Proactive community support tailored to holistic needs: A cohort study

Background: It is increasingly internationally recognised that a cancer diagnosis impacts on people practically and financially as well as physically and psychologically. It is less clear what to do about this. This study introduces an original community service designed to mitigate this wider impact. Non-clinical ‘link officers’ use holistic needs assessment (HNA) to help newly diagnosed people identify and quantify the severity of their physical, psychological, practical, financial and social concerns. A care plan is then agreed, usually involving community interventions from partner agencies. Following intervention, assessment is repeated. The primary aim of this study was to establish whether there was a significant difference between initial assessment and follow up, post intervention. Secondary aim was to identify potential predictors of increased levels of concern at baseline and follow-up. Method:Pre–post intervention observational cohort study. Paired t-test examined the difference in mean (SD) concern severity between baseline and follow-up. Multiple linear regression models were computed to hypothesise potential predictors of initial concern severity, and severity change.ResultsThe service saw 2413 people 2014-2017. Participants identified average 5.5 (4.7) concerns, financial concerns being most frequent. Mean severity at baseline was 7.12 (out of 10) (2.50), reducing to 3.83 (3.49) post-treatment, paired t(4454)=64.68,