Abstract P4-11-19: Utilization of the RE-AIM frameworkfor evaluating the implementation of group medical visit for low-income breast cancer survivors
Authors: Trejo Evelin , Velazquez Ana I. , Castillo Elizabeth , Cicerelli Barbara , McBride Robin , Burke Nancy J. , Dixit Niharika 
Published: March 2022

Abstract
Introduction: Providing cost effective comprehensive survivorship care (SC) remains a major challenge for which optimal delivery models are needed. Group medical visits (GMV) are commonly used in chronic diseases to deliver medical care, education, and empower patients. Pilot GMV studies for breast cancer survivors (BCS) have shown increases in peer support and patient education. This pilot study uses the RE-AIM framework for evaluation of the GMV intervention to support breast cancer survivors. RE-AIM is an efficient framework for systematic evaluation of health care interventions. RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) is the evaluation methodology based on the framework developed by a working team of scholars from health care, public health, and implementation science. Methods: The study was conducted at a public hospital in California. GMV consisted of 4, 2-hour, weekly sessions focused on therapy side effects and prevention, emotional health, sexual health, physical activity, and diet. Patient navigator (PN) recruited 3 consecutive GMV groups of 6 English-speaking BCS (n=18). Results: The Reach was determined by the number and proportion of participants in this study. Our participants were primarily English-speaking and were within 1-5 years of completing active breast cancer treatment. Participants of the GMV were from diverse backgrounds and low-income neighborhoods in San Francisco and were representative of breast cancer survivors in our population. Effectiveness of GMV were assessed through self-reported changes with increased knowledge of survivorship care plans, recognition, and management of long-term side effects of cancer treatments and knowledge of community-based resources. There was an increase from baseline in all these domains and in confidence communicating with their primary care provider. Adoption involved initial stakeholder engagement in the intervention and Implementation was assessed by the consistent content and delivery of the intervention. We did not evaluate Maintenance as it was out of the scope of this study. We found that ongoing need for services is extremely high in our BCS, suggesting that this intervention has the potential to be widely adopted by cancer survivors and survivorship programs. Overall, consistent attendance and active participation indicated that GMV are feasible in this setting. 94% of BCS reported GMV increased their awareness and confidence of SC. Participants reported high satisfaction, felt well-informed, and supported through the availability of GMV. BCS highlighted the benefits of integrating treatment, services, emotional support, and education. BCS suggested GMV should be implemented at time of cancer diagnosis and emphasized the key role of PN in GMV and supporting SC. Conclusions: GMVs were specifically designed to address unmet needs for services that are necessary for SC but not readily available. Our pilot data suggests PN facilitated GMV are a feasible and acceptable model to integrate SC in public hospitals. The evaluation of our intervention using the RE-AIM framework can aid potential adopters in developing and implementing GMV intervention to support BCS.
Citation Format: Evelin Trejo, Ana I. Velazquez, Elizabeth Castillo, Barbara Cicerelli, Robin McBride, Nancy J. Burke, Niharika Dixit. Utilization of the RE-AIM frameworkfor evaluating the implementation of group medical visit for low-income breast cancer survivors [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-19.