Innovative Breast CA Case Management for the Underserved

为服务不足的人群提供创新的乳腺 CA 病例管理

基本信息

批准号：
7286050
负责人：
PETER Christian RAICH
金额：
$ 15.53万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-22 至 2008-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7286050
关键词：
Hispanic Americans behavioral /social science research tag breast neoplasms clinical research counseling culture female health services research tag human subject low socioeconomic status medically underserved population patient care management patient oriented research psychological adaptation psychological aspect of cancer social support network telemedicine

项目摘要

DESCRIPTION (provided by applicant): Adjustment to the diagnosis and treatment of breast cancer is a complex process that unfolds over time, with medical, psychological, social, and functional factors impacted differentially through the continuum of care and follow-up. Women with breast cancer commonly report feeling overwhelmed by having to integrate large amounts of medical information and having to make decisions about treatment benefits, as well as immediate and long-term impact on their quality of life. There is an urgent need to develop and test interventions that mitigate psychosocial distress, provide guidance through treatment decision-making, and address the myriad cultural and logistical barriers to care that exist especially for low-income women with breast cancer. The Breast CARES program is proposed to specifically meet this need. The overall goal of this R21 proposal is to address a national priority in cancer control research by developing and conducting a feasibility study of a new and innovative model of an interdisciplinary case management program for underserved women with newly diagnosed breast cancer, including those who are Spanish-speaking. Three specific aims will guide this exploratory study: (1) design an interdisciplinary case management program, integrating two additional elements-on-site navigation and counselor-initiated telephone calls--into the traditional nurse-oriented case management model, for patients at strategic points before, during and after breast cancer treatment; (2) conduct a feasibility study of the Breast CARES program, using a one-group, intervention-only research design with specific focus on process evaluation, in the setting of an urban "safety net" health care system; and (3) utilize these essential process evaluation data to prepare and submit a research proposal for a large Phase III multi-institution randomized clinical trial to test the efficacy, cost-effectiveness, and exportability of this comprehensive information, navigation and psychosocial support program.

描述（由申请人提供）：乳腺癌诊断和治疗的调整是一个随着时间的推移而展开的复杂过程，通过连续的护理和随访，医学、心理、社会和功能因素会产生不同的影响。患有乳腺癌的女性通常表示，由于必须整合大量医疗信息、必须就治疗益处以及对生活质量的直接和长期影响做出决定，因此感到不知所措。迫切需要制定和测试干预措施，以减轻社会心理困扰，通过治疗决策提供指导，并解决特别是对于患有乳腺癌的低收入女性而言存在的无数护理文化和后勤障碍。乳房护理计划就是专门为了满足这一需求而提出的。该 R21 提案的总体目标是通过针对新诊断出乳腺癌的服务不足的女性（包括西班牙裔女性）开发和开展跨学科病例管理计划的创新模式的可行性研究，解决癌症控制研究的国家优先事项-请讲。三个具体目标将指导这项探索性研究：（1）设计一个跨学科的病例管理计划，将现场导航和咨询师发起的电话这两个附加要素整合到传统的以护士为导向的病例管理模式中，为处于战略地位的患者提供帮助。乳腺癌治疗前、治疗期间和治疗后的要点； (2) 在城市“安全网”医疗保健系统的背景下，采用单组、纯干预研究设计，重点关注过程评估，开展乳房关怀计划的可行性研究； (3) 利用这些重要的过程评估数据，准备并提交一项大型 III 期多机构随机临床试验的研究提案，以测试这一综合信息、导航和社会心理支持计划的功效、成本效益和可输出性。