Adaptation and implementation of a web-based Family centered Adolescent Sperm banking decision Tool for adolescent males with cancer
适应和实施基于网络的以家庭为中心的青少年精子库决策工具,用于患有癌症的青少年男性
基本信息
- 批准号:10733849
- 负责人:
- 金额:$ 36.71万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-09-21 至 2028-06-30
- 项目状态:未结题
- 来源:
- 关键词:21 year oldAddressAdolescenceAdolescentAdoptionAttitudeBehavior TherapyCancer BurdenCancer CenterCaregiversCaringChronic DiseaseClinicalClinical PathwaysCommunicationConsultControl GroupsCounselingDedicationsEnrollmentEnsureEquityEvaluationFamilyFeedbackFertilityFocus GroupsFundingFutureGoalsGuidelinesHospitalsHumanImpairmentInfertilityInfrastructureInpatientsInstitutionInternetKnowledgeLate EffectsLifeMale AdolescentsMalignant Childhood NeoplasmMalignant NeoplasmsMethodsMissionModificationMorbidity - disease rateNewly DiagnosedOnline SystemsOrganizational ChangeOutcomeOutpatientsParentsPathway interactionsPatientsPilot ProjectsPopulationProviderPublic HealthQuality of CareQuality of lifeRecommendationReportingResearchResource-limited settingResourcesServicesSiteSonSperm BanksSurvival RateSurvivorsSystemTeam ProcessTestingThinkingTimeUnderserved PopulationUnited States National Institutes of HealthWorkburden of illnesscancer therapychildhood cancer survivordesigndisabilityeffectiveness/implementation trialfamily buildingfertility preservationfuture implementationgroup interventionimplementation contextimplementation strategyimprovedinnovationmalemortalitymultidisciplinarynoveloncofertilitypremalignantprogramsprospectivepsychosocialpublic health relevancereproductivereproductive outcomesatisfactionshared decision makingtooltreatment effectusabilityweb platformweb-based tool
项目摘要
PROJECT SUMMARY
Advances in childhood cancer therapies have resulted in >80% five-year survival rates.1 With nearly 500,000
childhood cancer survivors in the U.S., there is a growing need to address and mitigate late effects of
treatment.2,3 Fertility impairment occurs in about half of male childhood cancer survivors and can negatively
impact quality of life.4,5 Sperm banking is an established and widely available form of fertility preservation.6
Despite recognizing the value of future parenthood and guidelines to bank sperm before treatment,6,7 banking
remains underutilized among male adolescents with cancer, especially at hospitals with low resources.8-10
Studies show adolescent males are more likely to bank sperm prior to cancer treatment if: 1) their institution
has dedicated fertility services,11 2) their provider recommends banking,12 and 3) their parents recommend it.13
To improve equitable care and access to sperm banking opportunities,10 family-centered decision tools, and
strategies to implement these tools, are critical. Our team developed the Family-centered Adolescent Sperm
banking Tool (FAST) and tested it prospectively among families of adolescent males newly diagnosed with
cancer. We found the FAST prompted deeper thinking and facilitated family communication about parenthood
goals and banking,17 and that sperm banking rates increased significantly.19 Given feasibility and equity
considerations (i.e., short time frame, variety of settings in which fertility counseling is delivered), the objective
of this proposal is to adapt the FAST to a web-based tool that can be accessed in inpatient/outpatient/non-
clinical settings, identify implementation strategies for high and low-resourced settings, and test these in a
three-site pilot study among 110 families of adolescent males (13-21 years of age) newly diagnosed with
cancer. Specific aims are to: 1) adapt the FAST (design and delivery) based on patient and caregiver
stakeholder feedback (usability testing), which will result in a web-based tool that is functional, acceptable to
families, and feasible to implement pre-cancer treatment; 2) conduct rapid contextual inquiry using a mixed-
methods approach with clinician stakeholders, to identify tailored implementation strategies for the web-based
FAST in both high and low-resourced pediatric cancer centers, prepare for adoption into clinical pathways, and
ensure fidelity and sustainability, and 3) pilot the web-based FAST and tailored implementation strategies
locally and at 2 additional sites (1 high and 1 low-resourced) to examine feasibility, acceptability, and impact on
banking rates (pre-/post design) to prepare for a larger multi-site hybrid implementation-effectiveness trial.
