Partner Engagement & Receipt of Surveillance in Colorectal Cancer Survivors

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 DESCRIPTION (provided by applicant): After curative treatment for colorectal cancer, ongoing surveillance is necessary to detect cancer recurrence. Limited recurrences in the liver, lung, and at the site of the primary cancer can be surgically resected with a cure rate as high as 50%. However, nearly half of the 1.2 million yearly survivors of colorectal cancer in the US fail to receive potentially life-saving surveillance. This gap between ideal care and actual care represents an opportunity to identify previously untapped sources of support to improve the likelihood of cure in a large group of patients. The under-use of surveillance in half of all colorectal cancer survivors requires that we consider novel methods to improve care. Engaging the partners of patients, who, according to the National Cancer Institute, is "part of the survivorship experience," may represent one approach to improving cancer surveillance. The majority of colorectal cancer patients are married or partnered. Partners serve as a potential resource that providers can engage to increase patients' receipt of surveillance. Our preliminary studies show that 80% of colorectal cancer patients want partners involved in treatment decisions; 85% report high levels of partner support. The aims of this mixed methods study are 1) To identify, through in-depth interviews, factors that influence the receipt of surveillance testing from the perspective of survivors of colorectal cancer and their partners; 2) To determine the partner-specific factors associated with a high level of partner engagement in the patient's surveillance care process. We hypothesize that engagement will be lowest among male and/or black partners; 3) to determine the relationship between level of partner engagement and patients' receipt of surveillance. We hypothesize that receipt of surveillance will be lowest among patients whose partners are least engaged in the surveillance care process. Analyses will account for the role of other factors, including age, comorbidity, socioeconomic status, race, [and spirituality] in receipt of surveillance. Aims 2 and 3 will be accomplished by surveying a large and diverse cohort of colorectal cancer survivors and their partners. Not only will the proposed project provide data to inform future interventions targeted at couples (colorectal cancer patient-partner dyads), it will also serve as a vehicle for the applicant's development into an independent researcher in health services research. The applicant already has a strong background in studies of the quality of colorectal cancer care and a clinical foundation in colorectal cancer. Through select coursework, mentorship from national experts in health services research [and social sciences], and completion of a carefully designed project linking skill acquisition to research aims, the applicant will emerge as an expert and independent investigator in health services research as it pertains to cancer survivorship.