The System for Patient Assessment of Cancer Experiences (SPACE): a cross-sectional study examining feasibility and acceptability.

BACKGROUND: Continuous quality improvement in cancer care relies on the collection of accurate data on the quality of care provided. It is suggested that such an approach should: (i) measure the patient's care experience throughout the cancer trajectory; (ii) use items and response scales that measure concrete and specific aspects of care; (iii) minimise recall bias; (iv) minimise the burden placed on patients for providing data; (v) minimise administrative burden; and (vi) collect actionable data. The System for Patient Assessment of Cancer Experiences (SPACE) was developed to meet these objectives. This study describes the feasibility and acceptability of the SPACE in a sample of oncology outpatients. METHODS: The SPACE was examined in four medical oncology centres. Adult patients were approached by a research assistant prior to their scheduled consultation. Consenting participants completed the SPACE on a computer tablet. Items were tailored to the patient's cancer treatment phase. RESULTS: Of the eligible participants, 1143 consented (83%) and 1056 completed the survey (92%). The average time taken to complete the survey was 6 min 28 s. A large proportion of the sample indicated that the survey was acceptable (88-93% across three acceptability items). CONCLUSION: This study demonstrates that the SPACE can be feasibly administered each time a patient comes to the oncology unit and is acceptable to patients. The SPACE could be used to quantify the care experiences which patients receive during their cancer care. The resulting data could be used to set benchmarks and improve the performance of cancer clinics.

A cross-sectional survey and latent class analysis of the prevalence and clustering of health risk factors among people attending an Aboriginal Community Controlled Health Service.

BACKGROUND: Indigenous Australians are a socially disadvantaged group who experience significantly poorer health and a higher prevalence of modifiable health behaviours than other Australians. Little is known about the clustering of health risks among Indigenous Australians. The aims of this study were to describe the clustering of key health risk factors, such as smoking, physical inactivity and alcohol consumption, and socio-demographics associated with clusters, among a predominantly Aboriginal sample. METHODS: Participants (n = 377) attending an Aboriginal Community Controlled Health Service (ACCHS) in regional/rural New South Wales, Australia, in 2012-2013 completed a self-report touch screen health risk survey. Clusters were identified using latent class analysis. RESULTS: Cluster 1 ('low fruit/vegetable intake, lower risk'; 51%) consisted of older men and women; Cluster 2 ('risk taking'; 22%) included younger unemployed males with a high prevalence of smoking, risky alcohol, and illicit drug use. Cluster 3 ('inactive, overweight, depressed'; 28%) was characterised by younger to mid aged women likely to have experienced emotional or physical violence. CONCLUSIONS: If future research identifies similar stable clusters of health behaviours for this population, intervention approaches targeting these clusters of risk factors should be developed and tested for Aboriginal and Torres Strait Islander Australians.

The impact of web-based approaches on psychosocial health in chronic physical and mental health conditions.

Chronic conditions such as cancer, cardiovascular disease and mental illness are increasingly prevalent and associated with considerable psychosocial burden. There is a need to consider population health approaches to reducing this burden. Web-based interventions offer an alternative to traditional face-to-face interventions with several potential advantages. This systematic review explores the effectiveness, reach and adoption of web-based approaches for improving psychosocial outcomes in patients with common chronic conditions. A systematic review of published work examining web-based psychosocial interventions for patients with chronic conditions from 2001 to 2011. Seventy-four publications were identified. Thirty-six studies met the criteria for robust research design. A consistent significant effect in favour of the web-based intervention was identified in 20 studies, particularly those using cognitive behavioural therapy for depression. No positive effect was found in 11 studies, and mixed effects were found in 5 studies. The role of sociodemographic characteristics in relation to outcomes or issues of reach and adoption was explored in very few studies. Although it is possible to achieve positive effects on psychosocial outcomes using web-based approaches, effects are not consistent across conditions. Robust comparisons of the reach, adoption and cost-effectiveness of web-based support compared with other options such as face-to-face and print-based approaches are needed.