Abstract A23: Fertility and Reproductive Health Resources Reported by Nurses Delivering Care for Minority Cancer Patients
Authors: Vadaparampil Susan , Bowman-Curci Meghan , Meade Cathy , Gwede Clement , Hudson Janella , Quinn Gwendolyn 
Published: March 2017

Background: African American and Hispanic cancer patients face disparities in cancer care affecting quality of life (QoL) and other health related outcomes. Reproductive health (RH) topics such as risk of infertility due to treatment, contraception, and fertility preservation (FP) are among these QoL issues. The American Society of Clinical Oncology (ASCO) clinical practice guidelines suggest oncology care providers discuss potential fertility loss and refer adolescent and young adult (AYA) patients to reproductive specialists. Yet, recent studies of survivors and retrospective chart reviews show sub optimal rates of discussions and referrals. Less is known about the availability of FP and RH resources for racial/ethnic minority cancer patients. The Educating Nurses about Reproductive Health Issues in Cancer Healthcare (ENRICH) program seeks to improve nurses' communication skills regarding FP and RH issues with AYA oncology patients. In the current study, we explored availability of FP and RH resources reported by ENRICH participants providing care to African American or Hispanic cancer patients.

Methods: Prior to starting the training program, applicants completed information about demographic characteristics, practice setting, and patient population, including an estimate of the proportion of their patients by race/ethnicity (0-25%, 26-50%, 51-75%, and 76-100%). Trainees also provided information about availability (yes/no) of FP and RH institutional resources including: established FP referral guidelines/procedures, reproductive endocrinologist and infertility specialist (REI) on staff, institutional partnership with an REI, RH material for staff, RH patient education material, and “other” RH resources. For the current analysis we used Chi-square tests to compare those who reported a patient population of &lt;25% of African American and Hispanic patients compared to those who reported &gt;26% patients population belonging to these particular racial/ethnic groups across all institutional FP and RH resources. Data on other racial/ethnic groups (White, Asian, Native Hawaiian, and American Indian) were collected, but did not provide sufficient variability with respect to the proportion of patients from those groups to conduct additional analyses.

Results: A total of 104 nurses participated in the 2016 ENRICH training program cohort. The majority were Non-Hispanic (82%) and White (90%), and female (99%). On average, nurses reported 14 years of experience, more than half (59%) had at least a bachelor's degree and worked in academic institutions (66%). Of the participating nurses, 50% reported &lt;25% of their patient population was African American; 50% reported their African American patient population was &gt;26%. Approximately half (59%) served &lt;25% Hispanic patients and 41% (n=43) identified &gt;26% of their patients being Hispanic. Regardless of the proportion of minority patients served, reported availability of FP and RH resources was low to moderate. For example, among only 37% of nurses serving majority Hispanic patients work at institutions with an REI on staff and 27% of those serving majority African American patients had institutional partnerships with REIs. However, among those providing care for Hispanics, those with a greater proportion of Hispanic patients reported higher frequencies of having an established FP referral guidelines/procedures (38% vs 60%) and institutional partnership with an REI (25% vs. 49%) compared to those reporting a smaller proportion (p&lt;0.05).

Conclusion: Available data suggest that among nurses participating in the ENRICH program, availability of FP and RH resources for minority cancer patients are low to moderate. One of the ENRICH goals is to impact individual and workplace level changes to facilitate discussion of FP and RH. Future directions include surveying ENRICH participants' at 6 months and 1 year after course completion to assess if the program aided in increasing availability of FP and RH resources among those serving minority patients.

Citation Format: Susan Vadaparampil, Meghan Bowman-Curci, Cathy Meade, Clement Gwede, Janella Hudson, Gwendolyn Quinn. Fertility and Reproductive Health Resources Reported by Nurses Delivering Care for Minority Cancer Patients. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A23.