspectives on social risk factor screening in intervention planning including from the patient, those conducting screening and referral services, and those providing services to the members of the community. Researchers conducted a series of interviews with patients, providers, and community-based organizations in Washington, DC to understand how to create meaningful exchanges between three Washington DC healthcare systems and community-based organizations to achieve racial equity. These interviews informed our initial roll out of social risk factor screening and referral processes to appropriately serve historically marginalized populations. The overall study objective is to deliver social risk factor screening to all breast and prostate cancer patients across three cancer centers in Washington DC and to provide community health worker support to address social, practical, and emotional needs. Simultaneously, we will conduct anti-bias training at the 3 cancer institutes and will measure patient experiences of discrimination in medical settings. There is a need to consider the cascade of screening, referring, and providing for cancer survivor needs with a focus on incorporating the patient perspective and destigmatizing social needs. In interviews we found that patients largely supported being asked about social risk factors in the healthcare setting. From the provider perspective limitations included appropriate referral channels for identified needs, sufficient staffing to support patients, and competing priorities. Community-based organizations cited a need for better coordinated care, awareness of power dynamics between large healthcare systems and community-based organizations, and engaging patients early in the treatment experience to provide needed support services. Ongoing lessons learned and adaptations to screening and referral protocols will be presented. The speakers presented on experiences with experiencing interactions in the clinical and community settings and layed out lessons learned from decades of experience working in the community and bridging healthcare settings to reflect on better coordinating efforts to serve cancer survivors and reduce health inequities.