Cancer survivors, of which there are nearly 17 million in the U.S., are at greater risk than the general population for developing chronic conditions. Addressing these associated risk factors is essential to improving cancer survivor health and well-being.

The objective of this study for the Centers for Disease Control and Prevention (CDC) is to:

• Implement proven health systems changes to reduce chronic disease risk factors in cancer survivors
• Disseminate best practices through the National Comprehensive Cancer Control Program (NCCCP)

Westat established subcontracts with 2 NCCCP awardees that partnered with local clinics within their network to implement health systems changes aimed at reducing chronic disease risk factors in cancer survivors.

We provided technical assistance to identify cancer survivors within the clinic population and their associated risk factors using available electronic health record (EHR) data. Using these data, Westat supported clinics to develop automated prompts, messaging, and referrals to streamline their clinical care workflow.

Westat will conduct key informant interviews with project and clinic staff to understand the contextual factors, facilitators, and barriers associated with implementing these changes.

One clinic used EHR data to identify cancer survivors with high body mass index (BMI) and developed automated referrals of these patients to a dietician.

The second clinic implemented an electronic malnutrition screening tool. Patients were referred to a dietician or given educational videos through an EHR messaging feature.

Key informant interviews will help us understand the critical components of the implementation process, challenges and barriers faced, and successes using the automated systems to facilitate care. The results will provide guidance for other NCCCP awardees to implement similar EHR enhancements.