The CAPE Initiative: A Pilot Study Evaluation

In a recent pilot program, the CAPE (Cancer Advocacy & Patient Education) Initiative, which aims to enhance patient education through digital tools, was evaluated in 4 diverse clinical settings. Linda Fleisher, PhD, MPH, and Emily Gentry, RN, BCN, OCN, key figures in this initiative, shared their insights and findings at the recent AONN+ Annual Conference, highlighting the program’s impact and future directions.

Dr Fleisher, a researcher at Children’s Hospital of Philadelphia and Fox Chase Cancer Center, though not technically a navigator herself, has played a crucial role in the evaluation and forward movement of navigation initiatives. Ms Gentry, executive director of Strategy and Operations at AONN+, emphasized the collaborative nature of their work, particularly how navigators and researchers can work together to evaluate and enhance patient care.

The AONN+ CAPE Initiative provides an evidence-based online patient education platform that allows navigators and other healthcare professionals to send personalized “E-prescriptions” to newly diagnosed patients with cancer.

What Is CAPE?

The AONN+ CAPE Initiative provides an evidence-based online patient education platform that allows navigators and other healthcare professionals to send personalized “E-prescriptions” to newly diagnosed patients with cancer. These E-prescriptions contain educational materials customized for each patient’s unique circumstances and treatment status.

Through communication and assessment, navigators and other healthcare providers can identify areas of focus or need for patients, such as taking an active role in decision-making, tips for self-care, or dealing with financial concerns. They can then curate relevant resources from the CAPE “modules” (designed specifically for each cancer type), and print/email them to the patient.

This approach furthers patients’ understanding of their diagnosis, treatment options, and coping abilities while also increasing their health literacy. In addition, the initiative utilizes a predetermined quality-of-life model to reduce distress and improve the overall patient experience.

“Being able to sit with patients, hear what’s in their heart, and really take the time to educate them so that they can be successful and equipped for their patient journey is a special opportunity,” said Ms Gentry. “That’s really the heartbeat and the passion behind CAPE.”

Although lung cancer was the initial focus, chronic lymphocytic leukemia and renal cell carcinoma are now included in the initiative, with lymphomas and endometrial and ovarian cancers in development.

Pilot Study Objectives

The pilot study focused on the implementation of the CAPE platform in real-world settings. The primary objectives were to:

• Evaluate how the CAPE platform improves patients’ understanding of their diagnosis and treatment
• Gather insights from both navigators and patients regarding the platform’s effectiveness
• Identify challenges and best practices for implementing the platform in various clinical workflows
• Explore future efforts to introduce and disseminate the CAPE platform across different oncology care settings

The study involved 4 diverse sites: Vidant Medical Center in North Carolina, Baptist Health in Kentucky, and Fox Chase Cancer Center and Temple University Hospital, both in Philadelphia. These sites represented a mix of rural and urban populations (with about 60 patient participants in total), ensuring a comprehensive evaluation. The study included a pretest, E-prescription intervention, and a 1-month posttest to gather feedback from patients.

The CAPE platform was evaluated using the PRISM (Practical Robust Implementation and Sustainability Model) framework. This framework helped assess the intervention’s characteristics, organizational context, patient reach, and effectiveness. The study also incorporated a focus group to gather additional insights from navigators who had not yet used the platform.

“Really what we were focused on was, does this help patients be more prepared, does this reduce their anxiety to some degree, and does it really help to improve conversations with their provider?” Dr Fleisher explained.

Key Findings

Patient Feedback

• The majority of patients found the CAPE platform very helpful in preparing them for treatment decisions and discussions with their providers
• Patients appreciated the personalized approach and the ability to share resources with their family and caregivers (and to review the prescribed information at any time during the treatment trajectory/when they are ready)
• Some patients reported increased anxiety due to the abundance of new information, underscoring the importance of navigator support in interpreting and managing this information

Navigator Feedback

• Navigators valued the flexibility of the CAPE platform, which allowed them to send resources via email or to print them for patients without internet access
• The ability to send information without meeting patients face-to-face was highlighted as a significant advantage
• Navigators noted challenges related to the handoff process between different care team members and the need for more metrics to track the platform’s impact

Implementation Insights

• The implementation guide developed as part of the study provided valuable recommendations for integrating the CAPE platform into clinical practice
• The study highlighted the importance of involving the entire care team in the implementation process and ensuring that all team members are aware of the resources being shared with patients
• Access to technology, such as iPads, facilitated the use of the platform in clinical settings
• Future efforts will include increasing access to the platform in multiple languages

By providing navigators and other healthcare professionals with a versatile tool to enhance patient understanding and engagement, the CAPE platform represents a significant step forward in patient-centered care.

“We found that when CAPE was introduced by the navigator, patients were more likely to respond positively,” Dr Fleisher noted. “Having that one-on-one with their navigator really has such power to get patients to focus on these materials.”

The CAPE pilot study demonstrated the potential of a personalized, digital approach to patient education in oncology care. By providing navigators and other healthcare professionals with a versatile tool to enhance patient understanding and engagement, the CAPE platform represents a significant step forward in patient-centered care.

“Combining innovation and technology with the human touch is really the best model,” said Ms Gentry. “And we’re excited to continue to hone in on that.”