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Appl Clin Inform 2024; 15(02): 404-413
DOI: 10.1055/s-0044-1787006
Special Section on Patient-Reported Outcomes and Informatics

Suicide Risk Screening for Head and Neck Cancer Patients: An Implementation Study

Bhargav Kansara
1   Department of Oncological Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States
,
Ameer Basta
1   Department of Oncological Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States
,
Marian Mikhael
1   Department of Oncological Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States
,
Randa Perkins
2   Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, Florida, United States
3   Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, Florida, United States
,
Phillip Reisman
3   Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, Florida, United States
,
Julie Hallanger-Johnson
4   Mayo Clinic College of Medicine and Science, Division of Endocrinology, Metabolism, Diabetes, and Nutrition, Rochester, Minnesota, United States
,
Dana E. Rollison
5   Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, United States
,
Oliver T. Nguyen
6   Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, United States
,
Sean Powell
7   Department of Social Work, Moffitt Cancer Center, Tampa, Florida, United States
,
Scott M. Gilbert
8   Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida, United States
,
Kea Turner
6   Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, United States
9   Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida, United States
› Author Affiliations Funding This research was supported in part by the Participant Research, Interventions, and Measurements Core at the Moffitt Cancer Center, a National Cancer Institute-designated Comprehensive Cancer Center (P30-CA076292).
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Abstract

Objectives There is limited research on suicide risk screening (SRS) among head and neck cancer (HNC) patients, a population at increased risk for suicide. To address this gap, this single-site mixed methods study assessed oncology professionals' perspectives about the feasibility, acceptability, and appropriateness of an electronic SRS program that was implemented as a part of routine care for HNC patients.

Methods Staff who assisted with SRS implementation completed (e.g., nurses, medical assistants, advanced practice providers, physicians, social workers) a one-time survey (N = 29) and interview (N = 25). Quantitative outcomes were assessed using previously validated feasibility, acceptability, and appropriateness measures. Additional qualitative data were collected to provide context for interpreting the scores.

Results Nurses and medical assistants, who were directly responsible for implementing SRS, reported low feasibility, acceptability, and appropriateness, compared with other team members (e.g., physicians, social workers, advanced practice providers). Team members identified potential improvements needed to optimize SRS, such as hiring additional staff, improving staff training, providing different modalities for screening completion among individuals with disabilities, and revising the patient-reported outcomes to improve suicide risk prediction.

Conclusion Staff perspectives about implementing SRS as a part of routine cancer care for HNC patients varied widely. Before screening can be implemented on a larger scale for HNC and other cancer patients, additional implementation strategies may be needed that optimize workflow and reduce staff burden, such as staff training, multiple modalities for completion, and refined tools for identifying which patients are at greatest risk for suicide.

Keywords

suicide prevention - patient-reported outcomes - EHR - ePROs

Availability of the Data

To protect the privacy of the individuals that participated in this study, the individual-level data underlying this article cannot be shared. Summary-level data may be requested.


Author Contributions

B.K.: Conceptualization; Writing—original draft; Writing—review & editing; Methodology; A.B.: Writing—review & editing; M.M.: Writing—review & editing; R.P.: Writing—review & editing; P.R.: Writing—review & editing; J.H.J.: Writing—review & editing; D.E.R.: Writing—review & editing; O.T.N.: Writing—review & editing; S.P.: Writing—review & editing; S.M.G.: Writing—review & editing; K.T.: Conceptualization; Methodology; Project administration.


Protection of Human and Animal Subjects

Moffitt Cancer Center Institutional Review Board of Record, Advarra, reviewed the study protocol and determined the study to be exempt.


Supplementary Material



Publication History

Received: 12 January 2024

Accepted: 27 March 2024

Article published online:
22 May 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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