Purpose Integration of palliative care into oncology practice remains suboptimal. Misperceptions about the meaning of palliative care may negatively impact utilization. We assessed whether the term and/or the description of palliative care services affected patient views. Methods 2×2 between-subject randomized factorial telephone survey of 169 patients with advanced cancer. Patients were randomized into 1 of 4 groups that differed by name (supportive care vs. palliative care) and description (patient-centered vs. traditional). Main outcomes (0–10 Likert scale) were patient understanding, impressions, perceived need, and intended use of services. Results When compared to palliative care, the term supportive care was associated with better understanding (7.7 vs. 6.8; p=0.021), more favorable impressions (8.4 vs. 7.3; p=0.002), and higher future perceived need (8.6 vs. 7.7; p=0.017). There was no difference in outcomes between traditional and patient-centered descriptions. In adjusted linear regression models, the term supportive care remained associated with more favorable impressions (p=0.003) and higher future perceived need (p=0.022) when compared to palliative care. Conclusions Patients with advanced cancer view the name supportive care more favorably than palliative care. Future efforts to integrate principles of palliative medicine into oncology may require changing impressions of palliative care or substituting the term supportive care.

Background Although critics have expressed concerns about cancer center advertising, the content of these advertisements has not been analyzed. Objective To characterize the informational and emotional content of cancer center advertisements. Design Systematic analysis of all cancer center advertisements in top U.S. consumer magazines (N=269) and television networks (N=44) in 2012. Measurements Using a standardized codebook, we assessed (1) types of clinical services promoted; (2) information provided about clinical services, including risks, benefits, and costs; (3) use of emotional advertising appeals; and (4) use of patient testimonials. Two investigators independently coded advertisements using ATLAS.ti. Kappa values ranged from 0.77 to 1.0. Results A total of 102 cancer centers placed 409 unique clinical advertisements in top media markets in 2012. Advertisements promoted treatments (88%) more often than screening (18%) or supportive services (13%; p<0.001). Benefits of advertised therapies were described more often than risks (27% vs. 2%; p<0.001) but rarely quantified (2%). Few advertisements mentioned insurance coverage or costs (5%). Emotional appeals were frequent (85%), most often evoking hope for survival (61%), describing cancer treatment as a fight or battle (41%), and evoking fear (30%). Nearly half of advertisements included patient testimonials, usually focused on survival or cure. Testimonials rarely included disclaimers (15%) and never described the results a typical patient might expect. Limitations Internet advertisements were not included. Conclusions Clinical advertisements by cancer centers frequently promote cancer therapy using emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, or costs. Further work is needed to understand how these advertisements influence patient understanding and expectations of benefit from cancer treatments.

Background Evidence-based interventions exist for prevention of chronic disease in older adults. Partnering with community organizations may provide a mechanism for disseminating these interventions. Objective To describe the partnership and program implementation by the Arthritis Foundation (AF) and the University of Pittsburgh. Methods The AF Exercise Program (AFEP; an existing evidence-based program) was enhanced with the “10 Keys”™ to Healthy Aging (a prevention-focused program bundling the most common risk factors for chronic disease and disability in older adults and applies behavior change strategies to enhance prevention). The program was delivered in 20 sessions over 10 weeks by community health workers in a cluster-randomized trial. Lessons Learned Partnering with an organization having an existing infrastructure supports program delivery at the community level. This partnership provided programming in 54 sites across Pittsburgh and surrounding communities. Conclusions This collaborative partnership created a productive synergy maximizing strengths in both research and program delivery.

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e18340 Background: Online crowdfunding, where individuals create campaigns to solicit donations, has grown as an avenue to combat the financial toxicities of cancer. The online platform GoFundMe hosts more than 80% of the global market for crowdfunding and has raised over US $5 billion from more than 50 million donors. While medical expenses are the leading cause of crowdfunding campaigns, limited research is available on the use of crowdfunding for cancer costs. Further, no studies have evaluated the use of crowdfunding for patients with lung cancer. Methods: In January 2019, we reviewed the first 200 consecutive campaigns that resulted for “lung cancer” on GoFundMe. Campaigns were included for analysis if their description stated funds were to be used for medical costs for a patient with lung cancer in the United States. Standardized data was collected from each campaign. Descriptive statistics were used to aggregate results. Multivariable linear regression analysis were performed to examine predictors of funds raised, adjusting for campaign duration. Results: The 157 included campaigns raised a total of US $1.2 million (mean $8,364) from 11,919 donors (median 53). Compared to a similar 2018 study, our study showed lung cancer campaigns raised less than breast cancer (mean $16,026) but more than prostate cancer (mean $1,449) campaigns. Nine campaigns that were seeking funds for alternative treatment raised a total of $119,660 (mean $13,296). Narratives of financial need that were significantly associated with greater funds raised were family financial need (+$7,416), medical costs not covered by insurance (+$7,369), and the campaign stating the patient was a never-smoker (+$8,162) (all P values < 0.05). Conclusions: Lung cancer has received less research funding relative to other cancer types and our study suggests a similar disparity with crowdfunding for medical costs. The “blame-the-victim” attitude that contributes to this funding disparity also exists within lung cancer crowdfunding as evidenced by the significantly greater amount of funds raised for campaigns that explicitly stated the patient was a non-smoker. Efforts to study crowdfunding for cancer costs should address the ethical implications of exacerbating funding disparities and funding for alternative treatments.