Pilot study of implementing the Shared Healthcare Actions & Reflections Electronic systems in Survivorship (SHARE‐S) program in coordination with clinical care

Abstract

AbstractIntroductionInitial cancer survivorship care planning efforts focused on information sharing demonstrated limited impact on patient health outcomes. We designed the Shared Healthcare Actions & Reflections Electronic Systems in survivorship (SHARE‐S) program to enhance survivorship guideline implementation by transitioning some effort from clinicians to technology and patients through supporting health self‐management (e.g., healthy lifestyles).MethodsWe conducted a single‐group hybrid implementation‐effectiveness pilot study. SHARE‐S incorporated three strategies: (1) e‐referral from the clinical team for patient engagement, (2) three health self‐management coach calls, and (3) text messages to enhance coaching. Our primary implementation measure was the proportion of patients e‐referred who enrolled (target >30%). Secondary implementation measures assessed patient engagement. We also measured effectiveness by describing changes in patient health outcomes.ResultsOf the 118 cancer survivor patients e‐referred, 40 engaged in SHARE‐S (proportion enrolled = 34%). Participants had a mean age of 57.4 years (SD = 15.7), 73% were female, 23% were Black/African American, and 5 (12.5%) were from a rural location. Patient‐level adherence to coach calls was >90%. Changes from baseline to follow‐up showed at least a small effect (Cohen's d = 0.2) for improvements in: mindful attention, alcohol use, physical activity, fruit and vegetable intake, days of mindfulness practice, depressive symptoms, ability to participate in social roles and activities, cancer‐specific quality of life, benefits of having cancer, and positive feelings.ConclusionThe SHARE‐S program successfully engaged cancer survivor patients. Once enrolled, patients showed promising improvements in health outcomes. Supporting patient self‐management is an important component of optimizing delivery of cancer survivorship care.