ENACCTing WELLNESS- a Community Centered Intervention to Enhance Treatment Option Decision- Making among Newly Diagnosed and Recurrent Hematologic Cancer Patients

Background: Less than three percent of adult cancer patients participate in cancer clinical trials. This rate is even lower among people of color and the medically underserved who tend to have higher cancer mortality rates than the population as a whole. With timely diagnosis and enhanced access to clinical trials, more patients with blood cancers will have expanded options for treatment and the opportunity to receive quality cancer care.

Methodology: ENACCTing WELLNESS is a pilot project with the Education Network to Advance Cancer Clinical Trials (ENACCT) and The Wellness Community (TWC), which seeks to demonstrate how community-centered education, outreach and support services can both address informational needs and enhance access to care among those living with blood cancers in four communities nationwide. Using an innovative ecological framework directing educational efforts at the intrapersonal, interpersonal, institutional and community perspectives, ENACCTing WELLNESS:

1. Provides one-on-one treatment decision support with a trained facilitator, using an evidence-based decision-making model, SCOPED (Situation-Choices-Objectives-People-Evaluation-Decisions), to prompt newly diagnosed/newly recurred patients to list questions about their diagnosis and treatment, including the option of receiving their treatment though a clinical trial;

2. Increases awareness of support services for patients, their family members, friends, and caregivers;

3. Educates primary care providers, especially those caring for the medically underserved, about options to refer patients to local clinical trials for first line treatment; and

4. Enhances cultural competency skills of local clinical trial investigators and their teams.

Results: This session will discuss the use of the SCOPED model in the conceptual framework of ENACCTing WELLNESS, and the collaborative effort between two community-centered organizations to enhance patient treatment decision-making options through provider training, referral, and one-on-one patient counseling. We will report lessons learned from phase I of the pilot study and preliminary evaluation data from health care provider training.

Implications: The framework implemented in this pilot may result in increased and timely primary care referral of patients with a suspected hematologic cancer and may assure decision quality as measured by high levels of decision self-efficacy and low levels of decision regret among patients contemplating treatment choices.