Validation of the Spanish Version of the Psychosocial Assessment Tool (PAT) in Pediatric Cancer

163 Background: In 2012, a congressional symposium identified the need for services to address psychosocial issues of children with cancer. In 2013, the Institute of Medicine recommended supportive oncology services be initiated at cancer diagnosis. Chicago providers of pediatric cancer are collaborating to improve care for children with cancer and their families focusing on psychosocial stressors and quality of life. Methods: The collaborative conducted a structured review of tools: Psychosocial Assessment Tool (PAT), Social Work Assessment Tool (SWAT), National Comprehensive Cancer Network (NCCN) Problem List, and √IN; with input from providers on stressors throughout the care continuum. The resulting screening tool was created and piloted in English and Spanish at 7 pediatric cancer hospitals. Social workers (SW) informally reported assessment of its usefulness. Results: Parents (n = 85) completed “Getting to Know You and Your Child” screening tool which inquired about caregivers, siblings, child’s interests, school, SSI/SNAP, challenges, and cultural/religious preferences. Providers reported families found the tool useful “to think about support needs.” The tool assessed 12 psychosocial stressors; the mean per patient/family was 2.4 (range 0-11). Most frequent stressors included: lack of support from friends, family, community (29%), paying for food (26%), job flexibility (26%), paying for utilities (25%), medical costs (23%), emotional support for family (22%), school concerns (21%). All who reported temporary residence also reported difficulty paying for housing (p < 0.01). Ten SWs reported this screening tool generated new insight into family structures, identified stressors and informed resolution efforts. Provider recommended adjustments to the screening tool: simplify terms for siblings, hobbies and spiritual, add pet question. Conclusions: Pilot testing of a psychosocial screening tool for pediatric and adolescent oncology informed providers of patient/family needs in a standard manner. Six of the seven pilot sites are implementing this tool as a standard practice. Preliminary data suggests patients and providers find the screener easy to use and informative.

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"Getting to know you and your child" screening questionnaire: Results from a Chicago-based collaborative.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.7_suppl.150 ◽

2018 ◽

Vol 36 (7_suppl) ◽

pp. 150-150

Author(s):

Christine B. Weldon ◽

Betty Roggenkamp ◽

Erika D Owen ◽

Jennifer Reichek ◽

Zayda Stewart ◽

...

Keyword(s):

Pediatric Cancer ◽

Assessment Tool ◽

Psychosocial Assessment ◽

Institute Of Medicine ◽

Family Needs ◽

Social Stressors ◽

Family Structures ◽

Standard Manner ◽

Almost All ◽

Adolescent Oncology

150 Background: In 2013 the Institute of Medicine recommended that supportive oncology services be initiated at time of cancer diagnosis. Providers of pediatric cancer care in the Chicago metro area, supported by The Coleman Foundation, created and pilot tested a standard psycho-social stressors screening instrument for children with cancer and their families. Methods: The collaborative conducted structured review of tools: Psychosocial Assessment Tool (PAT), Social Work Assessment Tool (SWAT), National Comprehensive Cancer Network (NCCN) Problem List, and √IN; and collected input from social workers and oncology providers on stressors throughout the care continuum. The resulting tool was piloted in English and Spanish at 7 pediatric cancer hospitals. Providers qualitatively reported assessment of its usefulness. Results: Patients/family (n = 57) completed the “getting to know you and your child” instrument which inquired about caregivers, siblings, child’s likes/hobbies, school situation, SSI/SNAP, challenges, and cultural/religious preferences. Providers reported that almost all families found the tool useful “to think about support needs”; one said it was invasive. The tool assessed 12 psychosocial stressors; the mean per patient/family was 2.49 (range 0-11). The most frequent stressors were support from friends, family, community (30%), paying for food (26%), job flexibility (26%), school concerns (25%), emotional support for family (25%), and medical costs (23%). All who reported temporary housing also reported difficulty paying for a place to live (p < 0.0001). Providers reported that the standard tool generated new insight into family structures, challenges and needs informing resolution efforts. Provider recommended adjustments: simplify terms for siblings, hobbies and spiritual, adding question about pets in the home. Conclusions: Pilot testing of a psycho-social screening tool for pediatric and adolescent oncology informed providers of patient/family needs in a standard manner. Four of the seven sites involved in the pilot are now implementing this tool as a standard practice; the remaining sites are performing analyses on how to incorporate the tool into their care processes.

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Implementation of family psychosocial risk assessment in pediatric cancer with the Psychosocial Assessment Tool (PAT): Study protocol for a cluster randomized comparative effectiveness trial

10.21203/rs.3.rs-38392/v1 ◽

2020 ◽

Author(s):

Anne Kazak ◽

Janet Deatrick ◽

Michele Scialla ◽

Eric Sandler ◽

Rebecca Madden ◽

...

