Oncology Provider and Patient Perspectives on a Cardiovascular Health Assessment Tool utilized during Post-treatment Survivorship Care in Community Oncology (Mixed Method Results from WF-1804CD) (Preprint)
Authors: Nightingale Chandylen L. , Dressler Emily V. , Kepper Maura , Klepin Heide D. , Craddock Lee Simon , Smith Sydney , Aguilar Aylin , Wiseman Kimberly D. , Sohl Stephanie J. , Wells Brian J. , DeMari Joseph A. , Throckmorton Alyssa , Kulbacki Lindsey W, , Hanna Jenny , Foraker Randi E. , Weaver Kathryn E. 
Published: August 2024

BACKGROUND

The Automated Heart-Health Assessment (AH-HA) tool is a novel electronic health record clinical decision support tool based on the American Heart Association’s Life’s Simple 7 cardiovascular health (CVH) metrics to promote CVH assessment and discussion in outpatient oncology. Before proceeding to future implementation trials, it is critical to establish the acceptability of the tool among providers and survivors.

OBJECTIVE

We assessed provider and survivor acceptability of the AH-HA tool and provider training at practices randomized to the AH-HA tool arm within WF-1804CD.

METHODS

Providers (physicians, nurse practitioners, physician assistants) completed a survey to assess acceptability of the AH-HA training, immediately following training. Providers also completed surveys to assess AH-HA tool acceptability and potential sustainability. Tool acceptability was assessed after 30 patients were enrolled at the practice with both a survey developed for the study as well as with domains from the Unified Theory of Acceptance and Use of Technology (UTAUT) survey (Performance Expectancy, Effort Expectancy, Attitude Toward using Technology, and Facilitating Conditions). Semi-structured interviews at the end of the study captured additional provider perceptions of the AH-HA tool. Post-treatment survivors (breast, prostate, colorectal, endometrial, and lymphomas) completed a survey to assess acceptability of the AH-HA tool immediately after the designated study appointment.

RESULTS

Providers (n=15) reported high overall acceptability of the AH-HA training (mean=5.8, SD=1.0) and tool (mean=5.5, SD =1.4); provider acceptability was also supported by UTAUT scores (e.g., Effort Expectancy mean=5.6, SD=1.5). Qualitative data also supported provider acceptability of different aspects of the AH-HA tool (e.g., It helps focus the conversation and give the patient a visual of continuum of progress). Providers were more favorable about using the AH-HA tool for post-treatment survivorship care. Enrolled survivors (n=245) were an average of 4.4 years post-treatment (SD =3.7). Most survivors reported that they strongly agreed/agreed that they liked the AH-HA tool (94.3%, n=231). A larger proportion of survivors with high health literacy strongly agreed/agreed that it was helpful to see their heart health score (98.2%, n=161) compared to survivors with lower health literacy scores (89.5%, n=68; p=0.005).

CONCLUSIONS

Quantitative surveys and qualitative interview data both demonstrate high acceptability of the AH-HA tool among both providers and survivors. Although most survivors found it helpful to see their heart health score, there may be room for improving communication with survivors who have lower health literacy.

CLINICALTRIAL

Assessing Effectiveness and Implementation of an EHR Tool to Assess Heart Health Among Survivors (AH-HA)
NCT03935282
https://clinicaltrials.gov/study/NCT03935282?term=NCT03935282&rank=1

INTERNATIONAL REGISTERED REPORT

RR2-https://doi-org.wake.idm.oclc.org/10.1016/j.conctc.2021.100808