Self-Management to Optimize Survivorship Care and Outcomes in Lung and Colorectal Cancer

自我管理以优化肺癌和结直肠癌的生存护理和结果

基本信息

批准号：
10376753
负责人：
VIRGINIA Chih-Yi SUN
金额：
$ 82.17万
依托单位：
BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-02 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10376753
关键词：
Address Adult Advanced Practice Nurse Aftercare Age American Anxiety Applications Grants Appointment California Cancer Survivor Caring Chronic Care Cities Collaborations Colorectal Colorectal Cancer Communication Complex Data Deterioration Discipline of Nursing Distress Dyspnea Early Diagnosis Early treatment Family Fatigue Friends Functional disorder Future Geriatric Assessment Goals Health Promotion Healthcare Systems Intervention Intestines Knowledge Long-Term Effects Lung Maintenance Malignant Neoplasms Malignant neoplasm of lung Manuals Mental Depression Modeling National Cancer Institute Neuropathy Oncologist Oncology Ostomy Outcome Pain Patients Population Price Primary Health Care Process Provider Quality of life Randomized Reach Effectiveness Adoption Implementation and Maintenance Recording of previous events Reporting Research Research Institute Research Priority Resources Science Self Efficacy Self Management Self Perception Specific qualifier value Survival Rate Survivors Symptoms Testing The Sun Time Treatment Efficacy Treatment outcome Universities Videoconferencing anticancer research arm associated symptom attentional control base care coordination care delivery care outcomes care providers comorbidity comparison intervention design disorder prevention efficacy testing experience follow-up human old age (65+)implementation facilitators improved improved outcome innovation intervention delivery patient oriented persistent symptom personalized care provider adoption response skills skills training survivorship symptom management symptomatic improvement telehealth treatment arm treatment effect

Address Adult Advanced Practice Nurse Aftercare Age American Anxiety Applications Grants Appointment California Cancer Survivor Caring Chronic Care Cities Collaborations Colorectal Colorectal Cancer Communication Complex Data Deterioration Discipline of Nursing Distress Dyspnea Early Diagnosis Early treatment Family Fatigue Friends Functional disorder Future Geriatric Assessment Goals Health Promotion Healthcare Systems Intervention Intestines Knowledge Long-Term Effects Lung Maintenance Malignant Neoplasms Malignant neoplasm of lung Manuals Mental Depression Modeling National Cancer Institute Neuropathy Oncologist Oncology Ostomy Outcome Pain Patients Population Price Primary Health Care Process Provider Quality of life Randomized Reach Effectiveness Adoption Implementation and Maintenance Recording of previous events Reporting Research Research Institute Research Priority Resources Science Self Efficacy Self Management Self Perception Specific qualifier value Survival Rate Survivors Symptoms Testing The Sun Time Treatment Efficacy Treatment outcome Universities Videoconferencing anticancer research arm associated symptom attentional control base care coordination care delivery care outcomes care providers comorbidity comparison intervention design disorder prevention efficacy testing experience follow-up human old age (65+)implementation facilitators improved improved outcome innovation intervention delivery patient oriented persistent symptom personalized care provider adoption response skills skills training survivorship symptom management symptomatic improvement telehealth treatment arm treatment effect

