Advancing cancer care and equity through telehealth, communication science, and behavioral economics

通过远程医疗、传播科学和行为经济学促进癌症护理和公平

• 批准号: 10453882
• 负责人: Justin Bekelman
• 金额: $ 113.75万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10453882
• 关键词: Address; Advanced Malignant Neoplasm; American; Area; Award; COVID-19 pandemic; Clinical; Communication; Communication Methods; Continuity of Patient Care; Discipline; Doctor of Philosophy; Effectiveness; Elements; Environment; Faculty; FarGo; Fostering; Foundations; Future; Goals; Grant; Growth; Health; Health Services Accessibility; Healthcare; Improve Access; Individual; International; Intervention; Knowledge; Learning; Malignant neoplasm of lung; Measures; Methods; Mind; Modeling; Molecular; Nurses; Outcome; Palliative Care; Patients; Pennsylvania; Pilot Projects; Randomized Clinical Trials; Recommendation; Research; Research Methodology; Research Personnel; Resources; Science; Secure; Sequential Multiple Assignment Randomized Trial; Telephone; Testing; Text Messaging; Time; Training; Universities; Work; asynchronous communication; behavioral economics; cancer care; cancer health disparity; care delivery; clinical practice; compare effectiveness; design; digital; effectiveness testing; evidence base; health equity; improved; innovation; insight; lung cancer screening; next generation; novel; pragmatic trial; screening; shared decision making; survivorship; symposium; telehealth; tool; trial design; waiver

PROJECT SUMMARY/ABSTRACT (OVERALL) The University of Pennsylvania Telehealth Research Center in Cancer Care (Penn TRC) will apply insights from communication science and behavioral economics to design and test innovative telehealth strategies to improve effectiveness and equity across the cancer care continuum, with an emphasis on understanding mechanisms of action. The COVID-19 pandemic led to dramatic growth in the use of telehealth for cancer care delivery, fostered by both clinical need and temporary waivers. Telehealth strategies have included both synchronous communication (real-time video or telephone conferencing) and asynchronous communication (sequential health information exchange through text messaging or secure portals). Yet, fundamental knowledge gaps include the extent to which telehealth may be superior to non-telehealth care delivery strategies for access, quality, and outcomes; how telehealth may enhance or detract from achieving health equity in cancer care in the context of the digital divide and persistent cancer disparities; and the impact of telehealth on health care efficiency. The Penn TRC will address an overarching research theme: to apply insights from communication science and behavioral economics to design and test synchronous telehealth strategies, supported by asynchronous elements, to improve access, quality, outcomes, equity, and efficiency across the cancer care continuum. We focus on lung cancer as a model for telehealth across the care continuum, from screening to treatment to survivorship. We bring together a team of international experts in communication science, behavioral economics, cancer care delivery, telehealth, health care innovation, mixed methods, and health equity to achieve the following specific aims: 1) Apply concepts, strategies, tools, and methods from communication science and behavioral economics to design and test synchronous telehealth strategies, supported by asynchronous elements, to improve access, quality, outcomes, equity, and efficiency for patients across the care continuum; 2) Conduct a pragmatic randomized clinical trial to compare the effectiveness of telehealth strategies to increase shared decision making for lung cancer screening using a Sequential Multiple Assignment Randomized Trial (SMART) design; 3) Conduct two rapid-cycle pilot projects, with methods and measures aligned with the pragmatic trial, to design and test the effectiveness of telehealth to improve cancer care, identify multilevel mechanisms of action, and lay the foundation for future, more definitive pragmatic trials; and 4) Build capacity to advance a national telehealth research agenda and train the next generation of investigators with expertise in cancer care, telehealth and health equity. By joining together interdisciplinary faculty across Penn, the Penn TRC will result in novel, scalable, and generalizable disseminated strategies to drive lasting improvements in cancer care and health equity. Penn has an unparalleled environment in which to bring together these areas of study.

项目摘要/摘要（总体） 宾夕法尼亚大学癌症护理远程医疗研究中心 (Penn TRC) 将应用见解 从通信科学和行为经济学到设计和测试创新的远程医疗策略 提高整个癌症护理连续体的有效性和公平性，重点是理解 行动机制。 COVID-19 大流行导致癌症护理中远程医疗的使用急剧增长 临床需求和临时豁免促进了交付。远程医疗策略包括 同步通信（实时视频或电话会议）和异步通信 （通过短信或安全门户进行连续的健康信息交换）。然而，根本 知识差距包括远程医疗可能优于非远程医疗服务的程度 获取、质量和结果的策略；远程医疗如何促进或阻碍实现健康 在数字鸿沟和持续存在的癌症差异的背景下，癌症护理的公平性；以及影响 远程医疗对医疗保健效率的影响。宾夕法尼亚大学 TRC 将讨论一个总体研究主题：申请 来自通信科学和行为经济学的见解来设计和测试同步远程医疗 由异步元素支持的策略，以提高访问、质量、成果、公平和效率 整个癌症护理连续体。我们专注于肺癌作为整个护理领域远程医疗的模型 从筛查到治疗再到生存的连续体。我们汇集了一支国际专家团队 传播科学、行为经济学、癌症护理服务、远程医疗、医疗保健创新、混合 方法和健康公平以实现以下具体目标： 1) 应用概念、策略、工具和 使用通信科学和行为经济学的方法来设计和测试同步远程医疗 由异步元素支持的策略，以提高访问、质量、成果、公平和效率 对于整个护理过程中的患者； 2) 进行务实的随机临床试验来比较 远程医疗策略的有效性，以增加肺癌筛查的共同决策 序贯多重分配随机试验（SMART）设计； 3）开展两个快速周期试点项目， 采用与务实试验相一致的方法和措施，设计和测试远程医疗的有效性 改善癌症护理，确定多层次的作用机制，并为未来奠定基础，更多 明确的务实试验； 4) 建设能力以推进国家远程医疗研究议程并培训 具有癌症护理、远程医疗和健康公平方面专业知识的下一代研究人员。通过联合起来 宾夕法尼亚大学 TRC 跨学科教师将带来新颖的、可扩展的和可推广的成果 传播战略以推动癌症护理和健康公平的持久改善。佩恩有一个 无与伦比的环境将这些研究领域聚集在一起。