Childcare provision during breast cancer radiation therapy: Piloting of the Waiting Room Watchers program through the Navigator-Assisted Hypofractionation (NAVAH) program.

Abstract

e23113 Background: Childcare responsibilities remain a major barrier to treatment adherence among women undergoing cancer therapy. The Waiting Room Watchers (WRW) program, developed by My Sister’s Keeper Cleveland and funded through the Navigator-Assisted Hypofractionation (NAVAH) initiative at University Hospitals Cleveland Medical Center, was designed to provide trained sitters in hospital waiting areas during oncology visits and radiation therapy. The initiative was offered to all major cancer centers in Cleveland, Ohio. While all expressed strong interest in addressing this barrier, MetroHealth Cancer Center was the only site to formally adopt and implement the pilot during the initial phase. Methods: From March to August 2025, WRW operated at the MetroHealth Cancer Center in Cleveland, Ohio. Requests were submitted through a digital platform that enabled real-time scheduling, tracking, and documentation. Sitters completed CPR and First Aid training. Utilization, satisfaction, and operational impact were assessed using caregiver and hospital staff feedback surveys. Results: Six service requests were received during the pilot period. One request could not be accommodated due to same-day (<5-hour) notice, and two resulted in patient no-shows. Two patients were successfully served: one breast cancer patient with a 1 year-old child, and one Sickle Cell patient (due to the frequency of management within Medical Oncology) with an 8-year-old child, the latter using the service three times (no-showed once). All completed sessions (n=4) received 5/5 ratings for professionalism, compassion, and reliability. Hospital staff described WRW as “invaluable,” noting that the breast cancer patient would not have completed radiation therapy without this support. Conclusions: Waiting Room Watchers, implemented through the NAVAH program, removes a critical childcare barrier that would otherwise limit patients’ ability to complete cancer treatment. Its successful launch (the first documented instance of aiding in radiation therapy completion in breast cancer) demonstrates feasibility and potential for national scale to advance equity in cancer care delivery. Implementation of the WRW program during the pilot phase resulted in institutional readiness and patient-centered leadership. The program proved feasible, safe, and impactful—improving treatment adherence, caregiver support, and clinic efficiency, and resulted in the first instance of facilitating radiation therapy in breast cancer. Expansion of WRW to Oklahoma City is underway to broaden equitable access to care through the NAVAH framework in concordance with the ongoing NAVAH Phase I clinical trial.