Rationale: Sexual violence (SV) statistics are staggering: 1 in 3 women and 1 in 6 men has experienced sexual violence in their lifetime. For SV survivors, cancer care can be triggering and retraumatizing due to perceived similarities between aspects of cancer treatment and the original SV (e.g., being asked to undress, lie still, being touched by authority figures). This triggering and retraumatization can be associated with non-adherence to cancer screening and treatment. Yet despite the prevalence of SV and the negative effects it can have on patients' cancer treatment experiences, training in working with SV survivors is not a standard component of cancer care providers' education. Objectives: The goal of the proposed R25E is to train a multidisciplinary group of cancer care providers in sensitive practice skills for working with survivors of SV. The proposed Sensitive Practice Training (SPT) Program will teach providers to help their SV survivor patients to feel as safe and empowered as possible during cancer screening and treatment. The program would be the first, nationwide, sensitive practice training program of its kind. The training format for the SPT program is blended learning, combining E-Learning and a two-day live workshop. The faculty represents multiple disciplines including psychology, radiation oncology, radiation therapy, and physical therapy.
The Specific Aims are to: 1) evaluate trainee accrual to, retention in, and satisfaction with our SPT training program; 2) evaluate the effectiveness of the SPT program on trainees' sensitive practice knowledge, skills, and self-efficacy for using these skills in practice; and, 3) evaluate the impact of the SPT program on trainees' real-world practice using a mixed-methods approach. The SPT content is guided by Schachter's ?Umbrella of Safety? principles (respect, rapport, taking time, sharing information, sharing control, respecting boundaries, mutual learning, understanding non-linear healing, demonstrating an understanding of sexual violence). The evaluation plan for the SPT program is guided by Miller's pyramid of clinical competencies, and will focus on four levels of evaluation: knowledge, competence, performance, and action. Evaluations will be linked to each training module, and will be administered prior to, during, and 3 months after program participation. Methods: A multidisciplinary group of cancer care providers (N=200; including medical, nursing, allied health, and psychosocial providers) from across the country will be recruited via professional organizations and conferences. Long-term goals: By training a large cohort of cancer care providers in sensitive practice techniques, the proposed R25E is a critical first step toward enhancing the ability of the cancer care workforce to meet the needs of SV survivors undergoing cancer care, a large and largely overlooked group. Connection to NCI mission: This project is consistent with NCI's emphasis on promoting health care quality and optimizing communication between clinicians and patients.
Cancer treatment providers ? whether or not they are aware ? encounter adult survivors of sexual violence in the course of their practice, and yet few providers have the training needed to meet the unique treatment needs of this group. The goal of the proposed R25E is to implement a blended learning program (E-Learning plus Live Workshop) to train cancer care providers in research-based, sensitive practice techniques to help reduce distress, increase feelings of safety and empowerment, and reduce triggering and retraumatization in survivors of sexual violence undergoing cancer screening and treatment. Through this training, we hope to improve the sensitivity of the cancer care offered to sexual violence survivors across the nation.
