Implementing pathways to identify and address employment concerns among people with cancer across diverse clinical settings

PROJECT SUMMARY/ABSTRACT Cancer diagnosis and treatment can lead to loss or reduction of employment with resulting losses of income, health insurance, and quality of life. These employment changes exacerbate the financial strain that people with cancer often experience. The overall objective of this project is to identify and refer patients with employment concerns to existing employment support resources through implementation and evaluation of an adaptive screening and referral workflow in diverse cancer care settings. Dr. Forcino will conduct a patient- level needs and assets assessment (Aim 1), evaluate implementation determinants at the clinic level (Aim 2), and design and pilot test an adaptive clinical workflow for screening and referral (Aim 3). These activities support NCI's stated goals of improving employment outcomes among cancer survivors, facilitating systematic financial hardship screening, and implementing health care delivery interventions that provide psychosocial support. Dr. Forcino is a newly-appointed Assistant Professor in the University of Kansas School of Medicine's Department of Population Health. To supplement Dr. Forcino's experience in patient-reported outcome measurement, interventions focused on literacy-based disparities, conducting key informant interviews, and research project management, she will pursue 4 training objectives. These include: (1) Developing methodological skills to conduct rigorous implementation research, including implementation science and pragmatic clinical trials; (2) Understanding social determinants and their interactions with health and social care delivery systems; (3) Learning the principles of participatory research and applying them to the proposed research program; and (4) Learning key professional skills to successfully lead an interdisciplinary research team. Dr. Forcino will be mentored throughout the award period by Dr. Simon Lee (primary mentor, University of Kansas School of Medicine), Dr. Ronald Chen (co-mentor, University of Kansas School of Medicine), and Dr. Kathleen Lyons (co-mentor, MGH Institute of Health Professions) to support her progression as a cancer control scientist. Dr. Forcino's long-term objective as an independent investigator is to sustain a patient- centered research program focused on implementing innovations to improve healthcare quality and patient experience with a focus on social needs among people living with cancer.