Implementation of a universal psychosocial screening program across the pediatric cancer treatment trajectory: a standard of care.
4 affiliations
- 1Children's Hospital of Philadelphia, Philadelphia, PA, USA. [email protected].
- 2University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. [email protected].
- 3Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- 4University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Abstract
Purpose
Guided by Rapid Evaluation and Assessment Methods (REAM) and using rigorous quality improvement processes, we describe implementation of an evidence-based psychosocial screening program at key transitions in childhood cancer treatment to guide care matched to need.Methods
Pediatric cancer patients (≥ 11 years) and caregivers (patients 0-17 years) were offered screening questionnaires electronically at 4-6 months, 18-24 months, and 4-6 years post-diagnosis through a phased implementation across three cancer center sites and in their preferred language (English, Spanish, Arabic). Screening questionnaires assessed cancer-related symptoms, health-related quality of life, cognitive function and school needs, caregiver adjustment and family risk, and resource needs. To assess adoption, feasibility, penetration, and sustainability, data related to screening processes, documentation completion rates, and adaptations were tracked and summarized. Qualitative interviews with patients, caregivers, and clinicians, based on the Consolidated Framework for Intervention Research (CFIR), were coded for acceptability and screening program optimization.Results
Across sites and timepoints, from June 2023 through November 2025, there was a 56% screening completion rate (470/846). Patient physical functioning, emotional functioning, and neurocognitive functioning, caregiver adjustment, and resource needs were consistently flagged for follow-up. Documentation of follow-up varied with rates of 74% for social workers and 34% for medical clinicians. Patients, caregivers, and clinicians endorsed moderate acceptability. Barriers to electronic health record integration complicated clinician workflows. From initiation, over 2 years, 55 adaptations were made to improve workflow, implementation strategies, screening processes, and measures.Conclusion
We achieved development, implementation, and optimization of a psychosocial screening program across our cancer center.
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BibTeX
@article{barakat2026implementation,
title = {{Implementation of a universal psychosocial screening program across the pediatric cancer treatment trajectory: a standard of care.}},
author = {Lamia P Barakat and Susanna Vargo and Shannon N Hammer and Anne Reilly and Charles Phillips and Patricia Burns-Lynch and Lisa A Schwartz and Megan N Perez},
journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer},
year = {2026},
month = oct,
doi = {10.1007/s00520-026-11317-2},
url = {https://europepmc.org/article/MED/42891695},
note = {CC BY},
}
RIS
TY - JOUR
TI - Implementation of a universal psychosocial screening program across the pediatric cancer treatment trajectory: a standard of care.
AU - Lamia P Barakat
AU - Susanna Vargo
AU - Shannon N Hammer
AU - Anne Reilly
AU - Charles Phillips
AU - Patricia Burns-Lynch
AU - Lisa A Schwartz
AU - Megan N Perez
PY - 2026
DA - 2026/10/17
JO - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
DO - 10.1007/s00520-026-11317-2
UR - https://europepmc.org/article/MED/42891695
AB - Purpose Guided by Rapid Evaluation and Assessment Methods (REAM) and using rigorous quality improvement processes, we describe implementation of an evidence-based psychosocial screening program at key transitions in childhood cancer treatment to guide care matched to need.Methods Pediatric cancer patients (≥ 11 years) and caregivers (patients 0-17 years) were offered screening questionnaires electronically at 4-6 months, 18-24 months, and 4-6 years post-diagnosis through a phased implementation across three cancer center sites and in their preferred language (English, Spanish, Arabic). Screening questionnaires assessed cancer-related symptoms, health-related quality of life, cognitive function and school needs, caregiver adjustment and family risk, and resource needs. To assess adoption, feasibility, penetration, and sustainability, data related to screening processes, documentation completion rates, and adaptations were tracked and summarized. Qualitative interviews with patients, caregivers, and clinicians, based on the Consolidated Framework for Intervention Research (CFIR), were coded for acceptability and screening program optimization.Results Across sites and timepoints, from June 2023 through November 2025, there was a 56% screening completion rate (470/846). Patient physical functioning, emotional functioning, and neurocognitive functioning, caregiver adjustment, and resource needs were consistently flagged for follow-up. Documentation of follow-up varied with rates of 74% for social workers and 34% for medical clinicians. Patients, caregivers, and clinicians endorsed moderate acceptability. Barriers to electronic health record integration complicated clinician workflows. From initiation, over 2 years, 55 adaptations were made to improve workflow, implementation strategies, screening processes, and measures.Conclusion We achieved development, implementation, and optimization of a psychosocial screening program across our cancer center.
SN - 0941-4355
SN - 1433-7339
ER -