Connecting People With Cancer to Employment Support

Investigators will conduct a prospective single-arm study at 2 sites to pilot and iteratively adapt a clinical workflow intervention, implementation strategies, and associated study procedures. Investigators will implement the clinical workflow intervention across each study site, then recruit consecutive patients (n=50) to complete patient-reported measures at 2 time points (T1: enrollment; T2: 6-month follow-up. Investigators will recruit staff members (n=20) to complete survey measures at 2 time points (T1: beginning of pilot study period; T2: end of pilot study period).

• Screening and Referral Workflow (Behavioral): The Screening and Referral Workflow intervention will include screening eligible patients for employment-related needs and referring those who require support to community-based employment resources.

Primary outcomes

• Enrollment Rate [Baseline]: T1 survey enrollment rate among eligible patients and staff
• Follow-up Survey Completion Rate [6 months]: Rate of study survey completion within 18 days of the 6-month follow-up timepoint
• Staff-reported Feasibility of Intervention [Approximately 9 months]: Proportion of staff disagreeing with one or more Feasibility of Intervention Measure items
• Acceptability of Intervention: Staff [Approximately 9 months]: Proportion of staff disagreeing with one or more Acceptability of Intervention Measure items
• Acceptability of Intervention: Patients [Baseline; 6 months]: Proportion of patients providing negative ratings for one or more Theoretical Framework of Acceptability questionnaire items
• Employment Concerns Screening [Baseline]: Proportion of eligible patients screened for employment concerns

Secondary outcomes

• Employment status [Baseline; 6 months]: Patient-reported employment status using the US Census Bureau's American Community Survey employment status items
• Sick leave duration [Baseline; 6 months]: Patient-reported sick leave duration reported in days
• Health-related quality of life [Baseline; 6 months]: Patient-reported quality of life using the EQ-5D-5L scale. Scores range 1-5, with higher scores indicating poorer quality of life (worse outcome).
• Health insurance status [Baseline; 6 months]: Patient-reported health insurance status using the US Census Bureau's American Community Survey health insurance status items
• Self-efficacy [Baseline; 6 months]: Patient-reported self-efficacy using the General Self-Efficacy Scale. Scores range 10-40, with higher scores indicating more self-efficacy (better outcome).
• Financial toxicity [Baseline; 6 months]: Patient-reported financial toxicity using the COST measure. Scores range 0-48, with higher scores indicating more financial toxicity (worse outcome).

Sex: All, ages: 18 Years to any

Eligible Patients:

* visiting a participating medical or radiation oncology clinic for new diagnosis, treatment, or follow-up of any type of cancer;
* employed at the time of cancer diagnosis;
* age 18 or older;
* able to give full informed consent;
* able to communicate in English or Spanish.

Eligible Staff:

* age 18 or older;
* employed at one of the participating clinical sites.

• Rachel C. Forcino, PhD, MSc, Principal investigator, University of Kansas Medical Center