My most important goal in the next year is to help guide ASPHO through an effective strategic planning process that will steer ASPHO for the next 3 to 5 years. The more vocal members are, and the more input we receive, the better our priorities over the next few years will support your work, your professional growth, and the care you provide to our patients. This is your Society, so your participation is crucial.

Why strategic planning? Professional membership organizations face a barrage of requests from members and partners to develop new programs, services, technologies, and more. They can’t do it all, and it can be challenging to decide which opportunities deserve resources. A strategic plan based on input by members “enables an organization to function from an intentional and active place rather than a reactive one. It streamlines decision making and acts as a road map for realizing the organization’s vision.”

A strategic plan helps you anticipate upcoming challenges by examining your organization’s internal strengths and weaknesses, scanning its external environment, and identifying and troubleshooting obstacles. It provides a framework and decision matrix to guide your day-to-day decisions, including prioritizing investments and opportunities to pursue.

Our current goals reflect work we have focused on and prioritized over the past 4 years. I would like to review our current goals and invite you to participate this summer in sharing what you need most from your membership organization!

We have expanded our collaboration and raised our profile through our External Relations and Advocacy goal. We continue to develop education, expand delivery opportunities of novel discoveries, and determine new ways to provide content through our Discovery and Education goals. ASPHO has focused on mentoring and showcasing career pathways through its Career Development goal and finally adding practice resources, creating awareness of the workforce and supporting recruitment and retention through our Workforce goal.

We already have had several meetings to prepare for strategic planning and hired a consultant to ensure we complete the process effectively. A key step of strategic planning will involve gathering input through focus groups and member surveys this summer. We hope to have a draft strategic plan by fall, and then we will be refining it and posting it for member comments and feedback this winter. We hope that you will be vocal. Next, we will make edits and share the new plan at the 2022 ASPHO Conference.

I invite you to participate and help guide your professional Society into the future!

Sincerely,
Jorge

So, why do so few survivors receive survivor-focused care and even fewer receive counseling on late-effects risk reduction and screening?¹ Survivors with higher income and private medical insurance have higher rates of healthcare utilization, whereas those who have lower educational attainment, less medical insurance, and travel further are less likely to obtain survivorship care.^2-5 Ethnic and racial minorities also are at increased risk for adverse health outcomes and loss to follow-up, disparities that may be related to disadvantaged socioeconomic background.⁶

While most Children’s Oncology Group (COG) institutions provide survivorship care, only half offer continuation of care into adulthood.⁷ The remaining sites transition survivors to primary or adult providers for long-term follow-up care. Survivorship care plans (SCP) facilitate that transition, because adult survivors rarely possess sufficient knowledge of their diagnosis and treatment to inform understanding of their late-effects risk,^8,9 but few internists report receiving a treatment summary, and most are unaware of available guidelines.^10,11

COG’s Long-Term Follow-up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers provide the essential framework for determining exposure-based risks for late effects and recommended surveillance.¹² Successful clinical application requires resource familiarity, access to the treatment history, and time to generate a personalized risk profile and plan for surveillance. Even among pediatric oncologists, up to one-third fail to recommend appropriate screening based on clinical history.¹³

National leaders in childhood cancer survivorship have developed evidence-based approaches to promote universal, equitable delivery of high-quality survivorship care. The strategies outlined here are designed to promote, foster, and maintain survivor engagement; support clinical decision-making and guidelines implementation; and address systemic barriers contributing to disparities in healthcare access and utilization.¹⁴

• Early engagement: Timely, structured delivery of rationale and plans for long-term follow-up beginning at the end of treatment prepares survivors and facilitates their transition to survivorship care.¹⁵

• Risk-based education: Repeated, personalized risk-based education improves survivor awareness of their health risks after only three visits.¹⁶

• Culturally adapted care: Optimal education delivery is in the survivor’s preferred language and considers their educational background, lifestyle, and learning preferences.^17,18

• Survivorship care plans (SCPs): A treatment summary, exposure-based risk for late effects, and surveillance recommendations inform long-term follow-up care. At minimum, the personalized SCP should be delivered at entry to long-term follow-up care and with each update/revision to the guidelines. SCPs are most effective when delivered with culturally adapted, risk-based education.¹⁹

• Web-based decision support tools: Online platforms facilitate the generation and delivery of accurate, comprehensive, and personalized SCPs²⁰ and are easily shared with members of the medical team. Some resources, such as Passport for Care, also serve as a survivor database. 

• Virtual visits: Telemedicine facilitates healthcare access by eliminating transportation and travel cost barriers. Experiences during the pandemic suggest both providers and survivors are highly satisfied by virtual survivorship care delivery.²¹ 

• Shared-care models: Successful survivorship care requires a close partnership between the oncology team and the primary care provider, including sharing of the SCP.²² Survivors that rely on a general practitioner for survivorship care may benefit from virtual visits with the closest survivor clinic.

