Implementation and Evaluation of a Screening Tool for Sexual Dysfunction for Pediatric Cancer Survivors

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PROJECT SUMMARY/ABSTRACT Background: Sexual dysfunction (SD) is estimated to occur in up to 50% of childhood cancer survivors (CCS) and has important implications for quality of life and mental health. Effective management of SD in AYA-CCS is substantially limited due to lack of screening and detection of SD in cancer survivorship settings. Adolescent and young adult-aged CCS (AYA-CCS) may be particularly vulnerable to SD and its under-recognition due to developmental challenges. This study addresses this critical barrier and serves as the first step in progressing toward the long-term goal of improving health-related quality of life in AYA CCS through improved screening, recognition and treatment of SD among CCS. Candidate: The proposed award will enable the candidate, Dr. Sopfe, to develop the skills necessary to progress toward her career as an independent researcher leading high quality pragmatic trials. Training: Specifically, Dr. Sopfe will gain experience in Dissemination & Implementation (D&I) science, pragmatic clinical trials, and mixed methods, which will propel her toward a research career aimed at developing and disseminating interventions to improve quality of life for CCS. In addition to experiential training through the research plan, Dr. Sopfe will benefit from a multidisciplinary mentorship team: Primary Mentor, Dr. Peterson (hybrid trials, qualitative research, patient-reported outcomes); Co-Mentor, Dr. Chow (pediatric cancer survivorship, clinical trials); and Methods Mentor, Dr. Studts (D&I, mixed methods). Dr. Sopfe’s training plan includes formal didactic coursework, workshops, and career development programs. Research Plan: This proposal’s overall objective is to use patient and provider stakeholder input to refine and test an approach to SD screening for AYA CCS in a clinic setting. Informed by D&I frameworks, this research proposal will used mixed methods and iterative testing and modification to refine an SD screening approach (Aim 1). This approach will be then tested in a pilot type 1 hybrid effectiveness-implementation study (Aims 2 and 3), employing mixed methods to assess patient and provider outcomes. Environment: The environment for this project is exceptional with a strong academic Section of Pediatric Hematology/Oncology/BMT at the University of Colorado, the resources of the University of Colorado Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (D&I Science Program, Qualitative & Mixed Methods Research Core). The clinical trial will occur through the 1) Children’s Hospital Colorado (CHCO) HOPE Survivorship Program; CHCO Neuro-Oncology group; and 3) Seattle Children’s Hospital Cancer Survivorship Program. This multiclinic design will ensure successful recruitment as well as increase generalizability of findings. Impact: The proposed study will serve as a necessary first step in improving screening, detection, and treatment of SD in AYA-CCS; future work will include establishing broader effectiveness our screening approach through a multicenter randomized trial, as well as development, testing, and dissemination of multidisciplinary interventions for SD in this population.