From Screening to Support: A Multi-Method Analysis of HRSN Integration in Cancer Care

Thomas Jefferson University

Status: Enrolling

Conditions: Cancer

Treatments: Other: Survey; Other: Interview

Study type: Observational

Funder types: Other

Identifiers

NCT07352579

JT 46229 (Other Identifier)

iRISID-2025-1005

Details and patient eligibility

About

This observational study aims to identify the factors that influence whether cancer patients accept or decline supportive care services after screening positive for health-related social needs (HRSNs) at the Sidney Kimmel Comprehensive Cancer Center.

The study focuses on adult oncology patients who previously reported at least one HRSN-such as transportation, food, housing, or utility needs-but declined assistance when it was offered.

The main questions it aims to answer are:

• What factors shape cancer patients' intentions to use supportive care services for HRSNs?
• Why do patients who screen positive for HRSNs choose not to accept help offered by the healthcare system?

Participants will:

• Complete a one-time electronic survey delivered via MyChart or email.
• Optionally participate in a semi-structured Zoom interview (for a subset of 20-30 survey respondents) to explore decision-making in greater depth.

Full description

This is a cross-sectional observational study. There will be 500 participants for MyChart survey and 20 participants for semi-structured interviews. Surveys will be distributed via MyChart and email and will take about 10 minutes to complete. The main purpose of this study is to understand why SKCCC participants are not seeking support for their corresponding HRSNs from the healthcare system. The hypothesis is that a range of factors are contributing to SKCCC patients' decline of resources to address risks identified in HRSN screening potentially inclusive of mistrust of healthcare systems, perception that there are no resources to help, feelings others can use the resources more than themselves, as well as protective factors like past resiliency and resourcefulness. An examination of the initial HRSN screening data for cancer patients within this health system revealed that, in 2024, 5,727 (74.7%; n=7662) patients who were in active cancer treatment completed the HRSN screening questionnaire in four domains: transportation access, food insecurity, housing instability, and utility needs. Of these, 716 patients (12.5%) reported having a need in at least one HRSN domain. However, only 343 patients (47.9%, n = 716) wanted help from the healthcare system to address their HRSN(s). This highlights that the majority (52.1%, n = 716) of cancer patients in active treatment who have been screened for HRSN have unmet needs that could be addressed but are not being flagged as such in our healthcare system. This preliminary data sheds light on the concrete and resource needs of cancer patients, but there is not a good understanding of why participants are not seeking support for their corresponding HRSNs from the healthcare system.

Enrollment: 500 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Individuals must meet all of the following inclusion criteria in order to be eligible to participate in the study:

  • Provide informed consent via check box for survey
  • Provide verbal consent via Zoom for interview
  • Must be able to read and understand English
  • Willing to comply with all study procedures and be available for the duration of the study
  • Patients with existing HRSN data in their EHR that answere4d yes to risk in at least one domain and no to wanting help/follow up

Exclusion criteria

• An individual who meets any of the following criteria will be excluded from participation in this study:

  • If they do not consent
  • Non-patients with existing HRSN data in their EHR
  • Individuals unable to complete the survey due to language barriers or other cognitive limitations

Trial design

500 participants in 1 patient group

Cancer Patients Screened for Health-Related Social Needs (HRSNs)

Description:

This group includes adult cancer patients receiving care at Sidney Kimmel Comprehensive Cancer Center (SKCCC) who previously completed a Health-Related Social Needs (HRSNs) screening in the electronic health record. This will be achieved by providing patients with a one-time survey. The surveys will be distributed via MyChart messages and emails. Additionally, 20 patients who complete the survey will be asked to complete a short interview to further understand why cancer patients identified as high-risk for HRSNs decline connections to care and intervention-ultimately to gain an understanding into the factors that they take into account when determining whether they want to be connected to a resource or service connection related to HRSNs.

Treatment:

Other: Interview

Other: Survey