Advancing the Quality of Cancer Care through Behavioral Economics and Implementation Science

通过行为经济学和实施科学提高癌症护理质量

• 批准号: 10683403
• 负责人: Rinad Sary Beidas
• 金额: $ 88.17万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10683403
• 关键词: Acceleration; Address; African American; American; Artificial Intelligence; Behavior; Cancer Center; Cancer Control; Cancer Patient; Communication; Communities; Coupled; Data Pooling; Development; Economics; Ecosystem; Ensure; Environment; Event; Evidence based practice; Female; Foundations; Funding; Future; Goals; Grant; Health; Healthcare; Hospitals; Incentives; Individual; International; Knowledge; Laboratories; Latinx; Learning; Link; Literature; Machine Learning; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Measurement; Measures; Medicaid; Medical; Medicine; Metastatic Neoplasm to the Bone; Methods; National Cancer Institute; Oncologist; Oral; Outcome; Patients; Pennsylvania; Pharmaceutical Preparations; Pilot Projects; Psychology; Qualitative Methods; Recommendation; Research; Research Personnel; Resources; Science; Scientist; Site; System; Technology; Testing; Tobacco Use Cessation; Tobacco use; Training; Underserved Population; Uninsured; Universities; Variant; behavioral economics; bone; cancer care; care delivery; care outcomes; chemotherapy; clinical research site; comparative; compliance behavior; effectiveness outcome; evidence base; heuristics; high reward; implementation determinants; implementation outcomes; implementation science; implementation strategy; improved; improved outcome; infancy; innovation; insight; lens; malignant breast neoplasm; multidisciplinary; next generation; novel; programs; research to practice; shift work; skeletal; success; symptom management; synergism; therapy adherence; timeline; tool; treatment as usual; uptake

The grand challenge addressed by the Penn Implementation Science Center in Cancer Control (Penn ISC3) is to apply insights from behavioral economics to accelerate the pace at which evidence-based practices for cancer care are deployed to improve outcomes for individuals with cancer. Penn offers a unique environment in which to conduct this paradigm-shifting work, given our expertise in implementation science, behavioral economics, and innovative cancer care delivery. The complementary and multi-disciplinary expertise of the three MPIs (Bei- das, Bekelman, Schnoll), coupled with existing Penn resources, including the Penn Center for Cancer Care Innovation [PC3I], the Center for Health Incentives and Behavioral Economics [CHIBE], and the Penn Imple- mentation Science Center at the Leonard Davis Institute [PISCE@LDI], represent a unique opportunity to ad- vance the quality of cancer care. The Administrative Core, led by Drs. Beidas, Bekelman, and Schnoll, will ensure that the activities of Penn ISC3 are coordinated, synergistic, and congruent with timelines. The Implementation Laboratory, led by Drs. Bekelman and Shulman, represents a diverse ecosystem that includes five hospitals and linked clinical sites, with over 200 oncologists that serve over 15,000 unique new patients annually. Our Research Program, led by Drs. Beidas and Buttenheim, will oversee the development and testing of implementation strat- egies that target patients and clinicians within our Implementation Lab and are centered on the idea of ‘nudging’ for optimal implementation and effectiveness outcomes. The Research Program includes investigators with ex- pertise in implementation science, behavioral economics, cancer care delivery research, healthcare innovation, measurement, and mixed methods. In the first two years, we propose three Signature Pilot Projects and two Methods Projects with a commitment to rapid learning that will allow Penn ISC3 to be optimally nimble. Signature Pilot Project 1 (Jenssen/Leone) tests patient- and clinician-directed implementation strategies to increase referral to tobacco cessation programs among cancer patients. Signature Pilot Project 2 (Bekelman/Patel) tests patient- and clinician-directed implementation strategies to increase higher-value bone modifying agents in patients with breast, lung, and prostate cancer. Common methods and measures are linked to allow for pooling of data and to accomplish our objectives of testing multilevel implementation strategies and mechanisms across contexts. Our exploratory and high-reward Signature Pilot Project 3 (Bekelman/Rendle) will test a patient-directed imple- mentation strategy that leverages artificial intelligence and machine learning to promote oral chemotherapy ad- herence and symptom management. Two methods projects, in support of the Projects, will advance the science of implementation methods. Methods Project 1 will develop a toolkit for the application of rapid cycle approaches (Asch/Buttenheim); Methods Project 2 will use qualitative comparative analysis to characterize multilevel con- textual variation (Barg/Rendle). The Penn ISC3 has the potential to identify novel, disseminable, and scalable ways to advance the quality of cancer care and improve the health outcomes for individuals with cancer. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page

宾夕法尼亚州癌症控制科学中心（Penn ISC3）提出的大挑战是 运用行为经济学的见解来加快癌症基于证据的实践的速度 部署护理以改善癌症患者的结果。 Penn提供了一个独特的环境 鉴于我们在实施科学，行为经济学方面的专业知识，进行这项范式转移工作， 和创新的癌症护理。三个MPI的完整和多学科专业知识（bei- DAS，Bekelman，Schnoll），再加上现有的Penn Resources，包括Penn癌症护理中心 创新[PC3I]，健康激励与行为经济学中心[Chibe]和Penn Imple- 在伦纳德·戴维斯学院（Leonard Davis Institute [Pisce@ldi]）中提及科学中心，这是一个独特的机会 万斯癌症护理的质量。由Drs领导的行政核心。 Beidas，Bekelman和Schnoll将确保 Penn ISC3的活动是协调，协同的，并且与时间表一致。实施 实验室，由博士领导。 Bekelman和Shulman代表了一个潜水生态系统，其中包括五家医院和 连接的临床部位，每年有200多名肿瘤学家为15,000多名独特的新患者提供服务。我们的研究 计划，由Drs领导。 Beidas和Buttenheim将监督实施策略的发展和测试 - 以我们的实施实验室中的患者和临床医生为目标的人，并以“轻推”为中心 用于最佳实施和有效性结果。该研究计划包括Ex-的研究人员 在实施科学，行为经济学，癌症护理提供研究，医疗创新方面有关 测量和混合方法。在头两年中，我们提出了三个签名飞行员项目和两个 方法项目致力于快速学习，这将使宾夕法尼亚ISC3在最佳方面敏捷。签名 试点项目1（Jenssen/Leone）测试患者和临床指导的实施策略以增加推荐 癌症患者中的烟草戒烟计划。签名试点项目2（Bekelman/Patel）测试患者 - 以及临床指导的实施策略，以增加具有高价值修饰剂的药物 乳腺癌，肺和前列腺癌。链接常见方法和措施以允许数据汇总和 为了实现我们测试跨环境的多级实施策略和机制的目标。 我们的探索性且高等的签名试点项目3（Bekelman/Rendle）将测试以患者为导向的实施 - 利用人工智能和机器学习来促进口服化学疗法的管理策略 - 此处和症状管理。两个方法项目，支持项目，将推进科学 实施方法。方法1项目1将开发用于应用快速周期方法的工具包 （Asch/Buttenheim）；方法2项目2将使用定性比较分析来表征多层次 文本变化（Barg/Rendle）。 Penn ISC3有潜力识别新颖，可传染和可扩展的 提高癌症护理质量并改善癌症患者的健康成果的方法。 PHS 398/2590（修订版06/09）页面延续格式页面