Abstract C058: The Impact of Preferred Language on Cancer WellBeing Screen Outcomes and Supportive Care Program Touch Points
Authors: Kim Justin , Irwin Scott , Tsang Kevin , Liu Hongyu , Tatonetti Nicholas , Liang Margaret 
Published: September 2024

Background: Preferred language is a potential barrier to linking patients to supportive resources. At a large health system, a Wellbeing Screen (WBS) is administered to identify needs and guide referral to the Patient & Family Support Program (PFSP). Abnormal WBS and number of PFSP physician touch points were compared among cancer patients with non-preferred English language (nPEL) vs. preferred English language (PEL). We hypothesized nPEL patients may have differing needs or provision of services. Methods: A single institution retrospective study evaluating WBS among all patients receiving ambulatory cancer care at one of 7 sites from 01/2021-12/2022 was performed. The WBS instrument assesses degree of impact for 15 wellbeing domains and is assigned to patients at each oncology-related visit if a WBS has not been completed within the last 30 days. PEL vs. nPEL patients were compared for percentage of abnormal screens defined as a response of moderate/severe impact on at least one domain. Number of touch points by PFSP physicians (Supportive Care Medicine; Rehabilitation; Psychiatry) were abstracted within 30 days after any abnormal WBS. Fisher’s exact test was used to calculate odds ratios and p-values. Results: A total of 12,642 patients were assigned at least one WBS during the study period, resulting in 56,821 assigned WBSs, of which 7,898 (13.9%) were assigned to nPEL patients. PEL patients were assigned a lower average number of WBSs compared to nPEL (4.4 vs. 5.3, p&lt;0.001). Of all assigned WBSs, 20,191 (35.5%) were completed. Of these, 10,097 (50.0%) were abnormal with moderate/severe impact on at least one domain. WBSs completed by PEL patients had 1.42 higher odds of moderate/severe impact on at least one domain compared to nPEL (p&lt;0.001) and higher odds of moderate/severe impact on 11 of the 15 individual domains (all p&lt;0.01). There were 5,628 PFSP physician touch points within 30 days of the 10,097 abnormal WBS. The most frequent touch points were provided by Supportive Care Medicine (55.5%), followed by Rehabilitation (29.2%) and Psychiatry (15.4%). The nPEL group had 0.34 lower odds of having any PFSP physician touch point (p&lt;0.001) and a lower average number of PFSP physician touch points (8.4 nPEL vs 16.5 PEL, p&lt;0.001) compared to the PEL group. nPEL had significantly lower odds of having a touch point provided by Rehabilitation (OR 0.44) and Psychiatry (OR 0.33), but significantly higher odds of having a touch point provided by Supportive Care Medicine (OR 3.01) (all p&lt;0.001). Conclusion: WBSs completed by PEL had higher odds of identifying moderate/severe impact on at least one wellbeing domain. The nPEL group had fewer PFSP physician touch points and differing odds of services from PFSP physicians compared to the PEL group. These differences may be due to bias in the screen, differences in understanding the value of services (ie., due to language barriers or cultural perception), or referral patterns. Further evaluation of non-physician PFSP services, such as Social Work, Clinical Nutrition, and Spiritual Care, is ongoing.

Citation Format: Justin Kim, Scott Irwin, Kevin Tsang, Hongyu Liu, Nicholas Tatonetti, Margaret Liang. The Impact of Preferred Language on Cancer WellBeing Screen Outcomes and Supportive Care Program Touch Points [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C058.