From grant to clinic: Outcomes and sustainability of an integrated psychosocial program in community oncology.

Abstract

346 Background: Psychosocial distress is highly prevalent among patients with cancer and their caregivers, yet access to integrated behavioral health services remains limited in community oncology settings. We describe clinical outcomes from the pilot phase of a psychosocial oncology program embedded within a community cancer center. Methods: From November 2024 through May 2026, patients and caregivers referred to the program completed validated assessments at baseline, post-treatment, and at 1- and 3-month follow-up, including the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-10), and FACIT-Fatigue. Clinical service utilization was tracked prospectively via a program referral log and provider tracking system. Treatment consisted of 6-8 sessions of evidence-based psychological treatment; treatment completion was defined as attendance at 5 or more sessions. Results: The program received 487 referrals; 65% completed or scheduled an intake. Of those who completed the intake, 90% initiated therapy and 60% completed treatment. The no-show rate was less than 1%. Of 84 patients with baseline assessments, 44% scored in the borderline or high range for anxiety, 26% for depression, 80% reported moderate to high perceived stress, and 51% met criteria for severe fatigue. Among 38 patients with paired assessments, anxiety decreased 40% (d=0.83), depression 31% (d=0.51), stress 19% (d=0.65), and fatigue improved 11% (d=0.43), with gains maintained at 3-month follow-up. Among caregivers (N=9), stress decreased 21% (d=0.94) and depression 26% (d=0.43). Patient satisfaction exceeded 97% and provider satisfaction was 86% (satisfied/very satisfied; n=14). Conclusions: Integrated psychosocial oncology is feasible and clinically impactful in a community cancer center setting, where access gaps remain most pronounced. Rapid program uptake, near-perfect patient engagement, and clinically meaningful reductions in anxiety, depression, stress, and fatigue were observed across both patients and caregivers, with gains sustained at 3-month follow-up. Successful transition from a grant-funded pilot to an insurance-based model offers a replicable sustainability pathway for embedding psychosocial services in community oncology at scale.