References

1. Nathan PC, Greenberg ML, Ness KK, et al. Medical care in long-term survivors of childhood cancer: a report from the childhood cancer survivor study. J Clin Oncol. 2008;26(27):4401-4409.
2. van Breeschoten J, De Abreu Lourenco R, Signorelli C, et al. Patterns and drivers of health care use in long-term childhood cancer survivors: a systematic review. Crit Rev Oncol Hematol. 2017;120:60-76.
3. Casillas J, Oeffinger KC, Hudson MM, et al. Identifying predictors of longitudinal decline in the level of medical care received by adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Health Serv Res. 2015;50(4):1021-1042.
4. Klosky JL, Cash DK, Buscemi J, et al. Factors influencing long-term follow-up clinic attendance among survivors of childhood cancer. J Cancer Surviv. 2008;2(4):225-232.
5. Nathan PC, Agha M, Pole JD, et al. Predictors of attendance at specialized survivor clinics in a population-based cohort of adult survivors of childhood cancer. J Cancer Surviv. 2016;10(4):611-618.
6. Castellino SM, Casillas J, Hudson MM, et al. Minority adult survivors of childhood cancer: a comparison of long-term outcomes, health care utilization, and health-related behaviors from the childhood cancer survivor study. J Clin Oncol. 2005;23(27):6499-6507.
7. Eshelman-Kent D, Kinahan KE, Hobbie W, et al. Cancer survivorship practices, services, and delivery: a report from the Children's Oncology Group (COG) Nursing Discipline, Adolescent/Young Adult, and Late Effects Committees. J Cancer Surviv. 2011;5(4):345-357.
8. Kadan-Lottick NS, Robison LL, Gurney JG, et al. Childhood cancer survivors' knowledge about their past diagnosis and treatment: Childhood Cancer Survivor Study. JAMA. 2002;287(14):1832-1839.
9. Syed IA, Klassen AF, Barr R, et al. Factors associated with childhood cancer survivors' knowledge about their diagnosis, treatment, and risk for late effects. J Cancer Surviv. 2016;10(2):363-374.
10. Suh E, Daugherty CK, Wroblewski K, et al. General internists' preferences and knowledge about the care of adult survivors of childhood cancer: a cross-sectional survey. Ann Intern Med. 2014;160(1):11-17.
11. Signorelli C, Wakefield CE, Fardell JE, et al. The role of primary care physicians in childhood cancer survivorship care: multiperspective interviews. Oncologist. 2019;24(5):710-719.
12. Landier W, Bhatia S, Eshelman DA, et al. Development of risk-based guidelines for pediatric cancer survivors: the Children's Oncology Group Long-Term Follow-Up Guidelines from the Children's Oncology Group Late Effects Committee and Nursing Discipline. J Clin Oncol. 2004;22(24):4979-4990.
13. Henderson TO, Hlubocky FJ, Wroblewski KE, Diller L, Daugherty CK. Physician preferences and knowledge gaps regarding the care of childhood cancer survivors: a mailed survey of pediatric oncologists. J Clin Oncol. 2010;28(5):878-883.
14. Mobley EM, Moke DJ, Milam J, et al. Disparities and Barriers to Pediatric Cancer Survivorship Care. Rockville, MD: Agency for Healthcare Quality and Research;2021. Technical Brief Number 39. https://effectivehealthcare.ahrq.gov/sites/default/files/pdf/tb-39-pediatric-cancer-survivorship-final.pdf. Published March 2021. Accessed May 21, 2021.
15. Lea S, Martins A, Fern LA, et al. The support and information needs of adolescents and young adults with cancer when active treatment ends. BMC Cancer. 2020;20(1):697.
16. Landier W, Chen Y, Namdar G, et al. Impact of tailored education on awareness of personal risk for therapy-related complications among childhood cancer survivors. J Clin Oncol. 2015;33(33):3887-3893.
17. Stolley MR, Sharp LK, Tangney CC, et al. Health behaviors of minority childhood cancer survivors. Cancer. 2015;121(10):1671-1680.
18. Kronenfeld JP, Graves KD, Penedo FJ, Yanez B. Overcoming disparities in cancer: a need for meaningful reform for Hispanic and Latino cancer survivors. Oncologist. 2021.
19. Hill RE, Wakefield CE, Cohn RJ, et al. Survivorship care plans in cancer: a meta-analysis and systematic review of care plan outcomes. Oncologist. 2020;25(2):e351-e372.
20. Gramatges MM, Bonaduce de Nigris F, King J, Horowitz ME, Fordis M, Poplack DG. Improving childhood cancer survivor care through web-based platforms. Oncology (Williston Park). 2018;32(1):e1-e10.
21. Kenney LB, Vrooman LM, Lind ED, et al. Virtual visits as long-term follow-up care for childhood cancer survivors: patient and provider satisfaction during the COVID-19 pandemic. Pediatr Blood Cancer. 2021;68(6):e28927.
22. McCabe MS, Bhatia S, Oeffinger KC, et al. American Society of Clinical Oncology statement: achieving high-quality cancer survivorship care. J Clin Oncol. 2013;31(5):631-640.

