Georgetown University Lombardi Comprehensive Cancer Center Support Grant

乔治城大学隆巴迪综合癌症中心支持补助金

• 批准号: 10409001
• 负责人: Louis M. Weiner
• 金额: $ 14.98万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10409001
• 关键词: Academic Medical Centers; Address; Adherence; Administrator; Adolescent and Young Adult; Adult; Age; Asians; Behavior; Bioinformatics; Cancer Center; Cancer Center Support Grant; Cancer Patient; Caring; Characteristics; Child; Childhood; Clinical; Communities; Community Health; Complex; Comprehensive Cancer Center; Comprehensive Health Care; Computerized Medical Record; Continuity of Patient Care; Diagnosis; Discrimination; Disease; Education; Employment; Epidemiology; Family; Geographic Locations; Goals; Guidelines; Health; Health Personnel; Health Services Research; Health system; Income; Inequality; Infrastructure; Interdisciplinary Study; Intervention; Interview; Knowledge; Late Effects; Latino; Literacy Programs; Longevity; Low income; Malignant Childhood Neoplasm; Malignant Neoplasms; Monitor; Nature; Outcome; Patients; Pediatric Oncology; Personal Satisfaction; Policies; Population; Population Heterogeneity; Population Sizes; Poverty; Primary Health Care; Provider; Research; Research Design; Resources; Retrospective cohort; Risk; Scientist; Service delivery model; Services; Source; Special Population; Specialist; Survivors; System; Testing; Universities; Variant; Washington; anticancer research; base; cancer prevention; cancer therapy; care coordination; care delivery; care outcomes; care providers; care systems; childhood cancer survivor; community engagement; cost; design; disparity reduction; ethnic minority population; follow-up; health data; health disparity; health equity; healthy lifestyle; improved; informant; organizational structure; patient population; programs; racial and ethnic; racism; ranpirnase; screening; social health determinants; survivorship

Cancer Center Organizational Assessment to Eliminate Outcome Disparities Among CCS Continuity of care for childhood cancer survivors (CCS) is essential to promote lifelong health and well-being, as many survivors will confront prolonged late-effects of their disease and treatment. However, there are barriers to CCS equitably accessing follow-up care. Underserved racial/ethnic minorities, especially those who are already facing multiple social determinants of health (SDOH) barriers, are among the most adversely impacted by this inequity. The majority of prior research has focused on the organization and delivery of CCS care in well- resourced and majority groups: gaps remain in studies designed to identify and reduce disparities among vulnerable CCS. The complex and multiply-determined nature of CCS care delivery, along with recognizing the importance of SDOH, inform our research. The goal of this P30 supplement application, submitted on behalf of Georgetown University's Lombardi Comprehensive Cancer Center (Washington, DC) and its NCI-designated research consortium partner John Theurer Cancer Center (Hackensack, NJ), is to better understand and help eradicate disparities and barriers to the receipt of recommended CCS care. This care includes risk-based cancer surveillance, screening, and management, the prevention of cancer late effects, and care coordination. We plan to do this by assessing our cancer centers' internal organizational attributes and behaviors (including both practices and policies) that may inadvertently curtail access to such care among adolescent and young adult (AYA; ages 15-39 years) CCS in our geographic areas. This is important because these AYAs could (and could continue to) be served by our health systems in addressing the needs of this special population. Among the issues we seek to study are: 1) how prevalent underserved AYA CCS are across our systems; 2) what happens if/when they transition from pediatric to adult care (or become lost to follow-up); 3) if they are universally identified and recognized by our systems as CCS in need of CCS services, and; 4) if differences in care outcomes exist and may be attributable to organizational and SDOH factors, among others. We will thoroughly analyze our AYA CCS care systems, determine how to improve their quality, and formulate institutional action plans that will close gaps and remove obstacles to underserved CCS receiving the services they need across the lifespan. These action plans will then be tested and followed-up in subsequent interventional pilot initiatives promoting adherence to cancer treatment or guideline-concordant care. And they will be sustained by resources and a strengthening of our organizational capacity to better serve our catchment's diverse populations of AYA CCS.

癌症中心组织评估以消除 CCS 之间的结果差异 儿童癌症幸存者 (CCS) 的持续护理对于促进终身健康和福祉至关重要，因为 许多幸存者将面临疾病和治疗的长期后期影响。然而，也存在障碍 CCS 公平地获得后续护理。服务不足的种族/族裔，尤其是那些 已经面临多重健康问题社会决定因素 (SDOH) 障碍，属于受影响最严重的群体之一 由于这种不平等。大多数先前的研究都集中在健康状况良好的 CCS 护理的组织和提供上。 资源丰富的群体和多数群体：旨在查明和减少群体之间差异的研究中仍存在差距 脆弱的 CCS。 CCS 护理服务的复杂性和多重决定性本质，以及认识到 SDOH 的重要性，为我们的研究提供信息。此 P30 补充申请的目标，代表提交 乔治城大学隆巴迪综合癌症中心（华盛顿特区）及其 NCI 指定的 研究联盟合作伙伴 John Theurer 癌症中心（新泽西州哈肯萨克）旨在更好地了解和帮助 消除接受推荐的 CCS 护理的差异和障碍。该护理包括基于风险的癌症 监测、筛查和管理，预防癌症晚期影响以及护理协调。我们计划 通过评估我们的癌症中心的内部组织属性和行为（包括 做法和政策）可能会无意中限制青少年和年轻人获得此类护理的机会 （AYA；年龄 15-39 岁）我们地理区域的 CCS。这很重要，因为这些 AYA 可以（并且可以 继续）由我们的卫生系统提供服务，以满足这一特殊人群的需求。其中 我们寻求研究的问题是：1）服务不足的 AYA CCS 在我们的系统中有多普遍； 2）发生了什么 如果/当他们从儿科过渡到成人护理（或失去随访）； 3）如果它们被普遍识别 并被我们的系统识别为需要 CCS 服务的 CCS，以及； 4) 护理结果是否存在差异 可能归因于组织和 SDOH 因素等。我们将彻底分析我们的AYA CCS 护理系统，确定如何提高其质量，并制定将关闭的机构行动计划 差距并消除服务不足的 CCS 获得其整个生命周期所需服务的障碍。这些 然后，将在随后促进遵守的干预试点举措中测试和跟进行动计划 癌症治疗或符合指南的护理。他们将通过资源和加强来维持 我们的组织能力，以更好地为 AYA CCS 流域的不同人群提供服务。