Abstract PS1-02-03: Talking to Employers and Medical Staff about Work: An Intervention to Increase Access to Work Accommodations

Abstract Background: Minimizing employment disruption during cancer treatment improves long-term job retention and may reduce financial hardship and its consequences, including treatment nonadherence, disease progression, and death. Patients who report receiving work accommodations (e.g., a flexible schedule) are more likely to remain employed during and after treatment. Our prior qualitative work showed that many cancer survivors were unaware of available accommodations and uncomfortable initiating requests. Symptom control during (neo)adjuvant therapy was also a barrier to continuing to work. To address these needs, we developed Talking to Employers and Medical Staff about Work (TEAMWork), a patient-informed intervention that provides education on work accommodations based on vocational rehabilitation principles, employer negotiation strategies, symptom self-management, and guidance on communicating with clinicians to enhance support (e.g., obtain work documentation). TEAMWork equips patients with strategies to effectively engage with employers and clinicians, thereby enhancing access to work accommodations and better symptom management during treatment. Methods: TEAMWork is available in English and Spanish, as a booklet and a mobile application (app). We have an ongoing randomized controlled trial comparing the TEAMWork app to the booklet. Here we present data regarding self-reported accommodations requested by study participants while enrolled on the trial. Eligible participants were women aged 18-65 years with stage I-III breast cancer who spoke English and/or Spanish, were employed pre-diagnosis, and planning to undergo systemic adjuvant chemotherapy. Patients were recruited between October 2021 - March 2025 from multiple New York City sites. Demographic and clinical data was collected through self-report and medical chart abstraction. Self-reported data on work accommodations was obtained at baseline and the midpoint of chemotherapy (mid-treatment). Results: Of the 420 participants at baseline, 89% spoke English and 11% spoke Spanish; 52.4% identified as White, 18.1% Black, and 18.1% Hispanic/Latino. The mean age was 48 years (standard deviation 9.2); 65.2% were college educated. All were employed, but only 78.5% were working at baseline. The baseline survey was completed prior to chemotherapy initiation for 47.9% of participants. Three hundred participants completed a mid-treatment survey. From baseline to mid-treatment, we observed an increased percentage of participants in both arms who reported new requests for the following accommodations: work from home (booklet: 30.1% to 41.3%; app: 28.4% to 34.4%), reduced hours (booklet: 33% to 53.8%; app: 28.4% to 45.9%), changes responsibilities or tasks (booklet: 7.7% to 29.4%; app: 10.4% to 22.9%), modified work environment (booklet: 6.2% to 18.2%; app: 8.5% to 12.1%), and additional breaks (booklet: 11% to 29.4%; app:11.8% to 22.9%). We observed a decline in new requests from baseline to mid-treatment for time off (overall: 50.7% to 45.3%) and time off to go to doctor’s appointments (overall: 76% to 60%). Conclusions: The TEAMWork intervention had promising early results in empowering patients with breast cancer to request work accommodations during chemotherapy. Declines in new requests for time off may reflect early awareness or consistent need for this type of accommodation from diagnosis through treatment, in contrast to growing needs for other accommodations throughout the treatment course. Both intervention formats, app and booklet, supported increased patient engagement in requesting accommodations, such as reduced hours and flexible work environments, which can help job retention during treatment. Future research will focus on identifying which intervention formats are most effective for different types of patients. Citation Format: Y. Sampathkumar, E. Kasuga, S. Patil, J. Suarez, C. Lopez, Y. De Los Santos, B. Narang, P. Enriquez, D. F. Makower, W. G. Lichtenthal, P. A. Parker, T. Bao, S. Rosenberg, F. M. Gany, V. S. Blinder. Talking to Employers and Medical Staff about Work: An Intervention to Increase Access to Work Accommodations [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-02-03.