Workplace/employer accommodations during cancer treatment (WE-ACT): A mobile health app to promote job retention.

595 Background: Cancer-related job loss is associated with increased risk of financial hardship and its sequelae, including treatment nonadherence and cancer progression. Access to work accommodations (e.g., flexible scheduling) is a key predictor of job retention. Prior research has focused on patients treated in the curative setting. The increased life expectancy of patients undergoing non-curative treatment has created an unmet need: many patients need and/or prefer to continue working during treatment. Methods: We developed a mobile application (app), titled WE-ACT: Workplace/Employer Accommodations during Cancer Treatment, which combines vocational rehabilitation approaches, communication coaching, and resources to improve access to work accommodations for adults with cancer. WE-ACT was adapted from an existing app for breast cancer survivors undergoing adjuvant therapy. To ensure that app content was relevant across a wide variety of cancer types and disease trajectories, modifications were made with input from interviews with patients with different cancer types and key informants. The finalized WE-ACT app was pilot tested among 59 patients with cancer who were between 18-65 years old, owned a smart phone or tablet, and received systemic and/or radiation therapy with curative or non-curative intent. Participants completed surveys and semi-structured interviews at baseline and after one month. Results: Of 59 participants (66% English, 34% Spanish), 68% were female and 75% worked full-time at diagnosis. Participants represented a range of occupations, including managerial/professional roles (n=15), service providers (n=23), sales/technical/administrative support (n=10), operators/fabricators/laborers (n=7), and arts/media/athletics (n=1). Cancer types included gastrointestinal (27%), breast (17%), head and neck (17%), and gynecologic (15%). Notably, 63% were receiving chemotherapy with non-curative intent. One month after receiving WE-ACT, 76% rated the app as “very user-friendly,” 98% considered it useful, 80% reported the app would be “very helpful” to other patients, and 95% would recommend it to other patients. 54% agreed WE-ACT made it easier to negotiate and/or ask for work accommodations (36% neither agree nor disagree), 49% agreed it made it easier to talk to their boss (42% neither agree nor disagree), and 49% agreed it made it easier to talk to their coworkers (44% neither agree nor disagree). Sections most frequently cited as helpful included Work Accommodations, Negotiation Coach, Legal Rights, and Symptom Tracker. Conclusions: This study highlights the need to address work-related concerns among cancer patients. WE-ACT was deemed valuable in navigating these concerns by patients at different points in their treatment trajectory. Further research is needed to determine the optimal timing for intervention and integration into clinical care.