Addressing the Training Gap in Oncology on Sexual Health: Development of the Sexual Health Integrative Fellowship Training (SHIFT) Course for Hematology-Oncology Fellows

PROJECT SUMMARY Over half of patients treated for cancer report concerns related to sexual health. If unaddressed, such concerns can cause substantial distress and compromise patients’ health and overall well-being. Although clinical guidelines uniformly recommend oncologists discuss sexual health with their patients, evidence suggests that

sexual health is overwhelmingly neglected in patients’ routine cancer care. Oncologists lack knowledge and skills with which to effectively discuss sexual health, largely because most have received no relevant training. A recent survey of hematology-oncology fellowship programs in the U.S. by our team found that the majority offer little to

no formal training in sexual health. The failure to educate hematology-oncology fellows on sexual health in the face of prevalent cancer-related sexual problems and considerable patient distress constitutes a critical gap in preparedness of the oncology workforce in the U.S. A training course for fellows on addressing cancer-related

sexual health is likely to be both highly acceptable and impactful because it would (a) fit well into the educational setting of the fellowship program and (b) provide the foundation for clinicians-in-training to develop effective clinical practice patterns that integrate regular communication about cancer-related sexual health. Therefore, we

propose to develop a novel virtual course, called Sexual Health Integrative Fellowship Training (SHIFT), that (a) will provide education and skills training in communication about cancer-related sexual health to hematology- oncology fellows and (b) is guided by theory, significant preliminary qualitative and intervention research by the

project team, and active involvement from a diverse Patient Advisory Board and other key stakeholders. Because certain cancer patient subgroups (e.g., sexual and gender minority patients) may have unique cancer-related sexual concerns and communication needs, SHIFT will include content to facilitate fellows’ effective

communication about sexual health with a diverse patient population. Aim 1 of the project is to develop the SHIFT course, which we expect will improve hematology-oncology fellows’ knowledge, beliefs based in social cognitive theory (i.e., self-efficacy and outcome expectancies for sexual health communication), and clinical

communication outcomes (i.e., comfort and communication about sexual health). Aim 2 is to evaluate the acceptability and impact of SHIFT on knowledge, beliefs, and sexual health communication among two cohorts of hematology-oncology fellows from Fox Chase Cancer Center (primary site) and Dana-Farber Cancer Institute.

We will then refine the course and plan for its dissemination. The proposed study will be the first to develop and test a training course designed to equip fellows in oncology to address sexual health with their cancer patients. This study represents a logical next step in an ongoing body of research centering on the development of

evidence-based interventions to improve patient-clinician communication about sexual health in cancer. The overarching goal of this line of work is to improve the health and quality of life for patients with cancer through integrating effective clinical communication about sexual health into their routine cancer care.