Update to 2019-2022 ONS Research Agenda: Rapid Review to Address Structural Racism and Health Inequities

Research Priorities of the Oncology Nursing Society: 2024-2027

PROBLEM STATEMENT

To define the Oncology Nursing Society Research Agenda for 2024-2027.

DESIGN

An iterative, multiple data sources consolidation through the Research Agenda Project Team.

DATA SOURCES

Previous research priorities, literature review, stakeholder survey, and research priorities from other cancer care organizations and funding agencies.

FINDINGS

10 evergreen statements articulated foundational values for oncology nurse scientists, and 5 topics emerged as research priorities for the upcoming three years: Advance patient-centric, precision symptom science; provide evidence for safe and effective cancer care delivery models and support of the oncology nursing workforce; describe the impact of the environment on cancer care outcomes; integrate patient navigation into cancer care across the trajectory; and advance the use of innovative methodologies in oncology nursing research.

IMPLICATIONS FOR NURSING

The Oncology Nursing Society Research Agenda is an effective resource for directing the organization's research vision. This foundational document directs funding awards and requests, mentorship, and policy initiatives.

Expanding Leadership and Professional Development Opportunities for Oncology Nurse Practitioners

Nurse practitioner (NP) involvement in professional organizations improves clinical practice, patient outcomes, and health care policy. Results of a survey for a local professional nursing organization showed a need for more NP-level education and NP mentorship and leadership training. Findings were applied to develop a leadership initiative through an NP-led continuing education program. At the conclusion of the program, NP presenters completed a survey. The NP presenters agreed that participating in this program and the mentoring that was provided helped them prepare for their sessions, improve their leadership skills, and prepare for additional speaking engagements. Additionally, each session's attendees completed evaluation surveys. Results from program attendees indicated a high level of agreement about meeting learning objectives in sessions and the effectiveness of the NP presenters. This innovative program may be modeled across a variety of nursing specialties, settings, and organizations to enhance NP professional development and support nursing-led continuing education. [J Contin Educ Nurs. 2024;55(2):94-100.].

Development of a Community Advisory Board to Guide Research About Cancer Disparities in the Black and African American Community

BACKGROUND

Researchers who aim to serve a community (i.e., racial, gender, ethnic group) of which they are not a part must do foundational work to understand that community and build intentional, thoughtful collaborations with the community to guide their work.

OBJECTIVES

This article aims to share a case exemplar of the formation period of a community advisory board (CAB) that conducts research focused on improving health equity in the Black and African American community.

METHODS

CAB development has three phases: formation, operation, and maintenance. Previous work has described and provided best practices for each phase. This article focused on the first phase, formation. Guided by critical race theory, with guidance from her mentor, a researcher partnered with a research assistant and a community health educator to develop a CAB. Details of their processes-which apply to the formation of other CABs-are presented.

DISCUSSION

During the board formation period, the major focus has been relationship building and developing a shared mission: "To work in partnership with researchers at the University of North Carolina to reduce cancer disparities in Black/African American communities by informing research and program development. As a liaison between the community and researchers, the Community Advisory Board will identify community needs, promote evidence-based interventions and information, raise awareness about health disparities in communities, and educate researchers." CAB formation is nuanced and unique, dependent upon the nature of the research to be conducted and the characteristics of the community and researchers. This case exemplar provides valuable insights to other researchers working to build community partnerships.

Exploration of shared decision making in oncology within the United States: a scoping review

PURPOSE

Shared decision making (SDM) among the oncology population is highly important due to complex screening and treatment decisions. SDM among patients with cancer, caregivers, and clinicians has gained more attention and importance, yet few articles have systematically examined SDM, specifically in the adult oncology population. This review aims to explore SDM within the oncology literature and help identify major gaps and concerns, with the goal to provide guidance in the development of clear SDM definitions and interventions.

METHODS

We conducted a scoping review using the Arksey and O'Malley approach along with the PRISMA Extension for Scoping Reviews Checklist. A systematic search was conducted in four databases that included publications since 2016.

RESULTS

Of the 364 initial articles, eleven publications met the inclusion criteria. We included articles that were original research, cancer related, and focused on shared decision making. Most studies were limited in defining SDM and operationalizing a model of SDM. There were several concerns revealed related to SDM: (1) racial inequality, (2) quality and preference of the patient, caregiver, and clinician communication is important, and (3) the use of a decision-making aid or tool provides value to the patient experience.

CONCLUSION

Inconsistencies regarding the meaning and operationalization of SDM and inequality of the SDM process among patients from different racial/ethnic backgrounds impact the health and quality of care patients receive. Future studies should clearly and consistently define the meaning of SDM and develop decision aids that incorporate bidirectional, interactive communication between patients, caregivers, and clinicians that account for the diversity of racial, ethnic, and sociocultural backgrounds and preferences.