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项目摘要

PROJECT SUMMARY The overarching goal of this five-year grant proposal, submitted on behalf of the Beckman Research Institute of City of Hope and the University of California, Riverside, in response to RFA-CA-19-035, is to test the efficacy of an advance-practice nurse (APRN)-driven telehealth Survivor Self-Management (SSM) Intervention in 414 lung and colorectal cancer survivors. This research is critical because lung and colorectal cancer survivors have high post-treatment needs, are older, and suffers from greater co-morbidities and poor quality of life (QOL). Lung and colorectal cancer survivors remain underrepresented in research, leading to significant disparities in post-treatment outcomes. Based on the Chronic Care Self-Management Model (CCM), the SSM Intervention includes the following components: 1) care coordination and communication between oncology and primary care on surveillance/follow-up, health promotion, disease prevention, and comorbidity management; 2) provision of clinician care plan to PCPs; 3) comprehensive patient/geriatric assessment for survivors of all ages; 4) personalized care plan for survivors; and 5) survivor self-management skills building for surveillance/follow-up, late and long-term effects of treatments, comorbidities, and healthy living. It is administered in five telehealth sessions (Zoom videoconferencing) and three subsequent maintenance telehealth sessions for survivors who are four months post-treatment. We will test the efficacy of the SSM Intervention using a randomized design of attention control arm versus an intervention arm to pursue the following specific aims: Specific Aim 1 (Primary): Determine the efficacy of the intervention on care coordination, communication, and provider knowledge at 4 months post-accrual; Specific Aim 2 (Primary): Determine the efficacy of the intervention on survivor outcomes at 4 months post-accrual; and Specific Aim 3 (Exploratory): Assess the reach, efficacy, adoption, implementation, and maintenance (RE-AIM) of the intervention. The RE-AIM Framework informs intervention delivery process, which will set the stage for future large scale implementation for sustainability in real-world care settings. This proposal is innovative because it addresses a critical need to improve care delivery and outcomes for high needs, understudied survivorship populations (lung, colorectal, older survivors), and the telehealth approach promotes scalability. The interdisciplinary team, which includes expertise in nursing science (Sun, Reb, Ferrell), oncology (Fakih), and primary care (Kim) is uniquely suited to conduct this research. The proposal is significant, with high scientific rigor and outcomes that are of critical importance to survivors, clinicians, healthcare systems, the National Cancer Institute, and the Beau Biden Cancer MoonshotSM. The research will address a critical gap in knowledge of how self-management interventions improve care delivery and outcomes during post-treatment transitions to follow-up care.

项目摘要该五年赠款提案的总体目标是代表贝克曼研究所提交的希望城市和加利福尼亚大学河滨分校对RFA-CA-19-035的响应是为了测试功效预先实践护士（APRN）驱动的远程医疗幸存者自我管理（SSM）干预414 肺和结直肠癌幸存者。这项研究至关重要，因为肺和大肠癌幸存者有很高的治疗需求，年龄较大，患有更大的合并症和生活质量差（QOL）。肺和结直肠癌幸存者在研究中的代表性不足，导致重要治疗后结果的差异。基于慢性护理自我管理模型（CCM），SSM 干预包括以下组成部分：1）肿瘤学之间的护理协调和沟通以及有关监视/随访，健康促进，疾病预防和合并症的初级保健管理; 2）为PCP提供临床医生护理计划； 3）全面的患者/老年评估各个年龄段的幸存者； 4）幸存者的个性化护理计划； 5）幸存者自我管理技能建设用于监视/随访，治疗，合并症和健康生活的晚期和长期影响。这是在五个远程医疗课程（缩放视频会议）和随后的三个维护中进行管理治疗后四个月的幸存者的远程医疗会议。我们将测试SSM的功效使用注意力控制臂的随机设计与干预臂进行干预以追求以下特定目的：特定目的1（主要）：确定干预措施的护理功效分类后4个月的协调，沟通和提供者知识；特定目标2（主要）：确定分类后4个月对幸存者预后的干预措施的疗效；和特定目标3 （探索性）：评估覆盖范围，功效，采用，实施和维护（RE-AIM）干涉。 RE-AIM框架为干预交付过程提供了信息，这将为将来奠定基础在现实世界中的护理环境中可持续性的大规模实施。该提议具有创新性，因为它解决了改善护理交付和满足高需求的结果的关键需求人群（肺，结直肠，年长的幸存者）和远程医疗方法可促进可扩展性。这跨学科团队，包括护理科学专业知识（Sun，Reb，Ferrell），肿瘤学（Fakih）和初级保健（KIM）非常适合进行这项研究。该提议很重要，科学很高对幸存者，临床医生，医疗保健系统，国家的严格和结果至关重要癌症研究所和Beau Biden Cancer Moonshotsm。这项研究将解决关键的差距了解自我管理干预措施如何改善治疗期间的护理交付和结果过渡到后续护理。