The Tablet-Based, Engagement, Assessment, Support, and Sign-Posting (EASSi) Tool for Facilitating and Structuring Sexual Well-Being Conversations in Routine Prostate Cancer Care: Mixed-Methods Study

Abstract

Background: Long-term side-effects associated with different prostate cancer treatment approaches are common. Sexual challenges are the most frequently occurring issues and can result in increased psychological morbidity. It is recognized that barriers to communication can make initiating discussions around sexual concerns in routine practice difficult. Health care professionals need to routinely initiate conversations, effectively engage with patients, and assess needs in order to provide essential support. One proposed method that could support health care professionals to do this involves the use of prompts or structured frameworks to guide conversations. Objective: This study aimed to assess feasibility, acceptability, and satisfaction with the tablet-based Engagement, Assessment, Support, and Sign-posting (EASSi) tool designed to facilitate and structure sexual well-being discussions in routine prostate cancer care. Methods: Health care professionals (n=8) used the EASSi tool during 89 posttreatment appointments. Quantitative data were recorded based on program usage and surveys completed by health care professionals and patients. Qualitative data exploring perceptions on use of the tool were gathered using semistructured interviews with all health care professionals (n=8) and a sample of patients (n=10). Results: Surveys were completed by health care professionals immediately following each appointment (n=89, 100%). Postal surveys were returned by 59 patients (66%). Health care professionals and patients reported that the tool helped facilitate discussions

Effects of a Brief E-Learning Resource on Sexual Attitudes and Beliefs of Healthcare Professionals Working in Prostate Cancer Care: A Pilot Study

“…These barriers can provide an ‘opt-out’ option leading to healthcare professionals not initiating discussions, potentially based on a perception that the patient is not ready or does not wish to discuss sexual issues [ 44 ]. While the EASSi engagement framework included in the e-learning draws on some aspects of these existing models, it attempts to build upon them by ensuring wider access to routine sexual care and support in prostate cancer care [ 45 ]. Its theoretical underpinning is more closely related to brief behaviour change models such as the 5 A’s model [ 46 ], which has been used as a framework to guide discussions in behavioural counselling interventions for smoking cessation and weight loss [ 47 , 48 ].…”

Application of the unified theory of behavior to strengthen sexual health discussions between providers and young patients in the United States

“…19 For example, evidencebased conceptual frameworks have been found to be valuable in helping providers talk to patients about sexual well-being and increasing the frequency with which providers discussed sexual well-being with patients. 28,29 Similarly, the use of a behavioral conceptual framework that articulates an individual's behavioral intentions and the factors that influence and moderate those intentions may also be a useful tool to facilitate conversations around sexual health. We propose the Unified Theory of Behavior (UTB), 30 a conceptual framework for examining proximal determinants of behavior, may be a tool that can help health care providers gain a more holistic and contextualized understanding of young patients' sexual health and well-being.…”

“… 26,27 However, given consistent and glaring evidence highlighting the lack of comprehensive sexual health conversations with adolescent and young adult patients, health care providers may benefit from additional tools and supports that aid them in broadening the scope of sexual health conversations 19 . For example, evidence‐based conceptual frameworks have been found to be valuable in helping providers talk to patients about sexual well‐being and increasing the frequency with which providers discussed sexual well‐being with patients 28,29 . Similarly, the use of a behavioral conceptual framework that articulates an individual's behavioral intentions and the factors that influence and moderate those intentions may also be a useful tool to facilitate conversations around sexual health.…”

Effects of a Brief e-Learning Resource on Sexual Attitudes and Beliefs of Healthcare Professionals Working in Prostate Cancer Care: A Single Arm Pre and Post‐Test Study

“…These barriers can provide an 'opt-out' option leading to healthcare professionals not initiating discussions, potentially based on a perception that the patient is not ready or does not wish to discuss sexual issues [46]. While the EASSi engagement framework included in the e-learning draws on some aspects of these existing models, it attempts to build upon them by ensuring wider access to routine sexual care and support in prostate cancer care [47]. Its theoretical underpinning is more closely related to brief behaviour change models such as the 5 A's model [48] which has been used as a framework to guide discussions in behavioural counselling interventions for smoking cessation and weight loss [49,50].…”