Antiracist symptom science: A call to action and path forward

Nurse scientists recognize the experience of racism as a driving force behind health. However, symptom science, a pillar of nursing, has rarely considered contributions of racism. Our objective is to describe findings within symptom science research related to racial disparities and/or experiences of racism and to promote antiracist symptom science within nursing research. In this manuscript, we use an antiracist lens to review a predominant symptom science theory and literature in three areas of symptom science research-oncology, mental health, and perinatal health. Finally, we make recommendations for increasing antiracist research in symptom science by altering (a) research questions, (b) recruitment methods, (c) study design, (d) data analysis, and (e) dissemination of findings. Traditionally, symptom science focuses on individual level factors rather than broader contexts driving symptom experience and management. We urge symptom science researchers to embrace antiracism by designing research with the specific intent of dismantling racism at multiple levels.

Sexual health and intimacy after cancer treatment in women of color: A systematic review

OBJECTIVE

Cancer diagnosis and treatment can significantly affect women's sexual health and intimacy, leading to diminished quality of life in survivorship. The perspectives and experiences of women of color (WOC) with cancer are critical to inform comprehensive, inclusive sexual wellbeing care in survivorship. The purpose of this systematic review is to summarize contemporary literature describing sexual wellbeing experiences of WOC treated for cancer.

METHODS

A comprehensive search of CINAHL, PubMed, Embase and PsycInfo and Scopus identified studies that addressed sex and intimacy of U.S. WOC treated for cancer published in the last 15 years. The authors identified emergent themes from the literature through thematic content analysis.

RESULTS

Eighteen studies (10 qualitative, 8 quantitative) met the inclusion criteria, all with breast or gynecologic cancer samples. Studies include African American (13), Asian American (3), and Latina (10) women, as well as Non-Hispanic Whites and 'other' race/ethnicity women. Overarching themes identified were: 1) impacts of treatment on sexual health and body image, 2) process of accepting and overcoming, 3) value of an engaged and supportive partner, and 4) current clinical practice and barriers to sexual health care.

CONCLUSIONS

WOC experience changes in sex and intimacy after cancer treatment, and experiences of sexual function, sexual communication, and sexual healthcare are often shaped by sociocultural experiences. An understanding of WOC's sexual health and intimacy after cancer treatment can inform inclusive, culturally responsive sexual health interventions.

Update to 2019-2022 ONS Research Agenda: Rapid Review to Promote Equity in Oncology Healthcare Access and Workforce Development

PURPOSE

The Oncology Nursing Society (ONS) tasked a rapid response research team (RRRT) to develop priorities to increase diversity, equity, and inclusivity in oncology clinical care and workforce development.

METHODS

An RRRT of experts in health disparities conducted a rapid review of the literature, consulted with oncology nurse leaders and disparities researchers, and reviewed priorities from funding agencies.

RESULTS

Significant gaps in the current oncology disparities literature were identified and used to inform priority areas for future research practice and workforce development in oncology nursing.

SYNTHESIS

This is the second article in a two-part series that presents findings on structural racism and health inequities in oncology nursing. In the first article, three priority areas for oncology nursing research were presented. In this article, strategies to improve diversity, equity, and inclusivity in clinical practice and the oncology workforce are described.

IMPLICATIONS FOR RESEARCH

Recommendations are presented to inform research, clinical, administrative, and academic oncology nursing settings on increasing diversity, equity, and inclusivity and deconstructing structural racism.

Update to 2019-2022 ONS Research Agenda: Rapid Review to Address Structural Racism and Health Inequities

PURPOSE

The Oncology Nursing Society (ONS) formed a team to develop a necessary expansion of the 2019-2022 ONS Research Agenda, with a focus on racism and cancer care disparities.

METHODS

A multimethod consensus-building approach was used to develop and refine the research priorities. A panel of oncology nurse scientists and equity scholars with expertise in health disparities conducted a rapid review of the literature, consulted with experts and oncology nurses, and reviewed priorities from funding agencies.

RESULTS

Critical gaps in the literature were identified and used to develop priority areas for oncology nursing research, practice, and workforce development.

SYNTHESIS

This is the first article in a two-part series that discusses structural racism and health inequities within oncology nursing. In this article, three priority areas for oncology nursing research are presented; in the second article, strategies to improve cancer disparities and equity and diversity in the oncology workforce are described.

IMPLICATIONS FOR RESEARCH

Research priorities are presented to inform future research that will provide methods and tools to increase health equity and reduce structural racism in oncology nursing practice, research, education, policy, and advocacy.