Individual Abstract within a Delegate Designed Symposium Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Challenges and successes of implementing the distance-delivered ‘Engage’ survivorship program for childhood cancer survivors in clinical practice (#133)

Christina Signorelli 1 2 , Jordana K McLoone 1 2 , Carolyn Mazariego 3 , Skye McKay 3 , Joseph Elias 2 3 , Karen Johnston 1 2 , Rachael Bell 1 2 , Claire E Wakefield 1 2 , Natalie Taylor 3 , Richard J Cohn 1 2
  1. Discipline of Pediatrics; School of Clinical Medicine, UNSW Sydney, Kensington, NSW, Australia
  2. Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
  3. School of Population Health, UNSW Sydney, Sydney, NSW, Australia

Over 80% of childhood cancer survivors report experiencing multiple and complex treatment-related health problems, which often develop after a long latent period and continue to increase. While comprehensive survivorship care is recommended to manage these health problems, access to survivorship care in Australia is limited and many survivors disengage from care due to various well-documented barriers.

‘Engage’ is a remotely delivered, multidisciplinary survivorship program which aims to improve survivors’ health-related self-efficacy (i.e. their confidence in their ability to self-manage their complex health needs in survivorship), and to improve their quality of life in survivorship. ‘Engage’ involves i) an online patient reported health assessment, ii) an online nurse-led consultation, iii) a remote multidisciplinary case review, iv) written, personalised education, recommendations, and care plan for survivors and their general practitioner, v) an online nurse-led consultation to ensure survivors understand the recommendations and can troubleshoot barriers to achieving them and accessing care needed.

The evaluation of ‘Engage’ is ongoing and includes simultaneous evaluation of the program’s effectiveness and its implementation across several children’s hospitals in Australia. We assess survivors’ outcomes pre-intervention and 1-, 6-, 12- and 24-months post-intervention and the perspectives of various key stakeholders critical to the evaluation and ongoing delivery of Engage. To date >200 survivors have been through the program across the project’s lifespan and 28 stakeholders (researchers, oncology staff, general practitioners) have participated in interviews.

This presentation will describe some of the successes and challenges of adopting Engage in clinical practice, such as adapting to ‘real-life’ clinical scenarios, managing varying levels of buy-in, adjusting to site-specific needs, ‘fitting’ online care in existing practice, and timing “implementation” and engagement with collaborators to support successful integration. In addition, we will detail our experience of adapting the program to new groups, for example establishing “Engage Brain” specifically for childhood brain cancer survivors.