Telemedicine Delivery of a Cancer Support Training Intervention: Partnership with Community-Based Survivorship Centers

There is a pressing need for effective educational and psychosocial interventions for cancer survivors living in rural North Carolina. Cancer Transitions (CT), a 6-week group intervention developed by the Cancer Support Community and LIVESTRONG, is used successfully to facilitate patient transition from active treatment to post-treatment care. With leadership and training, the CT program could be disseminated through community cancer settings across North Carolina. Utilizing telemedicine, this project addressed two critical gaps in North Carolina cancer care:
  1. A shortage of adequately trained leaders of group interventions for cancer survivors
  2. Limited access to effective educational, wellness and psychosocial programs for cancer patients
The proposed two phase, multi-site dissemination project:
  1. Provided training for ten CT group leaders, who then
  2. Conducted the six-week CT program in their community with groups of 10-15 cancer patients
Pre-intervention training sessions and weekly supervision throughout the CT program were delivered via videoconferencing technology. Outcome measures included: group leader retention, satisfaction with training, and competency with the CT program, as well as participant retention, satisfaction, and health related quality of life.

Providing training for health care professionals to deliver effective educational and psychosocial interventions is important to the mission of optimizing North Carolina cancer outcomes. This feasibility project tested the use of telemedicine technology to provide cancer support services for survivors who have limited access to these resources.

Findings:  The research team conducted 4 trainings and 4 supervision sessions of group leaders where all but the first training were done remotely using telemedicine & iPads.  These group leaders then conducted 12 Cancer Transitions 6-week programs for 108 cancer survivors and 12 caregivers across the state. The pilot study demonstrated that telemedicine training is a feasible way to increase access to survivorship support in both rural and urban communities. It should be considered as a viable alternative to in-person training for geographically diverse patient populations. Group leaders reported high satisfaction with this training model. Telemedicine not only increases training to health professionals but can also increase the access to cancer survivorship support. This is especially important given the inadequate delivery of an intervention known to be effective.

Geographic Area(s): Alamance, Buncombe, Carteret, Dare, New Hanover, Orange, Pitt, and Wake Counties

Research Team: Don Rosenstein, MD, professor of psychiatry and medicine (principal investigator); Lixin Song, PhD, RN, assistant professor of nursing; Anna Brandon, PHD, MCS, clinical assistant professor of psychiatry; Elizabeth Sherwood, RN, NP, group trainer; Michael Young, technical advisor; and Michelle Manning, MPH, and Mindy Gellin, RN, BSN, project coordinators.

For more information about this pilot research study, contact Mindy Gellin, project coordinator, at mindy_gellin@med.unc.edu.