The medical community has recognized that distress screening is a critical factor in quality cancer care. The Institute of Medicine (2007) recommends psychosocial screening for all cancer patients to improve integration of care. In the US, up to 85% of patients are treated in the community rather than comprehensive cancer centers. However, distress screening for patients in the community is largely non-existent. To bridge this gap, the Cancer Support Community (CSC) is testing the feasibility and effectiveness of community-based, comprehensive screening for cancer patients.
After 18 years of screening experience in hospital settings, City of Hope (COH), a NCI-designated Comprehensive Cancer Center, developed an automated touch-screen screening service for patients called SupportScreen™ .
Investigators from CSC and COH collaborated in order to create a validated screening tool that will ensure that all cancer patients have access to community-based psychosocial care.
Using the CIRC model
, the Demonstration Project includes 3 phases
- Phase (1) to refine the existing SupportScreen™ 53-item problem-related distress screening tool for the community context by reducing the number of questions and revising items as appropriate.
- Phase (2) to test the validity and reliability of the psychometric properties of the shortened 36-item tool.
- Phase (3) to test the feasibility of the 36-item problem-related distress screening measure and its use to link patients to available resources across five unique sites.
Building on what we have learned from the demonstration project, CSC is moving forward and creating a new screening measure, using new technology. Validation of a new screening instrument specifically designed for use within the community will increase knowledge of the unique needs of these survivors. More innovative technology will create a flexible method to deliver in multiple settings including CSC affiliates, community cancer centers, and oncology practices and hospitals. CSC will also pursue collaboration with organizations that are mandating psychosocial screening.
To carry out the expansion project, CSC will finalize the new, more streamlined measure, train ten affiliate sites on the new instrument and new delivery technology, conduct an IRB-approved study to validate the new measure and analyze the data collected, and create a training module for implementation of the new tool across additional sites.
The overall screening demonstration project has the potential to reach and influence the entire non-profit, community-based psychosocial oncology world. It also has the potential to create unique partnerships with small oncology practices and community cancer centers. Findings will move us closer to the ultimate goal of universal screening of patients, creating a mechanism of referral and follow up care.