Enriching Communication skills for Health professionals in Oncofertility and Trainers in Oncofertility Reproductive Communication and Health

患有癌症的青少年和青壮年（AYA）和幸存者的社会心理需求与成人不同

Adolescent and young adults (AYA) with cancer and survivors have psychosocial needs that are distinct from older adults, with reproductive health being a chief concern. Reproductive health for AYA patients with cancer and survivors includes potential infertility and need for fertility preservation counseling as well as other interrelated components such as romantic partnering, body image, sexuality, sexual identity and orientation, contraception, and psychosexual adjustment that vary in intensity of concern based on whether the AYA is in treatment or in survivorship. While oncologist physicians primarily treat the disease, allied health professionals (AHPs) involved in the care of AYA including, but not limited to, nurses, social workers, psychologists, and physician assistants often provide psychosocial care, health education, and information related to reproductive health that can impact AYA patients' and survivors decision-making and quality of life. AHPs need communication skills on these issues and resources to identify and facilitate referrals for additional services. Further, we have identified new ethical issues that our trainees encounter such as the challenges of discussing fertility with patients with a poor prognosis, lack of concordance on fertility preservation between minors and parents or between adult partners, and the growing use of posthumous assisted reproduction. Our previous R25 programs ENRICH (Educating Nurses in Reproductive Health Issues in Cancer Health) and ECHO (Enriching Communication skills for Health professionals in Oncofertility) has proven successful in training and skill building for AHPS with 712 learners to date. ECHO is a proven, evidenced-based program demonstrating short and intermediate term impacts on knowledge, perceived confidence, and communication skills. In the proposed renewal application, we seek to expand and extend ECHO in key curricula areas and develop a new cohort of “train the trainers” from our previous ENRICH and ECHO trainees in a new program entitled TORCH (Trainers in Oncofertility Reproductive Communication and Health). ECHO will continue to provide reproductive health communication skills training with expanded curricula in two areas: Sexual and Gender Minorities and Bioethics. TORCH will train prior learners to educate others in the practice setting on the principles of ECHO. Our approaches capitalize on advanced web-based learning technologies we have already developed to facilitate increased interactive learning and skill building. The (ECHO-TORCH) program aims are to: Train AHPs over the 5 year period of the ECHO training Program; Refine and implement the ECHO program to facilitate knowledge about and skills to address reproductive health needs of AYA oncology patients via a web-based learning community; Evaluate the impact of the ECHO and TORCH program at the participant and workplace level (e.g., policies, referrals, numbers trained);. Develop a network of AHPs trainers who disseminate ECHO content