Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC)
社区卫生工作者针对姑息治疗差异的干预措施的传播和实施 (DeCIDE PC)
基本信息
- 批准号:10686013
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-08-01 至 2027-07-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAdministratorAdoptionAdvance Care PlanningAdvanced Malignant NeoplasmAdvocacyAdvocateAfrican AmericanAfrican American populationAmerican Society of Clinical OncologyAwarenessCancer CenterCaregiversCaringChronic DiseaseCommunicationCommunitiesCommunity Health AidesCommunity HealthcareComplementConflict (Psychology)Consolidated Framework for Implementation ResearchDevelopmentDiseaseDisparityDissemination and ImplementationDocumentationEconomic FactorsEducationEffectivenessEnrollmentEnsureEvaluationEvidence based practiceFamilyFocus GroupsFundingGoalsHIV/AIDSHealthHealth Services AccessibilityHealth educationHealthcareHealthcare SystemsHomeHospitalsHybridsImprove AccessIndividualInterventionInterviewInvestigationKnowledgeLinkMalignant NeoplasmsMedical Care TeamMethodsModelingMotivationOncologistOutcomePain managementPalliative CarePatient CarePatient advocacyPatientsPersonsPhilosophyPhysiciansPilot ProjectsPopulationPublic HealthQuality of CareQuality of lifeRandomizedReach, Effectiveness, Adoption, Implementation, and MaintenanceRecommendationResearchResourcesRoleScanningServicesSiteSocial WorkSystemTechniquesTrainingTuberculosisUnderserved PopulationUnited States National Institutes of HealthWorkbarrier to carecancer carecare deliverycare outcomescare systemscompare effectivenesscontextual factorscultural competencecultural valuesdesigndisparity reductioneffectiveness-implementation randomized trialempowermentend of lifeend of life careethnic disparityevidence baseexperiencefamily burdenhealth care deliveryhealth care disparityhigh riskhospice environmentimplementation barriersimplementation evaluationimplementation facilitationimplementation interventionimplementation/effectivenessimprovedinformantintervention refinementmemberpalliativephysical symptompragmatic trialprocess evaluationpsychological symptomracial disparityresearch to practicesatisfactionskillssocial health determinantsstandard caresuccessful interventionunderserved communityuptake
项目摘要
SUMMARY
Palliative care can reduce physical and psychological symptoms, improve quality of life, and ensure goal-
concordant care at the end-of-life for patients with advanced cancer. There are persistent and worsening
disparities in end-of-life outcomes for African American patients which are confounded by the lower likelihood of
this population to access and receive palliative care. The basis for these disparities are multi-factorial, and at the
end of life, barriers include personal or cultural values in conflict with hospice philosophy, a lack of awareness of
hospice services, concern about burdening family, economic factors, and/or mistrust of the healthcare system.
The addition of individuals to the care team with a nuanced skillset focused on addressing such barriers to care
is a promising approach to enhance palliative care uptake. Community Health Workers (CHWs) are non-clinician,
culturally competent public health workers whose role is to promote access to services, provide health education,
support care delivery, and promote advocacy in underserved populations. CHWs supplement care for patients
with advanced chronic diseases, including HIV/AIDS, tuberculosis, and cancer, and their impact on improving
care in these settings is well-established. We developed an integrated CHW model – the Dissemination and
Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DECIDE PC) – that
utilizes CHWs as care team members to augment palliative care outcomes for underserved patients with
advanced-stage illnesses. In DECIDE PC, CHWs are trained to provide advocacy, support, motivation,
empowerment, and education regarding palliative and end-of-life care to patients and their caregivers. Our
preliminary experience suggests that CHWs can improve palliative care outcomes and improve patient and
caregiver satisfaction with care.
Our long-term goal is to reduce disparities in palliative care for African Americans with advanced cancer.
Integration of CHWs as members of the healthcare team may be an effective means to improve access to and
enhance the uptake of palliative care in this population. To explore this, we will conduct a randomized
effectiveness-implementation pragmatic trial at four diverse cancer centers to 1. compare the effectiveness of
the DECIDE PC intervention versus standard care in improving palliative care outcomes, including quality of life,
receipt of quality communication, advance care planning documentation/discussion, and hospice use, and 2.
evaluate contextual factors that influence the effectiveness, fidelity, and adoption of the DECIDE PC intervention.
