SPHERE (Survivorship Plan Health Record) Implementation Trial

PROJECT SUMMARY/ABSTRACT The Institute of Medicine recommends that each cancer patient receive a survivorship care plan that summarizes information important to the individual’s long-term care, including the following: (1) cancer type and treatments, (2) their potential consequences, (3) recommendations regarding preventive practices, and (4)

specific information about recommended follow-up. Despite their clinical importance, gaps in CRC surveillance care and preventive care exist among CRC survivors. Unmet symptom needs are also prevalent and undertreated. We propose to evaluate the capacity of an interactive survivorship care plan (SCP) delivered through an

Internet-based personal health record (PHR) to meet the needs of CRC survivors. PHRs combine health information and medical data with knowledge management and software tools to potentially enable patients to become active participants in their own care. A SCP delivered via an appropriately designed PHR may

promote increased concordance with CRC surveillance and preventive care guidelines through the exchange of health information between CRC survivors and health care providers. A survivorship care plan-personal health record (SCP-PHR) may also improve care for symptoms through the combination of longitudinal PHR-

based symptom measurement and tailored self-management tools. To understand the effectiveness of the SCP-PHR, we will conduct a randomized clinical effectiveness trial at the patient level. We will assess impact of the SCP-PHR across a variety of measures and outcomes, including CRC surveillance, preventive care

receipt, patient symptoms, and patient-centered quality. To simultaneously understand the effectiveness and implementation of the SCP-PHR, we will conduct a hybrid type I effectiveness-implementation trial consisting of the following components: (A) a randomized clinical effectiveness trial at the patient level, and (B) a mixed methods implementation study. The mixed methods

portion of the study will consist of a quantitative evaluation of patient attitudes toward technology associated with the frequency and patterns of SCP-PHR use, as well as a qualitative process evaluation using semi- structured interviews to assess facilitators and barriers to implementation of the SCP-PHR among key

stakeholders: patients, health care providers, and organizational leaders. This study design will enable us to meet the simultaneous needs of understanding the effectiveness and the health care context of SCP implementation.