Abstract B057: Nutrition-related clinical characteristics of patients in a safety net hospital oncology program and perspectives on wellness programming during cancer care
Authors: Raber Margaret , Rechis Ruth , Ho-Pham Thy , Kizub Darya , LaRue Denise , Ma Hilary , Walsh Michael T , Baum Miranda , Loomba Preena , Gardiner Haley , Basen-Engquist Karen 
Published: December 2023

This study aimed to explore cardiometabolic disease rates and related factors among a sample of oncology patients in a safety net hospital setting, as well as preferences for wellness programming from the perspective of both patients and providers. This multiple methods study included a retrospective review of electronic health record (EHR) data (n=5,136) and qualitative interviews with cancer survivors (n=31) seen at the Harris Health LBJ Hospital (LBJ Hospital) in the last five years, as well as healthcare providers (n=21) in the LBJ Oncology program. LBJ Hospital is part of Harris Health System, the safety-net public healthcare provider for the third largest county in the U.S.. The University of Texas MD Anderson Cancer Center provides oncology care at LBJ Hospital. Overall, the EHR data revealed high rates of comorbid cardiometabolic disease among patients with cancer being treated at LBJ Hospital. Over 67% of patients were prediabetic or diabetic based on HbA1c levels, and 66% had overweight or obesity. Weight fluctuated over the course of treatment, with acute weight loss at diagnosis followed by amplified weight regain into survivorship. Additionally, EHR data indicated high symptom burden was reported in the areas of tiredness, sleep, pain, well-being, poor appetite, shortness of breath, and anxiety. In interviews, survivors (including 11 still on active treatment and 20 off treatment) reported high interest in healthy eating and exercise programs, and preferred programs that were community-based and offered throughout cancer treatment and survivorship. Survivors highlighted the importance of getting information or referrals from providers regarding healthy eating and physical activity. Among interviewed healthcare providers, 90% said they would be interested in an automated referral program for healthy eating and exercise programming and 90% thought programming should start as soon as a patient was diagnosed. Ensuring the referral system was criteria-based and simple were top priorities for healthcare providers. Example metrics providers suggested using as referral criteria included BMI, weight changes, symptoms, and markers of cardiometabolic health. When asked to consider potential programs for patients to encourage healthy eating and exercise, free food/voucher programs, group classes and structural additions were mentioned, and several providers specifically mentioned the need to have programs based in a patient’s local community and/or near their primary care provider. Together, these findings suggest that there is a high need for diet and exercise interventions among the LBJ oncology population, as well as high interest in community-based programs and the integration of referrals to these programs as part of care.

Citation Format: Margaret Raber, Ruth Rechis, Thy Ho-Pham, Darya Kizub, Denise LaRue, Hilary Ma, Michael T Walsh, Miranda Baum, Preena Loomba, Haley Gardiner, Karen Basen-Engquist. Nutrition-related clinical characteristics of patients in a safety net hospital oncology program and perspectives on wellness programming during cancer care [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B057.