Abstract B26: Developing a community health educator (CHE) intervention model for identifying unmet needs and assessing behavioral change with tailored health education for breast and colorectal cancer patients after cancer treatment
Authors: Schwartzbauer Bonnie , Fiscella Kevin , Loader Starlene , Rousseau Sally 
Published: December 2010

Purpose: Prior studies document the unmet needs of cancer patients after treatment. Tailoring health education to patient needs may improve information usability and facilitate behavioral change. Our aim is to pilot a CHE intervention designed to assess and address the personal health education needs of cancer patients who recently completed primary cancer treatment.

Description of Pilot: We recruited one CHE and provided her with training in cultural competence, interpersonal/communication skills, interview techniques, needs assessment and coaching skills. During the first phase of the pilot, the CHE compiled an inventory of written and web-based educational materials from both local and national sources. The CHE also designed a needs assessment instrument and an instrument designed to succinctly summarize information for patients. During phase 2, the CHE piloted tailored health education with patients who recently completed breast or colorectal cancer treatment. At the first visit, the CHE assessed the patient's knowledge and understanding of their cancer treatment and follow-up care and coached the patient to talk about her/his current psychosocial, physical, and spiritual well-being to identify unmet needs. At the second visit, the CHE confirmed the information obtained at the first visit and reviewed the tailored education material based on the patient's stated needs. The CHE also invited the patient to discuss the usefulness of the educational materials and actions the patient has taken in response to receiving it.

Evaluation: The intervention is evaluated through a semi-structured phone interview conducted by a research assistant. The patient is asked about: 1) the appropriateness and usefulness of the educational resources received; 2) impact of CHE on patient's use of materials and follow through behavior and 3) an overall usefulness of the visits with CHE. The content of the interview is coded using qualitative methods.

Findings to Date: To date, tailored cancer health education has been piloted with 18 patients. Patients identified unmet needs in the areas of cancer related (27%), health promotion (26%), and social support (24%), instrumental support (17%), and other health related needs (6%). Patients welcomed the opportunity to continue a health conversation after cancer treatment. Comments by patients include: “scared, needed reassurance, needed to know the help resources out there”, “really the first time to address specific needs” and it “provided a feeling of comfort, someone to talk to, can't always talk to family”. Patients appreciate tailored health information and reported “had questions and got the right answers”, “very detailed and pertinent” and “did not expect to receive this type of information from her doctor.” This project was financially supported by a grant from the National Cancer Institute (3U1CA116924-05S2; Dr. Kevin Fiscella, Principal Investigator)

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B26.