Findings will result in an innovative decision tool that can be easily accessed on the web and implemented at a
wide variety of high and low-resourced settings to facilitate banking decisions among adolescent males with
cancer. These efforts will optimize long-term outcomes by expanding opportunities for parenthood and
contributing to improved quality of life in a growing population of survivors, including underserved populations.
项目概要
儿童癌症治疗的进步已使五年生存率超过 80%。1 近 500,000
对于美国的儿童癌症幸存者来说,越来越需要解决和减轻癌症的后期影响
治疗。2,3 大约一半的男性儿童癌症幸存者存在生育能力障碍,并且可能对生育能力产生负面影响
影响生活质量。4,5 精子库是一种成熟且广泛使用的生育力保存形式。6
尽管认识到未来为人父母的价值以及治疗前储存精子的指南,6,7
在患有癌症的男性青少年中,这一技术仍然没有得到充分利用,特别是在资源匮乏的医院。8-10
研究表明,如果满足以下条件,青春期男性更有可能在癌症治疗前储存精子:1) 他们的机构
有专门的生育服务,11 2) 他们的提供者推荐银行业务,12 和 3) 他们的父母推荐。13
为了改善公平护理和获得精子库机会的机会,10 个以家庭为中心的决策工具,以及
实施这些工具的策略至关重要。我们的团队开发了以家庭为中心的青少年精子
银行工具(FAST),并在新诊断患有此类疾病的青少年男性家庭中进行前瞻性测试
癌症。我们发现 FAST 促进了更深入的思考并促进了家庭关于为人父母的沟通
目标和银行,17 并且精子银行率显着增加。19 鉴于可行性和公平性
考虑因素(即时间短、提供生育咨询的环境多种多样)、目标
该提案的目的是将 FAST 改编为基于网络的工具,可以在住院/门诊/非住院患者中访问
临床环境,确定资源丰富和资源匮乏环境的实施策略,并在
对 110 个新诊断患有青少年男性(13-21 岁)家庭的三点试点研究
癌症。具体目标是:1)根据患者和护理人员调整 FAST(设计和交付)
利益相关者的反馈(可用性测试),这将产生一个功能齐全、可接受的基于网络的工具
家庭条件好,有可能实施癌前治疗; 2)使用混合式进行快速上下文查询
方法与临床医生利益相关者接触,以确定基于网络的定制实施策略
在资源丰富和资源匮乏的儿科癌症中心进行 FAST,为采用临床途径做好准备,以及
确保保真度和可持续性,以及 3) 试行基于网络的 FAST 和量身定制的实施策略
在当地和另外 2 个地点(1 个资源丰富的地点和 1 个资源匮乏的地点)检查可行性、可接受性和影响
银行利率(设计前/设计后),为更大规模的多站点混合实施有效性试验做好准备。
研究结果将产生一个创新的决策工具,可以在网络上轻松访问并在现场实施
各种资源丰富和资源匮乏的环境,以促进患有以下疾病的青少年男性进行银行业务决策:
癌症。这些努力将通过扩大为人父母的机会和
为提高越来越多的幸存者(包括服务不足的人群)的生活质量做出贡献。
项目成果
期刊论文数量(0)
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Leena Nahata其他文献
Leena Nahata的其他文献
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{{ truncateString('Leena Nahata', 18)}}的其他基金
Optimizing fertility preservation and decision quality in male AYA with cancer: A family-centered intervention
优化患有癌症的男性 AYA 的生育能力保留和决策质量:以家庭为中心的干预措施
- 批准号:
10631877 - 财政年份:2019
- 资助金额:
$ 36.71万 - 项目类别:
Optimizing fertility preservation and decision quality in male AYA with cancer: A family-centered intervention
优化患有癌症的男性 AYA 的生育能力保留和决策质量:以家庭为中心的干预措施
- 批准号:
10371075 - 财政年份:2019
- 资助金额:
$ 36.71万 - 项目类别:
Optimizing fertility preservation and decision quality in male AYA with cancer: A family-centered intervention
优化患有癌症的男性 AYA 的生育能力保留和决策质量:以家庭为中心的干预措施
- 批准号:
9906200 - 财政年份:2019
- 资助金额:
$ 36.71万 - 项目类别:
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