TRICOM-YCAN: An investigation and intervention to improve triadic communication for teenagers and young adults with cancer - Primary Care Unit

Title:	An investigation and intervention to improve triadic communication for teenagers and young adults with cancer.
Project Description:	Research Summary a.) Aims To understand experiences and perceptions of triadic communication among teenagers and young adults with cancer (TYACs), their supporters; and healthcare professionals (HCPs) caring for them. To develop an educational intervention for HCPs to support effective triadic communication Research Questions Who are supporting TYACs during healthcare consultations? What is the impact on TYACs’ experiences of communication when a supporter is present? How can we teach HCPs to navigate triadic communication for TYACs to be included? b.) Work which has led up to this project How to communicate effectively with TYACs is a research priority About 2,500 young people aged 13-24 years are diagnosed with cancer each year in the United Kingdom (UK). In a UK-wide survey of TYACs’ research priorities, communication was a striking cross-cutting theme. It is increasingly recognised that TYACs have experiences and communication needs that differ significantly from those of younger children and older adults. Effective clinical communication improves health outcomes, for example by ensuring patient engagement, facilitating decision-making, increasing treatment adherence, and reducing distress. Triadic communication is a key feature of teenage and young adult cancer care The presence of a third person in a conversation, triadic communication, is an important consideration with 87% of TYACs attending appointments with another person. Evidence suggests TYACs have little meaningful engagement in consultations with HCPs, conversation is directed towards parents, and parents may control decisions, which can trigger rebellion against treatment. Young people want/need to be heard. Communication skills training is sparse HCPs acknowledge that communicating with TYACs is challenging. This is multifactorial including the transitional nature of adolescence. Communication is a core skill for professionals who care for TYACs. Despite this, training is ad hoc and mostly for either doctors or nurses, only a minority is interprofessional. This is a considerable challenge given the multidisciplinary nature of TYAC care. Developing evidence-based, multi-professional training and education is a priority. Studies have focussed on TYACs, supporters, or HCPs individually, but few have examined triadic communication. Hart et al highlighted that further research should explore how to engage support, while being sensitive to the fact that supporters’ priorities and communication needs may conflict with those of TYACs. Young people want their supporters included but not over involved. I aim to develop, evidence-based training for health professionals, that meets the needs of TYACs and their supporters.
Project organisation
Start date:	1st October 2022
End date:	1st July 2026
Contact person:	Ms Debbie Critoph
Contact Details:	Primary Care Unit East Forvie Building Forvie Site, Robinson Way Cambridge Cambs CB2 0SR UK Telephone: tba E-mail: dc625@medschl.cam.ac.uk
Collaborative:	Phd Supervisors: Anna Spathis Robbie Duschinsky Helen Hatcher Rachel Taylor
Funding information
Funding Organisation:	Wellcome Trust
Funding Reference:
Funding Amount:

Further Information, References and Publications
A Ward, Critoph, D, Westacott, R, Williams, R and Dogra, N (2022) A collaboration on teaching and assessing triadic consultation skills. PEC innovation. 10.1016/j.pecinn.2022.100091 Critoph, D, Smith, L , Williams, R, Hatcher, HM (2021) Adolescent and Young Adult Cancer Placements: Developing Complex Clinical Communication Skills of Medical Students. Journal of Adolescent and Young Adult Oncology DOI: 10.1089/jayao.2021.0079 Smith, L, Critoph, D, Hatcher, HM (2020) How Can Health Care Professionals Communicate Effectively with Adolescent and Young Adults Who Have Completed Cancer Treatment? A Systematic Review. Journal of Adolescent and Young Adult Oncology.DOI: 10.1089/jayao.2019.0133