Pilot Project 1: Creating Bridges to Reproductive Health Care for Rural Adolescent and Young Adult Cancer Survivors

试点项目 1：为农村青少年和青年癌症幸存者搭建生殖保健桥梁

基本信息

批准号：
10762146
负责人：
Helina Hoyt
金额：
$ 7.18万
依托单位：
SAN DIEGO STATE UNIVERSITY
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：
2023-09-19 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10762146
关键词：
Adolescent and Young Adult Aftercare California Cancer Patient Cancer Science Cancer Survivor Cancer Survivorship Caring Catchment Area Clinic Clinical Communities Community Clinical Oncology Program Consult Consultations Continuity of Patient Care Contraceptive methods County Data Diagnosis Discipline of Nursing Distress Effectiveness Effectiveness of Interventions Evaluation Faculty Female Adolescents Fertility Focus Groups Future Geography Health Health Insurance Health Personnel Health Professional Healthcare Hispanic Hispanic Populations Infertility Intervention Interview Latina Learning Linguistics Malignant Neoplasms Menopausal Symptom Methods Mexico Newly Diagnosed Nursing Faculty Oncology Outcome Parents Pathway interactions Patients Pilot Projects Premature Ovarian Failure Quality of Care Quality of life Reporting Reproductive Health Reproductive Medicine Research Research Personnel Resource-limited setting Resources Risk Rural Rural Community Social Work Social Workers Specialist Structure Survivors Underserved Population Universities Work adverse pregnancy outcome anticancer research arm cancer care cancer education care delivery clinical care community engagement design effectiveness evaluation experience feasibility testing health care delivery health disparity health equity health literacy high risk hybrid type 1 trial implementation measures implementation outcomes implementation science improved low health literacy medically underserved multi-component intervention multi-site trial neoplasm resource novel oncofertility outreach patient navigation pilot test primary outcome psychosocial remote communities reproductive rural Hispanic rural area rural healthcare screening shared decision making survivorship telehealth uptake

项目摘要

PROJECT SUMMARY/ ABSTRACT – PILOT PROJECT Reproductive health care in cancer patients is an unmet need in Imperial County, a medically underserved, rural region of the Cancer Research and Education to Advance HealTh Equity (CREATE) Partnership’s catchment area with a predominantly Hispanic population. Reproductive health is a major issue for adolescent and young adult (AYA) cancer survivors because they can experience higher risks of infertility, adverse pregnancy outcomes, and unmet informational needs. Reproductive health care effectively reduces risks, but uptake is low because there are no scalable interventions to support the implementation of routine reproductive health care in underserved, geographically remote communities. Guided by the Cancer Survivorship Care Quality Framework, this pilot proposal seeks to adapt and pilot test a multi-component intervention to improve reproductive health care uptake by female AYA cancer survivors. The intervention has three components derived from our prior work: 1) a reproductive risk summary (RS) and survivorship care plan on reproductive health (SCP-R), 2) navigation, and 3) telehealth reproductive consults. In Aim 1, we will adapt the RS and SCP-R in English and Spanish to be responsive to the cultural, health literacy, and socio-ecological needs of Latina AYA survivors through focus groups with AYA survivors and parents/guardians, and semi-structured interviews with healthcare providers. We will also systematically evaluate barriers and facilitators to reproductive health care in Imperial County and examine how to fit the multi-component intervention to this setting, through focus groups with survivors and parents/guardians and interviews with healthcare providers and clinic staff. In Aim 2, we will conduct feasibility testing of the multicomponent intervention in a single arm pilot hybrid type 1 trial (evaluating effectiveness and observing implementation). The primary outcome is engagement in reproductive health care by 15 newly diagnosed and 15 post-treatment AYA survivors. Secondarily, we will qualitatively assess effectiveness, fit and implementation outcomes with AYA survivors, healthcare providers and health clinic staff. The proposal directly targets a critical health disparity faced by female AYA survivors in our catchment area and need for partnership between rural community health professionals and urban specialists to deliver quality reproductive survivorship care. We will generate a novel, scalable intervention and preliminary data to support a future multi-site trial on intervention effectiveness in increasing reproductive care in rural, medically underserved oncology settings. The partnership between SDSU, CRCD and UCSD researchers will be strengthened with collaborative learning, community engagement, and increased capacity of trainees to support future cancer research in Imperial County.

项目摘要/摘要 - 试点项目癌症患者的生殖医疗保健是帝国县未满足的需求癌症研究和教育的农村地区，以促进健康公平（创造）合作伙伴关系集水区，主要是西班牙裔人口。生殖健康是青少年的主要问题和年轻的成人（AYA）癌症存活，因为他们可以经历较高的不育风险，不良的风险怀孕结果和未满足的信息需求。生殖医疗保健有效地降低了风险，但吸收很低，因为没有可扩展的干预措施来支持常规生殖的实施服务不足的，地理偏远社区的医疗保健。在癌症生存护理的指导下高质量的框架，该试点建议旨在适应和试点测试多组分的干预措施以改进雌性AYA癌症存活的生殖医疗保健吸收。干预措施有三个组成部分从我们先前的工作中得出：1）生殖生殖的生殖风险摘要（RS）和生存护理计划健康（SCP-R），2）导航和3）远程医疗生殖同意。在AIM 1中，我们将适应RS和 SCP-R英语和西班牙语对文化，健康素养和社会生态需求做出反应拉丁阿雅（Latina Aya）通过焦点小组与AYA表面和父母/监护人以及半结构医疗保健提供者的访谈。我们还将系统地评估障碍和促进者帝国县的生殖医疗保健，并检查如何适应多组分干预措施通过焦点小组与有伴随和父母/监护人的焦点小组以及对医疗保健提供者的采访和诊所工作人员。在AIM 2中，我们将对单臂进行多组分干预的可行性测试试点混合1型试验（评估有效性和观察实施）。主要结果是通过15个新诊断和15个治疗后AYA表面表面进行生殖医疗保健的参与。次要，我们将与AYA表面相关的有效性，适合和实施成果，并将医疗保健提供者和健康诊所工作人员。该提案直接针对女性AYA在我们的集水区中表面表面，并且需要农村社区健康之间的伙伴关系专业人士和城市专家提供高质量的生殖生存护理。我们将生成一本小说，可扩展的干预和初步数据，以支持未来的多站点试验，以进行干预效果在粗糙的医学肿瘤学环境中增加生殖护理。之间的伙伴关系 SDSU，CRCD和UCSD研究人员将通过协作学习，社区来加强参与度，并提高学员支持帝国县未来癌症研究的能力。