The impact of preferred language on cancer wellbeing screen outcomes.

57 Background: Preferred language is a barrier to adequately screening patients for supportive care needs. At a large health system, a Wellbeing Screen (WBS) is regularly administered to identify stressors and guide referrals to supportive services. WBS completion rates and domains of wellbeing impacted were compared among cancer patients with non-preferred English language (nPEL) vs. preferred English language (PEL). We hypothesized nPEL patients may have lower completion rates or report differing needs. Methods: A single institution retrospective study evaluating WBS among all patients receiving ambulatory cancer care at one of 7 sites from 01/2021-12/2022 was performed. The WBS instrument assesses degree of impact for 15 wellbeing domains and is assigned to patients at each oncology-related visit if a WBS has not been completed within the last 30 days. PEL vs. nPEL patients were compared for rate of completion among assigned WBS, percentage of screens with moderate/severe impact on at least one domain and for each individual domain, and average number of domains with moderate/severe impact. Fisher’s exact test was used to calculate odds ratios and p-values. Results: During the study period, a total of 12,642 patients were assigned at least one WBS resulting in 56,821 assigned WBS, of which 7,898 (13.9%) were assigned to nPEL patients. Of all assigned WBS, 20,191 (35.5%) were completed. The odds of completing an assigned WBS was 1.6 times higher for the PEL compared to nPEL group (p<0.001), despite a lower average number of assigned WBS per patient in the PEL group (4.4 vs. 5.3, p<0.001). Of 20,191 completed WBS, 10,097 (50.0%) WBS identified a moderate/severe impact on at least one domain. WBS completed by PEL patients had 1.42 higher odds of moderate/severe impact on at least one domain compared to those completed by nPEL (p<0.001). WBS completed by PEL patients also had significantly higher odds of identifying a moderate/severe impact on 11 of the 15 individual domains (p-value <0.01): Life Disruption (OR 1.9), Sexual function (OR 1.7), Body Image (OR 1.5), Feeling Valued (OR 1.5), Worry About Others (OR 1.4), Depressed Mood (OR 1.3), Anxiety (OR 1.3), Treatment Decisions (OR 1.3), Sleep Issues (OR 1.3), Cognitive Problems (OR 1.2), and Physical symptoms (OR 1.2). Among all WBS with moderate/severe impact on at least one domain, the average number of domains affected was similar at 4 domains for both groups. Conclusions: WBS assigned to PEL had higher odds of being completed compared to nPEL. In addition, WBS completed by PEL had higher odds of identifying moderate/severe impact on at least one wellbeing domain and higher odds of identifying moderate or severe impact on 11/15 of the individual WBS domains when compared to those completed by nPEL. Cultural norms, such as differential importance of or meaning ascribed to the WBS domains, along with practical barriers, such as need for an interpreter, may impact these outcomes.