Support and Recovery After Surgery (STARS): Understanding Disparities in Post-Surgical Outcomes in GI Cancer (H-50019)

Introduction: Surgery is a cornerstone of treatment for gastrointestinal (GI) cancers, but it is associated with high risk of rehospitalization and unnecessary health care use. In many cases, this could be prevented if patients and their informal (e.g., family) caregivers followed discharge instructions and knew how to identify and respond to red-flag symptoms. Medically underserved patients are at increased risk for post-discharge complications, readmissions and ED visits, and poor quality of life (QOL) after surgery, but we know very little about why this is the case. One possibility is that medically underserved patients may lack the knowledge, skills, and resources to engage in self-management after hospital discharge and/or hold beliefs about cancer/health care that could serve as barriers to the recovery and rehabilitation process. Another possibility is that their needs for care and support are not being adequately met after they are discharged home from the hospital. 

Purpose: To understand how individual (e.g., knowledge, health literacy, beliefs) and socio-contextual factors (e.g., family caregiver and social network support, social determinants of health) contribute to disparities in health care use and quality of life in GI cancer surgical patients. 

Design: The STARS study comprises two parts. 

• Part 1 seeks to characterize barriers of discharge plan adherence among medically underserved and non-underserved patients. It involves interviews with readmitted CRC, liver, pancreas, and gastric cancer patients, caregivers, and healthcare providers. 
• Part 2 seeks to prospectively examine whether/how individual and social factors contribute to disparities in healthcare use, self-management, and quality of life among medically underserved and non-underserved patients. It involves completion of one survey prior to surgery and follow-up surveys at 30 and 90 days post-hospital discharge. It also involves a brief interview to understand available sources of support. 

Eligibility

• Part 1: Patients and caregivers of patients who were diagnosed with resectable cancer of the colon, rectum, liver, stomach, or pancreas who were admitted for surgery in the past 18 months and subsequently readmitted within 30 days of initial discharge.
• Part 2: Patients and caregivers of patients who were diagnosed with resectable cancer of the colon, rectum, liver, stomach, or pancreas who are planning to undergo a surgery for their cancer. 

Funding

Grant funding from the American Cancer Society.

#RSG 21-047-01-CPPB.