We anticipate this work will establish the effectiveness of a CHW-based palliative care intervention in a priority
population and generate generalizable knowledge to guide the development and implementation of interventions
to increase the use of palliative care services in underserved populations.
概括
姑息治疗可以减轻身体和心理症状,提高生活质量,并确保目标-
晚期癌症患者临终时的协调护理 存在持续恶化的情况。
非裔美国患者的临终结果存在差异,这些差异因较低的可能性而令人困惑
这些差异的基础是多因素的。
临终前的障碍包括与临终关怀理念相冲突的个人或文化价值观、缺乏对临终关怀的认识
临终关怀服务、对家庭负担的担忧、经济因素和/或对医疗保健系统的不信任。
护理团队中增加了具有细致入微技能的个人,专注于解决此类护理障碍
是提高姑息治疗采用率的一种有前途的方法,社区卫生工作者 (CHW) 是非临床医生,
具有文化能力的公共卫生工作者,其作用是促进获得服务、提供健康教育、
支持护理服务的提供,并促进社区卫生工作者为患者提供补充护理的宣传。
患有晚期慢性疾病,包括艾滋病毒/艾滋病、结核病和癌症,及其对改善病情的影响
我们开发了一个综合的社区卫生工作者模式——传播和护理。
针对姑息治疗差异实施社区卫生工作者干预措施 (DECIDE PC) –
利用社区卫生工作者作为护理团队成员,为服务不足的患者增强姑息治疗效果
在 DECIDE PC 中,CHW 接受培训以提供宣传、支持、激励、
向患者及其护理人员提供有关姑息治疗和临终关怀的赋权和教育。
初步经验表明,社区卫生工作者可以改善姑息治疗的结果,并改善患者和患者的健康状况。
护理人员对护理的满意度。
我们的长期目标是减少晚期癌症非裔美国人姑息治疗方面的差异。
将社区卫生工作者纳入医疗保健团队可能是改善获得医疗服务的有效途径
为了探索这一点,我们将进行一项随机研究。
在四个不同的癌症中心进行有效性实施实用试验,以 1. 比较以下方案的有效性
DECIDE PC 干预与标准护理在改善姑息治疗结果(包括生活质量)方面的比较
收到高质量的沟通、预先护理计划文件/讨论和临终关怀服务,以及 2.
评估影响 DECIDE PC 干预的有效性、保真度和采用的背景因素。
我们预计这项工作将优先确定基于社区卫生工作者的姑息治疗干预措施的有效性
人口并生成通用知识来指导干预措施的制定和实施
在服务不足的人群中增加姑息治疗服务的使用。
项目成果
期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Palliative Care Curriculum and Training Plan for community health workers.
社区卫生工作者姑息治疗课程和培训计划。
- DOI:
- 发表时间:2023-09-07
- 期刊:
- 影响因子:2.7
- 作者:Monton, Olivia;Abou;Fuller, Shannon;Barnes;Siddiqi, Amn;Woods, Alison;Patton, Jae;Ibe, Chidinma A;Johnston, Fabian M
- 通讯作者:Johnston, Fabian M
Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC): a study protocol for a hybrid type 1 randomized controlled trial.
社区卫生工作者对姑息治疗差异的干预措施 (DeCIDE PC) 的传播和实施:一项混合 1 型随机对照试验的研究方案。
- DOI:
- 发表时间:2023-09-18
- 期刊:
- 影响因子:3.1
- 作者:Siddiqi, Amn;Monton, Olivia;Woods, Alison;Masroor, Taleaa;Fuller, Shannon;Owczarzak, Jill;Yenokyan, Gayane;Cooper, Lisa A.;Freund, Karen M.;Smith, Thomas J.;Kutner, Jean S.;Colborn, Kathryn L.;Joyner, Robert;Elk, Ronit;Johnston, Fabian M.
- 通讯作者:Johnston, Fabian M.