The Special Feature section of eNews highlights member-authored opinion pieces on broad issues in pediatric hematology/oncology that are of interest to ASPHO's diverse membership. Share your perspective and expertise with colleagues in an eNews Special Feature. Contact This email address is being protected from spambots. You need JavaScript enabled to view it.  if you would like to contribute an article. 

Copyright© 2021 by the American Society of Pediatric Hematology/Oncology. All rights reserved. The views and opinions expressed in the Feature Articles are those of the author alone and do not imply an opinion on the part of ASPHO, its Board of Trustees, or staff. The information in this newsletter is intended to provide readers with resources and information that they may find useful and of interest and is only current as of the publication date. ASPHO is not liable to any party as a result of their reliance on the information, recommendations, services, or resources discussed or made available through this newsletter.

A diverse task force has commenced working on the development of the question content to ensure the survey is appropriately addressing important workforce topics within the subspecialty. This task force includes

• Chair, John Bergsagel, MD (Children’s Healthcare of Atlanta)
• Caroline Hastings, MD (Benioff Children’s Hospital–Oakland)
• Jeff Hord, MD (Akron Children’s Hospital)
• Michelle Hudspeth, MD (MUSC Children’s Hospital)
• Whitney Lerch, PA (UPMC Children’s Hospital)
• Lori Luchtman-Jones, MD (Cincinnati Children’s Hospital)
• Linda McAllister-Lucas, MD PhD (UPMC Children’s Hospital)
• Andrea Watson, MD (Essentia Health–Duluth)
• Jordan Wright, MD (Dayton Children’s Hospital)

Learn more about ASPHO’s workforce-based initiatives by visiting the workforce webpage, which includes information on our current workforce strategy.

Free to 2021 ASPHO Conference registrants, the event program will celebrate these distinguished award winners and their contributions impacting the science and practice of pediatric hematology/oncology:

• Recognizing Melissa Hudson, MD, and M. Monica Gramatges, MD PhD, Northwestern Mutual Award for Excellence in Childhood Cancer Survivorship recipients
• Bone Marrow Failure and MDS: Lessons from Rare Diseases, Akiko Shimamura, MD PhD, Frank A. Oski Memorial Award and Lectureship recipient
• Presentations by Alex Kentsis, MD PhD, and Kimberly Stegmaier, MD, St. Baldrick’s Foundation Robert J. Arceci Innovation Award recipients
• Recognizing Garrett Brodeur, MD, Distinguished Career Award recipient
• Artificial Intelligence Symposia, Patrick Leavey, MD, Ovidiu Daescu, PhD, and Anthony Chang, MD MBA MPH MS
• Presentation by Donald Mahoney, MD, George R. Buchanan Award and Lectureship recipient

Up to 4 AMA PRA Category 1 Credits™ available. The event will also be available in on-demand format.

Registration is now open! Everyone must register for the event, but conference registrants will receive complimentary registration. Please visit the ASPHO website for more information.

• Standard Approach to the Diagnosis of Severe Aplastic Anemia in Pediatrics
• Standard Approach to the Diagnosis of Myelodysplastic Syndrome (MDS) in Pediatrics
• Diversity in the Scientific Workforce
• Overcoming Obstacles to Advancement for Women in Medicine
• Integrative Oncology in Pediatrics, Programmatic Development Framework, Needs, and Challenges
• Enhancing Patient Care Guidelines and Research Involvement of Patients and Patient Advocates at All Stages
• Our Most Vital Procedure Best Practices for High-Stakes Communication

The specific schedule is being finalized and will be announced later this summer. Visit ASPHO Webinars for future information regarding the series.

Past webinars can be viewed in the Knowledge Center.

A 3-year-old male was referred to pediatric orthopedics by his pediatrician for a 5-month history of posterior neck pain. Since the initial complaint, the child has received twice weekly sessions by a chiropractor for stretching and massage over this 5-month period. Parents report episodes of “sharp” pain in which the child will grab his neck and cry. Other times, the child vocalizes that his neck hurts and holds the back of his head.

Take the Quiz

Despite this year’s switch to a virtual experience, #ASPHO2021 continued to provide an opportunity for the PHO community to connect, network, and learn from some of the top experts in the field. Attendees can continue to access on-demand recordings of education sessions, SIG workshops, and wellness activities, as well as complete evaluations for CME, through July 23. We hope to see you in Pittsburgh, May 4-7, 2022, for the 2022 ASPHO Conference! Plus, continue the learning on July 27 at ASPHO’s Summer Symposium with complimentary registration for conference registrants!

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Take advantage of ASPHO's Career Center resources to stay on top of job openings in the field. Skim the Resources section for resume writing, coaching, reference check, search strategy videos, and more. Create a personal account to save job postings and skim FAQs to learn how to best navigate the site! The Career Center is the go-to source where institutions post employment and targeted recruitment opportunities in the field.