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Meeting the guidelines: Implementing a distress screening intervention for veterans with cancer
Author(s) -
Azizoddin Desiree R.,
Lakin Joshua R.,
Hauser Joshua,
Rynar Lauren Z.,
Weldon Christine,
Molokie Robert,
Enzinger Andrea C.,
Payvar Susan,
Martin Joanna L.
Publication year - 2020
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.5565
Subject(s) - psychosocial , referral , medicine , distress , family medicine , population , veterans affairs , psycho oncology , psychological intervention , cancer screening , cancer , psychiatry , clinical psychology , environmental health
Background Guidelines recommend systematic evaluation of distress screening and referral for cancer patients. Implementation remains a notable gap for cancer centers serving disadvantaged communities. We present the implementation of a distress screening program within a Veterans Affairs hospital oncology clinic, serving a majority African American (AA) male population of low socioeconomic status (SES). Methods The Coleman Foundation funded this program supporting a palliative care physician and psychologist to implement screening in a phased approach as follows: (1) Organizing key stakeholders, (2) educating clinical staff, (3) delivering distress screening, (4) generating documentation, and (5) implementing clinical action and referral pathways. We utilized validated measures in the “Patient Screening Questions for Supportive Care” screening tool. Results This program was unsuccessful in screening all veterans with cancer; however, we were able to implement 3 years of longitudinal screening. In distress screens from the initial program period ( n = 253), patients were primarily males (95.6%) of older age ( m = 70, standard deviation = 9.45), AA (76.4%), with various cancers of advanced disease (69%). Males reported moderate psychosocial distress and elevated financial needs. For males with elevated psychosocial distress ( n = 63, PHQ‐4 ≥3), 36% were previously connected with psychosocial services. Following screening, engagement increased as the majority (77%) established psychosocial care. Conclusions This screening program had mixed success. Centralized program staff and available supportive care referrals were critical for program implementation. Screening may have increased engagement in social work/mental health services for males of low SES. Screening programs should be tailored to the needs of underserved communities with accessible housing/food subsidies.