The overall purpose of this study is to test an innovative model of reducing barriers to the management of pain and fatigue in cancer patients. These two symptoms were recognized by the NIH State of the Science Conference on Symptom Management in Cancer as critical symptoms impacting QOL and as priority areas for future research. The model, """"""""Passport to Comfort"""""""" (or Passport) addresses patient, professional and system barriers to the relief of pain and fatigue and is based on established guidelines developed by the National Comprehensive Cancer Network (NCCN). ? The specific aims are: ? Aim 1- Test the effects of the """"""""Passport"""""""" intervention at 1 and 3 months post intervention comparing Baseline data (Phase I) to the High Intensity Intervention (Phase II). ? Aim 2 - Test the effect of select demographic and disease/treatment variables on outcomes of the Passport Model at 3 months post intervention compared to pre intervention. ? Aim 3 - Examine perceived patient and professional satisfaction with the Passport Model. ? Aim 4 - Test the effects of the """"""""Passport"""""""" intervention comparing High Intensity (Phase II) to Low Intensity (Phase III). ? The study is designed in three phases. Phase I consists of Usual Care/Baseline in order to describe the current status of pain and fatigue management in this population and setting. Phase II will be a High Intensity Intervention in which intensive interaction by the investigators will be implemented along with peer audit and feedback in order to address each of these categories of barriers. Phase III will be a Low Intensity Support Intervention in which the investigators will attempt to move the intervention to a more realistic model of care that can be replicated in other clinical and community settings as well as maintained in this setting after the conclusion of the project. ? ?
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