"It's the Exact Same Treatment … Except Only 5 Min Away": A RE-AIM Evaluation of a Speech-Language Pathology Shared-Care Model for Rural Patients With Head and Neck Cancer.

Abstract

Challenges accessing post-treatment speech-language pathology (SLP) services can add to treatment burden for rural patients with head and neck cancer (HNC). Hence, the aim of this study was to evaluate a shared-care SLP service designed to support local SLP access for patients with HNC, using the RE-AIM framework. RE-AIM evaluation involved 5 staff and 23 patients. Data sources included service statistics, costs, quality of life measures, satisfaction surveys, and interviews. Shared-care demonstrated strong reach and effectiveness: 91% of patients received most or all care locally. Average patient-attributable cost savings were AUD$801.94/person. Patients were highly satisfied, reporting equivalent care between local and tertiary services. Clinicians valued professional development and service integration. Communication systems and infrastructure assisted implementation. Policy alignment supported maintenance. The shared-care model enhanced rural SLP service access while maintaining quality care and lowering patient burden. Effective communication and clinical support were key enablers, demonstrating shared-care as a sustainable approach for rural post-HNC treatment SLP services.