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Fabian M Johnston其他文献
Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC): a study protocol for a hybrid type 1 randomized controlled trial
社区卫生工作者针对姑息治疗差异的干预措施 (DeCIDE PC) 的传播和实施:混合 1 型随机对照试验的研究方案
- DOI:
- 发表时间:
2023 - 期刊:
- 影响因子:3.1
- 作者:
Amn Siddiqi;Olivia Monton;Alison P Woods;Taleaa Masroor;Shannon Fuller;Jill Owczarzak;G. Yenokyan;Lisa A. Cooper;Karen M. Freund;Thomas J. Smith;Jean S. Kutner;Kathryn L. Colborn;Robert L Joyner;Ronit Elk;Fabian M Johnston - 通讯作者:
Fabian M Johnston
Palliative Care Curriculum and Training Plan for community health workers
社区卫生工作者姑息治疗课程和培训计划
- DOI:
10.1136/spcare-2023-004527 - 发表时间:
2023-09-07 - 期刊:
- 影响因子:2.7
- 作者:
Olivia Monton;Aida Abou;Shannon Fuller;Tracy Barnes;Amn Siddiqi;Alison P Woods;Jae Patton;C. Ibe;Fabian M Johnston - 通讯作者:
Fabian M Johnston
Individual and Systemic Barriers Blocking Community Health Workers from Helping the Seriously Ill.
阻碍社区卫生工作者帮助重病患者的个人和系统性障碍。
- DOI:
10.1089/jpm.2022.0516 - 发表时间:
2023-11-20 - 期刊:
- 影响因子:2.8
- 作者:
Julian T Rowe;Elaina Parrillo;Olivia Stanford;Jennifer Wenzel;Fabian M Johnston - 通讯作者:
Fabian M Johnston
Implementation Barriers and Recommendations for a Multisite Community Health Worker Intervention in Palliative Care for African American Oncology Patients: A Qualitative Study.
非洲裔美国肿瘤患者姑息治疗中多地点社区卫生工作者干预的实施障碍和建议:定性研究。
- DOI:
10.1089/jpm.2023.0703 - 发表时间:
2024-05-08 - 期刊:
- 影响因子:2.8
- 作者:
Alison P Woods;Olivia Monton;Shannon Fuller;Amn Siddiqi;Cheryl Lyn Errichetti;Taleaa Masroor;Robert L Joyner;Ronit Elk;Jill Owczarzak;Fabian M Johnston - 通讯作者:
Fabian M Johnston
Fabian M Johnston的其他文献
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{{ truncateString('Fabian M Johnston', 18)}}的其他基金
I TITRATE PC: An Implementation based Community Health Worker Intervention to address Disparities in Palliative Care
I TITRATE PC:基于实施的社区卫生工作者干预措施,以解决姑息治疗中的差异
- 批准号:
10345787 - 财政年份:2022
- 资助金额:
-- - 项目类别:
I TITRATE PC: An Implementation based Community Health Worker Intervention to address Disparities in Palliative Care
I TITRATE PC:基于实施的社区卫生工作者干预措施,以解决姑息治疗中的差异
- 批准号:
10668944 - 财政年份:2022
- 资助金额:
-- - 项目类别:
Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC)
社区卫生工作者针对姑息治疗差异的干预措施的传播和实施 (DeCIDE PC)
- 批准号:
10208168 - 财政年份:2021
- 资助金额:
-- - 项目类别:
Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC)
社区卫生工作者针对姑息治疗差异的干预措施的传播和实施 (DeCIDE PC)
- 批准号:
10457912 - 财政年份:2021
- 资助金额:
-- - 项目类别:
Promoting Early Utilization of Palliative Care for African Americans Using Culturally Informed Patient Navigation
使用文化知情的患者导航促进非裔美国人早期使用姑息治疗
- 批准号:
9753149 - 财政年份:2016
- 资助金额:
-- - 项目类别:
Promoting Early Utilization of Palliative Care for African Americans Using Culturally Informed Patient Navigation
使用文化知情的患者导航促进非裔美国人早期使用姑息治疗
- 批准号:
9162174 - 财政年份:2016
- 资助金额:
-- - 项目类别:
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