ASCO's State Affiliate Grant Program helps jump-start exciting local projects undertaken by state oncology societies. Established in 2005, the program has so far awarded 38 grants to its state affiliates for projects ranging from creating a statewide clinical trial network to providing career planning seminars for oncology fellows.

Projects recently completed by the Hawaii Society of Clinical Oncology (HSCO) and the Washington State Medical Oncology Society (WSMOS) offer excellent examples of the kinds of initiatives supported by the program.

Hawaii Addresses Patient Language Barriers

Many immigrant and first-generation Filipinos in Hawaii are not fluent or literate in English. "We struggle to talk meaningfully about the diagnosis, prognosis, treatment options, side effects of therapy, and goals of treatment," says Past HSCO President William S. Loui, MD. After learning from community focus groups that a DVD would be a useful medium for patient education, HSCO applied for and received a $10,000 grant from ASCO to help develop a DVD for use with patients.

"We are beta-testing the DVD now and doing a survey to assess its effectiveness," Dr. Loui says. He has had gratifying responses from patients. "Last month, I was struggling in a consultation with an elderly Filipina, and a gap in comprehension was evident. I brought her and her adult grandson into my office to watch the DVD on the computer. After 15 minutes, we could tell that she had better insight into the proposed chemotherapy. Her grandson was also appreciative because he had been struggling to translate the medical terms."

Dr. Loui says that the most powerful part of the DVD is the first section, in which cancer survivors who are fluent in Tagalog, the official language in the Philippines, or Ilocano, the Philippine dialect most common in Hawaii, relate their own feelings and experiences. Other segments of the DVD provide information about chemotherapy, radiation therapy, surgery, and clinical trials.

HSCO hopes to produce hundreds of the DVDs to distribute to patients, doctors, clinics, and cancer programs. "We're looking for funding to have a copy for everyone who asks," Dr. Loui comments.

Washington Aim: Boost Supply of Midlevel Providers

With an eye to increasing the use of midlevel providers in oncology practice, WSMOS used an ASCO grant to conduct two surveys to profile oncology practices and training programs in the state and to create a resource for enhanced interaction. Both surveys had a 51% response rate.

WSMOS found that 68% of the responding practices employed either nurse practitioners (NPs) or physician assistants (PAs) who perform all of the functions of physicians. "We were somewhat surprised-and pleased-by the widespread use of midlevel providers in oncology practices," says Jonathan C. Britell, MD, Past President of WSMOS.

The second survey polled training programs about annual numbers of graduating students, clinical externships offered, and interest in developing an externship in oncology. The 17 responding programs reported that they graduate 10 NPs annually; PAs are not trained in these programs. The programs did not express interest in collaborating in oncology training.

"They are really focused on filling a primary care need," comments WSMOS President Jeffery C. Ward, MD. He thinks additional flow of NPs into oncology will require either on-the-job training after graduation or significant oncology experience by an individual before beginning NP training.

WSMOS has published the survey results and profiles of both training programs and oncology practices, with contact information, in a brochure posted on the WSMOS website and mailed to all members. "The WSMOS initiative to create a directory and profile the professional roles of NPs and PAs is our first effort to help alleviate the anticipated workforce shortage," Dr. Britell comments. ■

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