A Randomized Controlled Trial to Evaluate the Survivorship Needs Assessment Planning Tool for Head and Neck Cancer Survivor-Caregiver Dyads

评估头颈癌幸存者-护理人员二元组生存需求评估规划工具的随机对照试验

• 批准号: 10365273
• 负责人: Katherine Regan Sterba
• 金额: $ 44.89万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10365273
• 关键词: Address; Adoption; Aftercare; Anxiety; Behavior; Cancer Center; Cancer Survivor; Caregiver Burden; Caregivers; Caring; Case Study; Clinic; Clinical; Communication; Data; Deglutition; Early Intervention; Educational Materials; Enteral Feeding; Face; Future; Goals; Head and Neck Cancer; Health Personnel; Home; Infrastructure; Intervention; Knowledge; Life; Link; Maps; Medical; Mental Depression; Methods; Monitor; Needs Assessment; Outcome; Patients; Phase; Physical Function; Pilot Projects; Play; Randomized Controlled Trials; Recommendation; Recovery; Reporting; Research; Role; Rural; Self Efficacy; Self Management; Services; Severities; Site; Social Functioning; Southeastern United States; Structure; Supportive care; Surveys; Survivors; Symptoms; System; Tablets; Technology; Testing; Time; Toxic effect; Transitional Care Planning; Visit; Well in self; arm; base; cancer care; care coordination; care systems; caregiving; comparative efficacy; depressive symptoms; design; experience; flexibility; follow-up; health care service utilization; health care settings; implementation study; improved; improved outcome; interest; novel; programs; psychologic; psychosocial; reduce symptoms; rehabilitation service; routine care; skills; survivorship; symptom management; tool; treatment as usual; treatment effect; uptake; wound care

PROJECT SUMMARY Head and neck cancer (HNC) caregivers face significant challenges at the end of treatment as they transition to the home setting and care for survivors with devastating late and long-term treatment effects. The overall goal of this research is to improve post-treatment recovery outcomes in HNC survivors and their caregivers through the delivery of a tablet-based, dyadic survivorship needs assessment planning (SNAP) tool implemented into clinic workflow at the end of treatment. SNAP is a technology-enabled survivorship care planning (SCP) system that uses a self-management focus to: 1) prepare caregivers as they transition to the next phase of caregiving and 2) optimize healthcare utilization (e.g., receipt of recommended medical and supportive care) in caregiver- survivor dyads. Our interdisciplinary team will conduct a randomized controlled trial to test the effects of SNAP compared to usual SCP care on caregiver and survivor outcomes (N=176 dyads) and gather crucial data to guide best practices for disseminating the system to diverse HNC care settings in the future. Specific Aim 1 will evaluate the effects of SNAP on caregiver burden in caregivers, symptom severity in survivors and psychological well- being in dyads at 6 months. Specific Aim 2 will evaluate the effects of SNAP on healthcare utilization uptake, unmet needs and self-efficacy in dyads at 3 months. Specific Aim 3 will use mixed methods to characterize key barriers and facilitators to SNAP system adoption in HNC healthcare settings diverse by practice structure, patient volume and rural/urban status using surveys in a national panel of HNC healthcare providers (N=200) and 5 in-depth case study visits with HNC centers in the southeastern United States to guide refinement of SNAP program delivery strategies and tools. SNAP is novel in its focus on using technology to build a clinic infrastructure to automate care practices to assess, address and support survivorship needs in HNC caregiver-survivor dyads at the end of treatment. SNAP invests in the critical roles played by caregivers through a stepped, dyadic approach to accelerate recovery. Results will provide critical evidence to finalize this sustainable, technology-enabled care planning system for a multi-site implementation study.

项目概要 头颈癌 (HNC) 护理人员在治疗结束时面临着重大挑战，因为他们过渡到 对幸存者的家庭环境和护理具有毁灭性的后期和长期治疗效果。总体目标 这项研究的目的是通过以下方式改善 HNC 幸存者及其护理人员的治疗后康复结果： 提供基于平板电脑的二元生存需求评估规划（SNAP）工具 治疗结束时的临床工作流程。 SNAP 是一个技术支持的生存护理计划 (SCP) 系统 以自我管理为重点：1) 让护理人员做好过渡到护理下一阶段的准备 2) 优化护理人员的医疗保健利用（例如，接受推荐的医疗和支持性护理） 幸存者二人组。 我们的跨学科团队将进行一项随机对照试验，以测试 SNAP 与 对护理人员和幸存者结果（N = 176 对）进行常规 SCP 护理，并收集关键数据以提供最佳指导 未来将该系统传播到不同 HNC 护理机构的实践。具体目标 1 将评估 SNAP 对护理人员负担、幸存者症状严重程度和心理健康的影响 6个月大时成对。具体目标 2 将评估 SNAP 对医疗保健利用率的影响， 3个月时两人未满足的需求和自我效能。具体目标3将使用混合方法来表征关键 HNC 医疗保健环境中采用 SNAP 系统的障碍和促进因素因实践结构而异， 使用全国 HNC 医疗保健提供者小组调查得出的患者数量和农村/城市状况 (N=200) 对美国东南部的 HNC 中心进行 5 次深入案例研究访问，以指导 SNAP 的完善 计划交付策略和工具。 SNAP 的新颖之处在于它专注于使用技术来构建诊所基础设施，以自动化护理实践来评估、 在治疗结束时解决和支持 HNC 护理者-幸存者二人组的生存需求。 SNAP 投资 通过逐步的、二元的方法来加速康复，护理人员发挥着关键作用。结果将 提供关键证据来最终确定这个可持续的、技术支持的多站点护理计划系统 实施研究。