Integrating social care into gynecologic oncology: Identifying and addressing patient's social needs

Katherine Cotangco; Elizabeth Pineda; Veda Hingarh; Natsai C Nyakudarika; Joshua G Cohen; Christine H Holschneider

doi:10.1016/j.ygyno.2023.11.001

Integrating social care into gynecologic oncology: Identifying and addressing patient's social needs

Gynecol Oncol. 2023 Dec:179:138-144. doi: 10.1016/j.ygyno.2023.11.001. Epub 2023 Nov 18.

Authors

Katherine Cotangco¹, Elizabeth Pineda², Veda Hingarh³, Natsai C Nyakudarika⁴, Joshua G Cohen⁵, Christine H Holschneider⁶

Affiliations

¹ Department of Obstetrics and Gynecology, Olive View-UCLA Medical Center, Sylmar, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
² Keck Medicine of USC, Los Angeles, CA, USA.
³ Department of Obstetrics and Gynecology, Olive View-UCLA Medical Center, Sylmar, CA, USA.
⁴ Department of Obstetrics and Gynecology, Harbor UCLA Medical Center, Torrance, CA, USA.
⁵ Division of Gynecologic Oncology, City of Hope Orange County, Irvine, CA, USA.
⁶ Department of Obstetrics and Gynecology, Olive View-UCLA Medical Center, Sylmar, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: cholschneider@dhs.lacounty.gov.

PMID: 37980768
DOI: 10.1016/j.ygyno.2023.11.001

Abstract

Objective: We aimed to identify social needs of gynecologic oncology patients using a self-administered social needs assessment tool (SNAT), compare the SNAT to a formal social work assessment performed by cancer care navigators (CCN), and provide SNAT-informed community resources.

Methods: We analyzed prospectively collected data from a performance improvement initiative in a safety-net gynecologic oncology clinic between October 2021 and July 2022. We screened for eight social needs domains, health literacy, desire for social work, and presence of urgent needs. Clinicodemographic data were abstracted from the electronic medical record. Univariate descriptive statistics were used. Inter-rater reliability for social needs domains was assessed using percent agreement.

Results: 1010 unique patients were seen over this study period. 488 (48%) patients completed the SNAT, of which 265 (54%) screened positive for ≥1 social need. 83 (31%) patients were actively receiving cancer treatment, 140 (53%) were in post-treatment surveillance, and 42 (16%) had benign gynecologic diagnoses. Transportation (19% vs 25%), housing insecurity (18% vs 19%), and desire to speak with a social worker (16% vs 27%) were the 3 most common needs in both the entire cohort and among patients actively receiving cancer treatment. 78% patients in active treatment were seen by a CCN and received SNAT informed community resources. The percent agreement between the SNAT and formal CCN assessment ranged from 72%-94%.

Conclusions: The self-administered SNAT identified many unmet social needs among gynecologic oncology patients, corresponded well with the formal social work CCN assessment, and informed the provision of community resources.

Keywords: Gynecologic cancer; Minority populations; Social needs assessment.

MeSH terms

Female
Genital Neoplasms, Female* / therapy
Health Literacy*
Humans
Reproducibility of Results
Social Support