Factors Associated With Self-Report Symptom Screening Adherence in Pediatric Cancer Patients

Introduction: Objective was to describe the association between baseline characteristics and the number of Symptom Screening in Pediatrics Tool (SSPedi) assessments completed over an 8-week period. Methods: This was a sub-analysis of a cluster randomized controlled trial among 10 sites that were randomized to the intervention group. Participants were English- or Spanish-speaking pediatric patients 8–18 years of age newly diagnosed with cancer. Participants were prompted to complete SSPedi three times weekly for 8 weeks. The outcome was the number of SSPedi assessments completed during the 8-week period. Factors associated with the number of assessments were determined using mixed effects Poisson regression. Results: At the 10 intervention sites, 216 patients were included in the analysis. Among these participants, 129 (59.7%) were male, 112 (51.9%) were white, and 83 (38.4%) were Hispanic. The number of SSPedi assessments was significantly higher for participants 11–14 years (rate ratio (RR) 1.13, 95% confidence interval (CI) 1.02–1.25) and 15–18 years (RR 1.15, 95% CI 1.04–1.27) compared to 8–10 years. Participants completed more SSPedi assessments if they were Asian compared to white (RR 1.27, 95% CI 1.10–1.46), non-Hispanic compared to Hispanic (RR 1.15, 95% CI 1.04–1.28) and from families with a household income ≥$60,000 (RR 1.12, 95% CI 1.03–1.21). Participants completed fewer SSPedi assessments if they had solid tumors compared to leukemia (RR 0.91, 95% CI 0.84–0.99). Conclusion: Adherence to three-times weekly SSPedi varied by age, race, ethnicity, cancer diagnosis, and family income. This information may facilitate interventions to support routine symptom screening in clinical practice. Trial Registration: NCT04614662.