Evaluation of Psychosocial Support Services for Adolescent and Young Adult Patients at Roswell Park Cancer Institute Allison Polakiewicz, MPA Project Proposal.

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Evaluation of Psychosocial Support Services for Adolescent and Young Adult Patients at Roswell Park Cancer Institute Allison Polakiewicz, MPA Project Proposal Project Advisor: Dr. Warden The Adolescent and Young Adult (AYA) population of cancer patients is one that is often mixed in with the population of pediatric and adult patients when it comes to their treatment plans. It is important for the caregivers of AYAs to understand that they have specific needs, which differ from those of pediatric and adult patients. As AYAs are classified as a group between the ages of 15-39, they face several psychosocial issues and challenges that become even more difficult to deal with when they have a diagnosis like cancer. These challenges include, but are not limited to, education and career attainment, dating, family and friend relationships, developing a healthy body image, increased health risks, self- esteem, stress, depression, financial burdens, and fertility concerns. The purpose of this study is to evaluate the effectiveness of the Psychosocial Support Services for Adolescent and Young Adult (AYA) Patients at Roswell Park Cancer Institute (RPCI). This program evaluation will use a mixed methods approach as an explanatory sequential design. To evaluate program effectiveness, quantitative data will be collected through surveying the patients who are currently utilizing the Support Group. To further explain the data from the quantitative results, a qualitative phase will be conducted as a follow up through focus groups and interviews. Results will be used to determine factors such as whether or not the program is meeting its goals and objectives, what the program is doing successfully in efforts to promote and offer their services, areas and suggestions for improvement in efforts to increase the number of clients, and overall effectiveness of the services on the patients who utilize them. Introduction and Purpose Statement The AYA population of cancer patients is a unique group with specific needs that are different from pediatric and adult patients. As AYAs are classified as a group between the ages of 15-39, they face several psychosocial issues and challenges that become even more difficult to deal with when they have a diagnosis like cancer. Tasks such as education and career attainment, relationships with family and friends, body image, and infertility concerns are just a few of the many areas of concern for AYA cancer patients. Unfortunately, AYA patients are often treated as either pediatrics or adults (Hanson, 2014). The quality of care that AYA patients are receiving is important to understand. Literature Review It is important that the healthcare professionals are able to identify such emotional struggles and provide recommendations of support services to the patient. It is strongly advised by the NCCN Guidelines that AYA cancer patients be referred to cancer centers that have expertise and experience in treating this age group. (National Comprehensive Cancer Network, 2015) As a preventative approach, regular psychosocial screenings and care planning helps the healthcare providers to identify the patients who are at risk of negative psychosocial outcomes, monitor their coping, and identify areas of need which require additional care and support (Palmer, Patterson et al., 2014). A number of quality of life (QoL) and unmet needs tools for adult cancer patients and survivors are available, however, very few measures specific to AYAs have been identified. Self-report measures are often preferred for assessing psychosocial health, but there is a need for these measures need to accurately reflect the unique situation of AYAs. Literature Review Continued The technique used in order to select participants for this research was a convenience sample. The sampling frame included all Adolescent and Young Adult (AYA) patients at Roswell Park Cancer Institute (RPCI) who utilized the Psychosocial Support Services monthly meetings, offered through the Psychosocial Oncology Department. The technique of a convenience sample was selected so that the patients who are in need of psychosocial support could be as fairly represented as possible. As the size of this sample is smaller than that of the actual population of AYA patients at RPCI, it is expected that not all of the results obtained can be applied towards all AYAs. The sample was selected as a means to benefit RPCI in evaluating the effectiveness of their Psychosocial Support Services for AYAs. As RPCI is a National Cancer Institute- designated Comprehensive Cancer Center, results and recommendations made through this research can potentially be applied to other cancer centers which treat AYAs. Sample Selection Hypothesis 1: The Psychosocial Support Services for Adolescent and Young Adults at Roswell Park Cancer Institute are successfully meeting their goals and objectives. Null Hypothesis: The Psychosocial Support Services for Adolescent and Young Adults at Roswell Park Cancer Institute are not successfully meeting their goals and objectives. Hypotheses This program evaluation will be a nonexperimental case study n=1 method with a mixed methods approach as an explanatory sequential design. In the quantitative phase of this evaluation, the same survey will administered at the Adolescent and Young Adult (AYA) Support Group monthly meetings over the course of 3 months. The purpose of doing so is to determine whether or not the patients who are utilizing the services feel that the program is meeting its goals and objectives as well as their personal expectations, and the overall effectiveness of the program. To follow, the qualitative phase of this evaluation will consist of a focus group with the survey participants to interpret the results of the surveys, and one-on-one interviews with randomly selected participants in order to avoid selection bias. Data Collection and Instrument Hanson, R. (, 2014). Healthy Kids: Bridging the gap for young adult cancer patients. St. Louis Post-Dispatch. National Comprehensive Cancer Network (, 2015). "NCCN Announces New Guidelines for Adolescent and Young Adult (AYA) Oncology." from D= D=310 Palmer, S. and D. Thomas (, 2008). A practice framework for working with 15–25 year-old cancer patients treated within the adult health sector References