Evaluation of a survivorship needs assessment planning tool for head and neck cancer survivor-caregiver dyads

Abstract

Purpose: The objectives of this study were to test the acceptability and feasibility of a survivorship needs assessment planning (SNAP) tool for head and neck cancer (HNC) survivors and caregivers, evaluate short-term changes in psychosocial outcomes after completing the SNAP session and develop strategies for system refinement. Methods:We used a prospective one-group design and mixed methods with HNC survivors and caregivers (N=25 dyads). Participants completed baseline and 6-week surveys before and after completing a SNAP clinic visit to assess psychosocial outcomes and acceptability. Intervention sessions included tablet-based needs assessments driving tailored care plans. Dyads' open-ended feedback and clinician interviews (N=12) evaluated acceptability and feasibility.Results: SNAP data collection time burden and technology challenges were minimal and care plans included messages (M=19), educational materials (M=13) and referrals (M=4.5; 86% Behavioral Medicine, 77% Nutrition, 65% Physical Therapy). Participants reported high satisfaction with the session and care plan, highlighting the key strengths of pulling complex medical information together and the focus on caregiver well-being, with multiple suggestions to facilitate clinic workflow. Depression and unmet needs decreased and survivorship knowledge increased significantly in survivors and caregivers (p <.05) over the 6-week period. Conclusions:The SNAP tool is an innovative technology-based survivor-centered strategy to assess and manage needs in HNC survivors and caregivers. Results support its acceptability and ability to address dyads' needs; the tool merits further testing in a clinical trial.

Family Caregivers’ Experiences of Caring for Patients With Head and Neck Cancer

“…One previous dyadic, web-based intervention developed in a qualitative study using interactive health communication technologies has shown a promising effect in facilitating the HNC survivors and caregivers during the usability testing period. 66 Sterba and colleagues 24 tested the acceptability and feasibility of a technology-based care planning tool (SNAP) and found it was productive to assess and address HNC dyads’ dynamic needs. In a wellness program interest survey, caregivers reported their preference to receive programs delivered by mail including tangible and mobile materials.…”

Interventions for head and neck cancer survivors: Systematic review

“…Thirteen studies targeted surveillance and management of psychosocial effects (Table 2). Four studies focused on psychosocial outcomes of cancer treatment as the primary study outcome, including one RCT with a high risk of bias 21 and three non‐randomized studies with a medium 28 to high risk of bias 34,40 . The RCT studied sexual interest after a stepped care program intervention targeting psychological distress; this trial did not show a statistically significant effect 21 .…”

“…The RCT studied sexual interest after a stepped care program intervention targeting psychological distress; this trial did not show a statistically significant effect 21 . The non‐randomized studies looked at the effect of a nurse‐led intervention on psychosocial adjustment and health‐related quality of life (HRQOL) showing no statistically significant difference between groups, 28 the effect on self‐efficacy with a web‐based tool showing an improvement with descriptive statistics but no tests of significance, 34 and a statistically significant improvement in depression, unmet needs, and survivorship knowledge in both survivors and care‐givers 40 . Of note, this was the only study identified by this systematic review that targeted an intervention to the patient‐caregiver dyad rather than the survivor alone.…”

“…We identified very few studies targeting common HNC psychosocial symptoms and conditions, specifically fatigue, neurocognitive function, depression, sexual health, and coping. Only two small studies of Internet‐based tools specifically targeted depression and unmet survivorship needs, both showing favorable effects, but requiring more definitive clinical trials with longer follow‐up to demonstrate benefit 34,40 . Additionally, we did not identify interventions addressing hearing loss 45 and renal dysfunction associated with cisplatin‐induced kidney injury, 46 which are both important side effects of treatment with chemotherapy that impact long‐term physical health and function.…”

“…Additional reasons for introduction of bias included incomplete information on follow-up of participants, 15 limited information on power calculations, 14,21,22 and lack of target accrual 13 or patient attrition. 19 The 15 non-randomized studies included 12 with a high risk of bias 25,27,29,[32][33][34][35][36][37][38][39][40] and three with a medium risk of bias. 26,28,30,31 Common reasons for introducing bias included lack of planned sample size/power calculations or pre-specified endpoints.…”