1. Data Analysis Continued Introduction and Purpose Statement
Evaluation of Psychosocial Support Services for Adolescent and Young Adult Patients at Roswell Park Cancer Institute
Allison Polakiewicz, MPA Project
Project Advisor: Dr. Ceesay
Second Reader: Daniel Keppel
Data Analysis Continued
Introduction and Purpose Statement
Research Design
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. 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 such as education and career attainment, relationships, self-esteem, 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). 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.
This program evaluation was a nonexperimental case study n=1 method with a mixed methods approach as an explanatory sequential design.
Qualitative Phase I: This phase consisted of a content analysis of the program’s marketing materials followed by an interview with the Program Directors.
Quantitative Phase II: Data was collected in phase II through a participant questionnaire which was distributed over the course of three months.
Results were 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, overall effectiveness of the services on the patients who utilize them, and whether or not the program is meeting the standards according to best practices in the field.
Suggestions made by the participants in efforts to make such discussions more comfortable were to have guided topics for each session, dividing the group by gender, and having people attend more frequently. No participants found out about the Group through the hospitals website which is significant as the content analysis portion of this evaluation found that the website was very disorganized and not up to date. As a result of this, it is very important that the hospital social workers continue to inform patients and survivors about the Group, as those who may be out of treatment might not have any reason to utilize the hospitals website and would not have a way to see brochures or flyers if they are only placed in the hospital.
More than half of the respondents indicated that being able to relate to others was what they liked the most about the program, and that factors such as inconsistent timing between events were what they liked least. As far as having guided topic discussions, it would be the most beneficial to either have set topics or at least have it as an option during the Support Group. Factors such as communication, friendships, discussing the future, and feeling understood were a few of the things that participants said they were getting out of the Group.
Review & Critique of Literature
Table 1: Age of Participants
Frequency
Percent
Valid Percent
Cumulative Percent
Valid
23.00 1
12.5
24.00
25.0
25.00
37.5
29.00
50.0
31.00
62.5
33.00
75.0
34.00
87.5
36.00
100.0
Total 8
AYA patients are often treated as either pediatrics or adults (Hanson, 2014). Having healthcare professionals who are trained and educated in caring for this specific age group can improve the communication between the hospital staff and patient, and ultimately help in alleviating the emotional struggles the patient may face.
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.
Summary, Results, Implications
Overall, the results of this evaluation indicated that the participants of the Group are satisfied with the Group, that their needs are being met, and that the Program Directors goals and objectives are being met. While there were limitations to this study and recommendations for improvement, no participants in this study stated that they were dissatisfied with what the Group had to offer. 
A limitation of this evaluation was that the researcher had limited access to the Adolescent and Young Adult patients at Roswell Park Cancer Institute due to HIPAA rules and regulations, restricting the researcher to obtaining any participant feedback to only those who were physically able to attend the Group over the 3-month collection period. The sample size of this evaluation was small (n = 8); however, the total number of Group attendees on record over the past year is 14.
Recommendations/Future Research:
Establish a design of best practices in order for other cancer treatment centers to successfully design and evaluate an Adolescent and Young Adult Support Group of their own. It is suggested to do this in partnership with other world-renowned cancer treatment centers.
Consistent advertising.
Inform patients of the program post-admission to increase attendance.
Dedicate half of the Group session to a guided topic.
Increase the number of AYA events.
Data Analysis
The results of this program evaluation were based on a content analysis, interview with program directors, and primarily a survey. There were 8 survey participants total who ranged between the ages of with 7 female and 1 male. One of the most significant findings of this research was that no participants selected that they were below “somewhat satisfied” with the Support Group, indicating that 100% of the participants had positive answers. In addition, none of the participants indicated that they were uncomfortable talking about topics such as relationships, self-esteem, depression, body image, work and education in the Support Group.
Sample Selection
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, and the size of the entire AYA population as a whole is just too large to reach in its entirety.
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.
References
Table 2, Survey Q2: Overall, how satisfied are you with the Support Group?
Frequency
Percent
Valid Percent
Cumulative Percent
Valid
Very satisfied 4
50.0
Somewhat satisfied
100.0
Total 8
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
Palmer, S. and D. Thomas (, 2008). A practice framework for working with 15–25 year-old
cancer patients treated within the adult health sector