Abstract B069: Patient perspectives on reimagining survivorship care: A “Chipotle” model to enhance personalized cancer recovery
Authors: Jaffe Shoshana Adler , Rieder Stephanie , Gundelach Amy C. , Boyce Tawny , Rutledge Teresa , Dayao Zoneddy , Sussman Andrew L. , Kano Miria 
Published: January 2023

Abstract
Background: As the population in the United States grows, diversifies, and lives longer, the number of cancer survivors is expected to increase from 15.5 million (2016) to an estimated 20.3 million by 2026. Cancer survivors require surveillance for recurrent and subsequent malignancies, management of long-term and late effects of cancer treatment, consistent care to address comorbid conditions, health promotion and care coordination. Current survivorship care relies on distribution of a highly formulaic survivorship care plans. It likewise lacks mechanisms for communication between the oncology care team and patients’ primary care providers who see them for follow up care. Such service limitations hinder patient-responsive care for ethnically/racially, geographically, culturally and socioeconomically diverse cancer patients. Methods: Between 2020 and 2021, we convened a socio-demographically diverse Patient Advisory Board (PAB) to explore ways to improve survivorship care. All PAB members had breast or gynecological cancer diagnoses within the past five years. The research team developed discussion guides prior to each meeting to facilitate a wide ranging conversation. We conducted five PAB meetings via Zoom, maintained communication via email, and distributed four surveys on the web-based Snap Survey platform to discuss topics brought up during previous meetings or to introduce ideas for in-depth discussion at next meetings. We recorded conversations, transcribed them, and used thematic coding to identify key points for care transformation. Results: PAB members highlighted three key ideas to improve survivorship care. 1) It should not begin after treatment concludes, instead, it is a continuum with three distinct stages: diagnosis, treatment, and post-treatment. 2) Tailored documents should be generated for each patient at each stage containing stage specific medical information as well as guidance and resources on topics aligned with the patient’s unique goals for recovery. 3) Communication between a patient’s PCP and the oncology care team should begin at diagnosis and continue post-treatment, and include the patient. The PAB and research team envisioned a “Chipotle” model whereby patients have the opportunity to customize their care needs by choosing from a menu of options. The foundation (or “tortilla”) of this model allows for standard medical information to be included and serve as the foundational layer. At each survivorship stage, patients could add selected “toppings” as needed (i.e., mental health services, financial counseling, nutrition, sexual health and education, and exercise and well-being) to encourage cancer recovery. PAB members suggested that this model would allow them to play an active role in their survivorship care journeys. Conclusion: The PAB outlined a clear potential design to improve cancer survivorship care. Future work should pilot this new design to determine the acceptability and usefulness of such a model.
Citation Format: Shoshana Adler Jaffe, Stephanie Rieder, Amy C. Gundelach, Tawny Boyce, Teresa Rutledge, Zoneddy Dayao, Andrew L. Sussman, Miria Kano. Patient perspectives on reimagining survivorship care: A “Chipotle” model to enhance personalized cancer recovery [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B069.