Supportive Care Service Availability for Cancer Caregivers in Community Oncology Practices
Condition: Supportive Care
MeSH terms: Neoplasms
Study type: Observational

Summary: 
      The purpose of this study is to understand current practices for engaging with informal
      (unpaid) caregivers of patients with cancer, characterize the availability of supportive care
      services, and assess the perspectives of multi-disciplinary oncology health care providers
      regarding identifying and supporting caregivers.
    

Detailed description: 
      The primary goals of this study are to: 1) estimate the prevalence of: a) caregiver
      identification practices, b) psychosocial and/or needs assessment practices for caregivers,
      and c) the availability of and funding models for supportive care services for caregivers at
      community oncology practices (Objective 1), and 2) assess the perspectives of
      multi-disciplinary oncology health care providers regarding: a) perceived responsibility for,
      and barriers to, assessing and supporting caregivers, b) the importance of and self-efficacy
      in communicating with caregivers, and c) preferences regarding systems approaches to assess
      and meet caregivers' needs (Objective 2). Additionally, we will explore various practice and
      provider -level factors that are associated with the listed outcomes in objectives 1 and 2
      respectively (Objective 3a and 3b). This study is estimated to enroll 138 Supportive Care
      Leaders (e.g., Director of Psychosocial Oncology, Supportive Care Services, or Cancer Patient
      Support) and 690 multidisciplinary Oncology Providers including physicians, nurses, and
      physician assistants/nurse practitioners. Participants will complete a one-time web-based
      survey (estimated at 15-20 minutes to complete). The supportive care leader survey will
      capture: (1) practice characteristics including caregiver identification and psychosocial
      assessment practices and preferences; supportive care resources; practice structure; practice
      technology resources; and status of the Caregiver Advise Record and Enable (CARE) Act. The
      oncology provider survey will capture: (1) provider skills in caregiver communication;
      perceived responsibility, knowledge and skills, and awareness of resources for meeting
      caregiver needs; barriers to meeting caregiver needs; provider characteristics; and system
      intervention preferences.

      For data capture regarding supportive care leaders (Objective 1 and 3a), this will be a
      convenience sample of responders from all WF NCORP sites, therefore no randomization or
      stratification is necessary.

      Regarding objectives pertaining to oncology providers (Objective 2 and 3b), participating
      sites with corresponding supportive care leaders will identify an appropriate supportive care
      leader to generate 3 lists of providers: 1) physicians, 2) nurses, and 3) physician
      assistants/nurse practitioners who routinely provide cancer care (Oncology Care Provider
      Identification Form, Appendix B). Using previous Landscape data regarding oncology
      physicians, we estimate that 50% of practice groups have 1-9 oncology physicians, 25% have
      10-20, and 25% have 20+ physicians. After practices respond with lists of physicians, nurses,
      and physician assistants/nurse practitioners, we will classify each site as small, medium,
      and large using the criteria for physicians listed above. Assuming similar distributions as
      seen in Landscape, we will randomly sample 4, 12, and 20 total providers at small, medium,
      and large sites respectively. With approximately 50% of practices participating, we plan to
      target a weighted average of 10 providers per practice with the goal of a weighted average of
      5 completed provider surveys (50% response/practice) for a total of 690 providers included in
      objective 2 (sample size justification follows in section 9.3). In addition, we will stratify
      and proportionally allocate by provider types identified at each site using self-weighting
      samples supplied in their lists of providers. Therefore of those randomly sampled, we will
      target roughly the same proportion of physicians, nurses, and PA/nurse practitioners as
      identified from their site administrator. Coordinators at each NCORP practice will provide
      e-mail addresses only for randomly selected providers (selected numbers from a numbered
      list), based on the size of the center and stratified proportional to provider types.
    

Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        This study will be open to all Adult NCORP Components and Sub-components. Participants will
        include supportive care leaders (staff member who is most knowledgeable about supportive
        care services) and multidisciplinary oncology providers (physicians, nurses, and physician
        assistants/nurse practitioners who routinely provide cancer care and have been in practice
        at component/subcomponent for at least 6 months).
      
Keywords: Caregivers; Oncology; Cancer