Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA.
Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
Support Care Cancer. 2023 Mar 16;31(4):216. doi: 10.1007/s00520-023-07679-6.
Cancer survivors experience high rates of physical inactivity that often go unaddressed. The My Wellness Check program (MWC) is an EHR-integrated screening and referral system that includes surveillance of physical activity and triage to cancer rehabilitation medicine services. This study examined assessment of physical activity and subsequent referrals to cancer rehabilitation medicine.
A secondary analysis was performed for survivors who completed the MWC between April 2021 and January 2022. Univariable and multivariable logistic regression modeled determinants of qualification for a physical activity referral and provider completion of referral to cancer rehabilitation medicine. Referral was based on responses to the Moving Through Cancer questionnaire. Adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95% CI) were calculated.
There were 1,174 survivors who completed the assessment, of which 46% (n = 540) reported physical inactivity. After controlling for group differences, individuals with moderate-severe physical dysfunction (aOR: 1.750; 95% CI: 1.137, 2.693) had higher odds, and self-reporting Hispanic or Latino ethnicity (aOR: 0.720; CI: 0.556, 0.932) had lower odds of physical inactivity. Only 31% (n = 168) received a completed physician referral to cancer rehabilitation medicine following identification of physical inactivity. No patient-level factors were associated with receiving a physician referral. Following referral, 8% (n = 13) utilized cancer rehabilitation medicine services.
Patient-level and clinical factors may predict qualification for physical activity referrals; however, they don't appear to predict referral completion to cancer rehabilitation medicine. Future research should focus on potential provider- and organization-level factors that interact and influence access to cancer rehabilitation medicine services.
癌症幸存者经历着高比例的身体活动不足，而这些问题往往未得到解决。My Wellness Check 计划（MWC）是一个与电子病历集成的筛查和转介系统，包括对身体活动的监测和分诊至癌症康复医学服务。本研究评估了身体活动评估以及随后向癌症康复医学转介的情况。
对 2021 年 4 月至 2022 年 1 月期间完成 MWC 的幸存者进行了二次分析。单变量和多变量逻辑回归模型用于确定身体活动转介资格的决定因素以及提供者是否完成向癌症康复医学的转介。转介基于对 Moving Through Cancer 问卷的回答。计算了调整后的优势比（aOR）和相应的 95%置信区间（95%CI）。
共有 1174 名幸存者完成了评估，其中 46%（n=540）报告身体活动不足。在控制组间差异后，中度至重度身体功能障碍的个体（aOR：1.750；95%CI：1.137，2.693）更有可能出现这种情况，而自我报告的西班牙裔或拉丁裔种族（aOR：0.720；CI：0.556，0.932）出现身体活动不足的可能性较低。只有 31%（n=168）在确定身体活动不足后收到了医生完成的向癌症康复医学转介。没有患者层面的因素与收到医生转介有关。转介后，8%（n=13）利用了癌症康复医学服务。
患者层面和临床因素可能预测身体活动转介的资格；然而，它们似乎并不能预测向癌症康复医学的转介完成情况。未来的研究应集中于潜在的提供者和组织层面的因素，这些因素相互作用并影响癌症康复医学服务的获取。
