Advancing Health Equity in Radiation Oncology: CEBRE Implementation for Multilingual Patients
Underlined: presenting author
Background
Communicating the External Beam Radiotherapy Experience (CEBRE) is a graphic educational tool developed to improve patient understanding of external beam radiotherapy (EBRT). Designed at a 3rd‑grade reading level, CEBRE uses cartoon‑style illustrations and simplified text to depict each stage of radiotherapy, including consultation, simulation and planning, treatment delivery, and post‑treatment care. It also includes customizable sections for treatment schedules, fraction counts, and annotated anatomy. Prior international implementations have demonstrated reductions in patient anxiety, as measured by the State‑Trait Anxiety Inventory (STAI). Communication disparities and limited health literacy remain common in radiation oncology, particularly among linguistically diverse patient populations.
Methods
Our clinic serves a predominantly Hispanic/Latino population and some members Haitian community. To address communication gaps and improve patient preparedness for radiotherapy, we will implement CEBRE as a quality‑improvement intervention in two phases. Phase 1 will deploy existing English and Spanish versions of CEBRE. Following the consultation, the nurse practitioner will review the resource with the patient, who may then take it home for continued reference. Phase 2 will focus on translating CEBRE into Haitian Creole to address an identified language gap in our clinic. Patient understanding will be assessed at three time points: immediately after consultation (baseline), after CEBRE presentation and prior to the simulation planning session.
ANTICIPATED RESULTS We anticipate that CEBRE implementation will improve patient comprehension of the radiotherapy process and reduce treatment‑related anxiety across assessment time points. We expect that the Haitian Creole translation will further enhance accessibility for Haitian patients, reducing reliance on informal interpreters and improving clarity of treatment expectations. Overall, the intervention is expected to strengthen patient engagement, support informed decision‑making, and improve the quality of communication within the radiation oncology workflow.
Conclusion
Integrating CEBRE into our clinic’s radiotherapy education process is expected to address key communication barriers affecting Hispanic and Haitian patients. By providing clear, visually accessible, and linguistically appropriate information, CEBRE has the potential to improve patient understanding and emotional readiness for treatment. The Haitian Creole version will be shared with the original CEBRE developers to support broader dissemination and public availability, contributing to more equitable radiotherapy education across diverse patient populations.