Keyword(s):

Pediatric Cancer ◽

Comparative Effectiveness ◽

Assessment Tool ◽

Psychosocial Care ◽

Implementation Strategies ◽

Interactive Systems ◽

Psychosocial Assessment ◽

Use Of Resources ◽

Healthcare Needs ◽

Cluster Randomized

Abstract BackgroundChildhood cancer affects and is affected by multiple levels of the social ecology, including social and relational determinants of health (e.g. economic stability, housing, childcare, healthcare access, child and family problems). The 2015 Standards of Psychosocial Care in Pediatric Cancer outline optimal psychosocial care sensitive to these ecological factors, starting with assessment of psychosocial healthcare needs to promote medical and psychosocial outcomes across all children with cancer. To address the first standard of family psychosocial assessment, the Psychosocial Assessment Tool (PAT) is a validated screener ready for broad implementation.MethodThe PAT will be implemented across a national sample of 18 pediatric cancer programs ranging in size (annual new patients) in a mixed methods, comparative effectiveness study, guided by the Interactive Systems Framework for Dissemination and Implementation, comparing two implementation Strategies. It is hypothesized that implementation will be more successful at the patient/family, provider, and institutional level when Training (Strategy I) is combined with Implementation Expanded Resources (Strategy II). There are three aims: 1) Refine the two implementation strategies using semi-structured qualitative interviews with 19 stakeholders including parent advocates, providers, pediatric oncology organization representatives, healthcare industry leaders; 2) Compare the two theoretically based and empirically informed strategies to implement the PAT in English and Spanish using a cluster randomized controlled trial across 18 sites. Stratified by size, sites will be randomized to cohort (3) and strategy (2). Outcomes include adoption and penetration of screening (patient/family), staff job satisfaction/burnout (provider), and cost effective use of resources consistent with family risk (institution); 3) Based on the results of the trial and feedback from the first and second aim, we will develop and disseminate a web-based PAT Implementation Toolkit.DiscussionUse of the PAT across children’s cancer programs nationally can achieve the assessment Standard and inform equitable delivery of psychosocial care matched to family need for all patients.Trial RegistrationClinicalTrials.gov, NCT04446728, registered 23 June 2020

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Implementation of family psychosocial risk assessment in pediatric cancer with the Psychosocial Assessment Tool (PAT): study protocol for a cluster-randomized comparative effectiveness trial

Implementation Science ◽

10.1186/s13012-020-01023-w ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Anne E. Kazak ◽

Janet A. Deatrick ◽

Michele A. Scialla ◽

Eric Sandler ◽

Rebecca E. Madden ◽

...

Keyword(s):

Risk Assessment ◽

Study Protocol ◽

Pediatric Cancer ◽

Comparative Effectiveness ◽

Assessment Tool ◽

Psychosocial Risk ◽

Psychosocial Assessment ◽

Effectiveness Trial ◽

Cluster Randomized ◽

Psychosocial Risk Assessment

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First experience with electronic feedback of the Psychosocial Assessment Tool in pediatric cancer care

Supportive Care in Cancer ◽

10.1007/s00520-017-3719-3 ◽

2017 ◽

Vol 25 (10) ◽

pp. 3113-3121 ◽

Cited By ~ 4

Author(s):

Sasja A. Schepers ◽

Simone M. Sint Nicolaas ◽

Heleen Maurice-Stam ◽

Elisabeth M. van Dijk-Lokkart ◽

Esther M. M. van den Bergh ◽

...

Keyword(s):

Pediatric Cancer ◽

Cancer Care ◽

Assessment Tool ◽

Psychosocial Assessment ◽

Electronic Feedback

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Implementation of family psychosocial risk assessment in pediatric cancer with the Psychosocial Assessment Tool (PAT): Study protocol for a cluster randomized comparative effectiveness trial

10.21203/rs.3.rs-38392/v2 ◽

2020 ◽

Author(s):

Anne Kazak ◽

Janet Deatrick ◽

Michele Scialla ◽

Eric Sandler ◽

Rebecca Madden ◽

...

Keyword(s):

Pediatric Cancer ◽

Comparative Effectiveness ◽

Assessment Tool ◽

Psychosocial Care ◽

Implementation Strategies ◽

Interactive Systems ◽

Psychosocial Assessment ◽

Use Of Resources ◽

Healthcare Needs ◽

Cluster Randomized

Abstract Background: Childhood cancer affects and is affected by multiple levels of the social ecology, including social and relational determinants of health (e.g. economic stability, housing, childcare, healthcare access, child and family problems). The 2015 Standards of Psychosocial Care in Pediatric Cancer outline optimal psychosocial care sensitive to these ecological factors, starting with assessment of psychosocial healthcare needs to promote medical and psychosocial outcomes across all children with cancer. To address the first standard of family psychosocial assessment, the Psychosocial Assessment Tool (PAT) is a validated screener ready for broad implementation. Method: The PAT will be implemented across a national sample of 18 pediatric cancer programs ranging in size (annual new patients) in a mixed methods, comparative effectiveness study, guided by the Interactive Systems Framework for Dissemination and Implementation, comparing two implementation Strategies. It is hypothesized that implementation will be more successful at the patient/family, provider, and institutional level when Training (Strategy I) is combined with Implementation Expanded Resources (Strategy II). There are three aims: 1) Refine the two implementation strategies using semi-structured qualitative interviews with 19 stakeholders including parent advocates, providers, pediatric oncology organization representatives, healthcare industry leaders; 2) Compare the two theoretically based and empirically informed strategies to implement the PAT in English and Spanish using a cluster randomized controlled trial across 18 sites. Stratified by size, sites will be randomized to cohort (3) and strategy (2). Outcomes include adoption and penetration of screening (patient/family), staff job satisfaction/burnout (provider), and cost effective use of resources consistent with family risk (institution); 3) Based on the results of the trial and feedback from the first and second aim, we will develop and disseminate a web-based PAT Implementation Toolkit. Discussion: Use of the PAT across children’s cancer programs nationally can achieve the assessment Standard and inform equitable delivery of psychosocial care matched to family need for all patients.Trial Registration: ClinicalTrials.gov, NCT04446728, registered 23 June 2020

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