Florez, Narjust

175 Background: In 2009, ASCO confirmed that addressing cancer care disparities is critical for the Society and committed to approaches to eliminate such disparities. Yet, gaps remain in identifying the best approaches to do so. It remains unknown which cancer care providers serve patients from “underserved populations'' (defined as individuals who have historically received inadequate health care and health care services), what unmet needs they experience in their cancer care delivery, and how best to engage and support these providers. The objectives of this study were to explore challenges faced by providers serving underserved patients to inform development of a broader online survey and identify solutions that ASCO can implement to better support these providers. Methods: A multi-phase mixed-methods approach was utilized. Phase 1 involved key informant semi-structured interviews with 12 oncology providers caring for adult patients in the US from April to May 2021. Phase 2 involved survey development based on themes identified in Phase 1. The survey assessed: provider needs; processes for eliciting, documenting, and addressing social and economic needs of patients; and how ASCO could best support these providers. Phase 3 involved email distribution of the online survey in May 2022 to 5800 individuals identified through ASCO’s customer database. Eligibility criteria included providing care for adults with cancer in the US and prior consent to receive ASCO survey communications. Results: Of 477 respondents, the majority were ASCO members (88%), in an academic practice (57%), medical oncologists (77%), non-Hispanic (89%) and/or Caucasian/White (67%) and had > 15 years’ clinical experience (57%). A majority (60%) provided ≥25% of their clinical time providing cancer care to underserved populations and routinely engaged with administration to secure resources (61%) and local community organizations to obtain services (42%) for patients. Most (43-77%) indicated that a social worker/case manager was primarily responsible for addressing patient social needs. The majority reported that identification and dissemination of best practices (55%) and development of a return-on-investment business model (60%) would best help address patient needs. Some respondents expressed a desire to collaborate with ASCO on policy reform (32%) and for ASCO to help build or strengthen partnerships with local initiatives (29%). Conclusions: This is the first US-based survey assessing barriers and solutions to delivering cancer care among underserved populations. The findings from this work provide insights about how ASCO can help equip practices to address the social needs of their patients. Further work will be conducted to develop and implement suggested solutions.

72 Background: The integration of biopsychosocial screening programs (BSP) has been promoted as a way by which to identify unmet needs and to provide tailored treatments to patients. Studies have reported mixed outcomes regarding the impact of such services on hospital admissions during cancer treatment. This study sought to evaluate the effect of a BSP on hospital admissions and length of stay among a large, heterogenous sample of patients diagnosed with cancer (March 2020 to December 2021). Methods: We enrolled consecutive patients diagnosed with cancer receiving treatment at a single institution located in the capital of Brazil. We assessed patients’ characteristics via chart review (e.g., age, sex, histology, hospital admission, length of hospitalization). In addition, as per the BSP protocol, patients were assessed via standardized self-report questionnaires (Distress Thermometer, FACT-G, Patient-Generated Subjective Global Assessment), and appropriate interventions are provided. This program was offered at no cost to all patients and engagement was voluntary. We compared the number of hospital admissions and length of stay between groups (patients who participated in the BSP vs. those who did not). Mixed linear models adjusted for selected characteristics (age, type of cancer and disease stage) were assessed. Results: A total of 1014 patients were included in this analysis. From the total sample, 84% participated in the BSP and 20% were hospitalized for an average of 9 days (ranging from 1-80 days). Mostly patients were female (63%), median age was 63 years old. Breast cancer (26%), hematological (18%), and gastrointestinal cancer (14%) were the most common types of cancer, and the majority had advanced disease (stage III-IV; 67%). Compared to those who engaged in the BSP, patient’s characteristics were well balanced, however, the proportion of patients hospitalized during their cancer treatment was higher among patients who did not participate in the BSP (27% vs 8%: P = 0.001), as was the length of hospitalization spent more days in the hospital than patients who has participated in the BSP (M = 9.5 days vs M = 4.2 days; P = 0.001). Conclusions: Our findings suggest the benefit of a BSP in reducing hospitalizations and length of stay among patients with cancer. An integrated model of care may assist in targeting patient’s unmet needs and may positively impact clinical and hospital-based outcomes. This is the first study to evaluate the effects of a BSP among a Brazilian population using real world data.