Cancer Registry for Understanding and Improving Survivorship Experiences (CRUISE)

用于了解和改善生存体验的癌症登记处 (CRUISE)

• 批准号: 10410413
• 负责人: Scarlett L Gomez
• 金额: $ 64.1万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-10 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10410413
• 关键词: Address; Administrator; Area; California; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caring; Clinic; Colorectal Cancer; Cultural Sensitivity; Early Diagnosis; Education; Effectiveness; Elements; Emotional; Environment; Ethnic Origin; Ethnic group; Evaluation; Face; Financial Hardship; Fostering; Future; Goals; Health; Health behavior; Health system; Healthcare; Healthcare Systems; Hospitals; Human Resources; Infrastructure; Institute of Medicine (U.S.); Intervention; Interview; Knowledge; Linguistics; Medical; Minority; Nature; Oncology; Outcome; Patient Outcomes Assessments; Patient Recruitments; Patients; Policy Maker; Population Heterogeneity; Population Study; Primary Health Care; Process; Provider; Quality of life; Race; Recommendation; Research; Resources; Risk; San Francisco; Second Primary Cancers; Socioeconomic Status; Surveys; Survival Rate; Survivors; Testing; Time; Underserved Population; Use Effectiveness; Variant; Work; active method; aging population; cancer site; cancer therapy; care providers; clinical care; comorbidity; ethnic diversity; experience; health care delivery; health care service utilization; health equity; implementation science; improved; innovation; literacy; malignant breast neoplasm; multilevel analysis; neoplasm registry; patient oriented; patient population; population based; racial and ethnic; racial diversity; sex; social; social determinants; socioeconomics; survivorship; virtual

Project Summary There are currently an estimated 15.5 million cancer survivors in the U.S., which is expected to increase in number and racial/ethnic diversity. Cancer survivors face many unique challenges, including late and long-term health effects, emotional and financial hardships, and a greater risk for developing second cancers and other serious health conditions. These challenges may be even more prevalent among underserved populations. In 2006, the Institute of Medicine (IOM) recommended the widespread implementation of survivorship care plans (SCPs) to facilitate the transition from active treatment to cancer survivorship, from oncology care to primary care. SCPs are intended to encompass the details of cancer treatment, which can be shared with current and future medical providers; anticipatory education for survivors; and provision of information about available resources relating to survivorship needs. The recommendations call for oncology treatment teams to review SCPs with patients at the conclusion of their cancer treatment. Early research in the years since the IOM recommendations has shown that implementation of SCPs is not widespread, evidence of improved survivor outcomes is limited, and there is considerable variation in the content of SCPs, with many plans failing to adhere to all of the IOM recommendations. Moreover, there is virtually no research on whether existing SCPs are culturally- or linguistically-tailored to patients and whether they address key social determinant barriers among underserved patients. More research is needed to thoroughly explore the efficacy and viability of SCPs in real-world settings. Specifically, while previous research has uncovered key cultural differences in survivorship experiences, we still know little about the appropriateness, effectiveness, and implementation of SCPs among cancer survivors from diverse racial/ethnic, cultural, and socioeconomic backgrounds. The overarching goal of this proposal is to investigate the extent to which SCPs are implemented in clinical care and used among diverse and underserved populations of breast and colorectal cancer survivors in California. Leveraging population-based cancer registries, we therefore propose the Cancer Registry for Understanding and Improving Survivorship Experiences (CRUISE) project, which takes a comprehensive, multi-level approach to examine the implementation of, and patient experiences with, SCPs, with focus on underserved populations. Our aims are as follows: 1) to examine the use and effectiveness of SCPs on patient-reported outcomes in breast and colorectal cancer survivors in the Greater San Francisco Bay Area; 2) to investigate the implementation and content of survivorship strategies and support including SCPs in use in California health systems serving diverse cancer patient populations; and 3) to convene a Delphi panel of stakeholders to develop best practices for delivering SCPs to meet the needs of diverse patient populations. The current proposal will advance our understanding of the implementation and effectiveness of SCPs from both the perspective of survivors and healthcare systems, focusing in particular on underserved patient populations.

项目摘要 目前，美国估计有1550万癌症幸存者，预计将增加 数字和种族/种族多样性。癌症幸存者面临许多独特的挑战，包括晚期和长期 健康影响，情感和经济困难，以及发展第二癌和其他的更大风险 严重的健康状况。在服务不足的人群中，这些挑战可能更为普遍。在 2006年，医学研究所（IOM）建议广泛实施生存护理计划 （SCP）促进从主动治疗到癌症生存的过渡，从肿瘤学护理到原发性 关心。 SCP旨在涵盖癌症治疗的细节，可以与当前和 未来的医疗提供者；幸存者的预期教育；并提供有关可用的信息 与生存需求有关的资源。这些建议要求肿瘤治疗团队审查 在癌症治疗结束时，患者与患者进行了SCP。自IOM以来的早期研究 建议表明，SCP的实施不是广泛的，这是改善幸存者的证据 结果是有限的，SCP的内容有很大差异，许多计划未能 遵守所有IOM建议。而且，几乎没有关于现有SCP的研究 在文化或语言上对患者进行了限制，以及他们是否应对关键的社会决定因素障碍 在服务不足的患者中。需要更多的研究来彻底探索SCP的功效和生存能力 在现实世界中。具体而言，尽管以前的研究发现了关键的文化差异 生存经历，我们仍然对适当性，有效性和实施一无所知 来自不同种族/种族，文化和社会经济背景的癌症幸存者中的SCP。这 该提案的总体目标是调查在临床护理中实施SCP的程度 并在加利福尼亚州的乳腺癌和结直肠癌幸存者中使用。 因此，我们提出了基于人群的癌症注册机构，我们建议癌症注册处 并改善生存经验（Cruise）项目，该项目采用了全面的多层次方法 检查SCP的实施和患者经验，重点是服务不足的人群。 我们的目的如下：1）检查SCP对患者报告结果的使用和有效性 大旧金山湾地区的乳腺癌和结直肠癌幸存者； 2）调查 生存策略的实施和内容，包括加利福尼亚州使用的SCP 为多样化的癌症患者人群提供服务的系统； 3）召集一个利益相关者的Delphi小组 开发提供SCP的最佳实践，以满足不同患者人群的需求。电流 提案将促进我们对SCP的实施和有效性的理解 幸存者和医疗保健系统的观点，尤其是服务不足的患者人群。