Cancer Registry for Understanding and Improving Survivorship Experiences (CRUISE)

用于了解和改善生存体验的癌症登记处 (CRUISE)

基本信息

批准号：
9802764
负责人：
Scarlett L Gomez
金额：
$ 64.98万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-06-10 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9802764
关键词：
Address Administrator Area California Cancer Patient Cancer Survivor Cancer Survivorship Caring Clinic Colorectal Cancer Comorbidity Cultural Sensitivity Early Diagnosis Education Effectiveness Elements Emotional Environment Ethnic Origin Ethnic group Evaluation Face Financial Hardship Fostering Future Goals Health Health behavior Health system Healthcare Healthcare Systems Hospitals Human Resources Infrastructure Institute of Medicine (U.S.)Intervention Interview Knowledge Linguistics Medical Minority Nature Outcome Patient Outcomes Assessments Patient Recruitments Patients Policy Maker Population Heterogeneity Population Study Primary Health Care Process Provider Quality of life Race Recommendation Research Resources Risk San Francisco Second Primary Cancers Socioeconomic Status Surveys Survival Rate Survivors Testing Time Underserved Population Use Effectiveness Variant Work active method aging population cancer site cancer therapy care providers clinical care ethnic diversity experience health care delivery health care service utilization health equity implementation science improved innovation literacy malignant breast neoplasm multilevel analysis neoplasm registry oncology patient oriented patient population population based racial and ethnic racial diversity sex social socioeconomics survivorship virtual

项目摘要

Project Summary There are currently an estimated 15.5 million cancer survivors in the U.S., which is expected to increase in number and racial/ethnic diversity. Cancer survivors face many unique challenges, including late and long-term health effects, emotional and financial hardships, and a greater risk for developing second cancers and other serious health conditions. These challenges may be even more prevalent among underserved populations. In 2006, the Institute of Medicine (IOM) recommended the widespread implementation of survivorship care plans (SCPs) to facilitate the transition from active treatment to cancer survivorship, from oncology care to primary care. SCPs are intended to encompass the details of cancer treatment, which can be shared with current and future medical providers; anticipatory education for survivors; and provision of information about available resources relating to survivorship needs. The recommendations call for oncology treatment teams to review SCPs with patients at the conclusion of their cancer treatment. Early research in the years since the IOM recommendations has shown that implementation of SCPs is not widespread, evidence of improved survivor outcomes is limited, and there is considerable variation in the content of SCPs, with many plans failing to adhere to all of the IOM recommendations. Moreover, there is virtually no research on whether existing SCPs are culturally- or linguistically-tailored to patients and whether they address key social determinant barriers among underserved patients. More research is needed to thoroughly explore the efficacy and viability of SCPs in real-world settings. Specifically, while previous research has uncovered key cultural differences in survivorship experiences, we still know little about the appropriateness, effectiveness, and implementation of SCPs among cancer survivors from diverse racial/ethnic, cultural, and socioeconomic backgrounds. The overarching goal of this proposal is to investigate the extent to which SCPs are implemented in clinical care and used among diverse and underserved populations of breast and colorectal cancer survivors in California. Leveraging population-based cancer registries, we therefore propose the Cancer Registry for Understanding and Improving Survivorship Experiences (CRUISE) project, which takes a comprehensive, multi-level approach to examine the implementation of, and patient experiences with, SCPs, with focus on underserved populations. Our aims are as follows: 1) to examine the use and effectiveness of SCPs on patient-reported outcomes in breast and colorectal cancer survivors in the Greater San Francisco Bay Area; 2) to investigate the implementation and content of survivorship strategies and support including SCPs in use in California health systems serving diverse cancer patient populations; and 3) to convene a Delphi panel of stakeholders to develop best practices for delivering SCPs to meet the needs of diverse patient populations. The current proposal will advance our understanding of the implementation and effectiveness of SCPs from both the perspective of survivors and healthcare systems, focusing in particular on underserved patient populations.

项目概要目前美国估计有 1550 万癌症幸存者，预计这一数字还会增加数量和种族/民族多样性。癌症幸存者面临许多独特的挑战，包括晚期和长期的挑战健康影响、情感和经济困难，以及患第二种癌症和其他癌症的更大风险严重的健康状况。这些挑战在服务不足的人群中可能更为普遍。在 2006年，医学研究所（IOM）建议广泛实施幸存者护理计划（SCP）促进从积极治疗到癌症生存、从肿瘤护理到初级的转变关心。 SCP 旨在涵盖癌症治疗的细节，可以与当前和未来共享未来的医疗提供者；对幸存者进行预期教育；并提供有关可用信息的信息与生存需求相关的资源。这些建议要求肿瘤治疗团队进行审查癌症治疗结束时的 SCP 与患者。 IOM 成立以来的早期研究建议表明 SCP 的实施并不普遍，有证据表明幸存者有所改善结果有限，SCP 的内容差异很大，许多计划未能实现遵守 IOM 的所有建议。此外，几乎没有关于现有SCP是否存在的研究是否在文化或语言上适合患者以及是否解决了关键的社会决定性障碍在服务不足的患者中。需要更多的研究来彻底探索 SCP 的功效和可行性在现实世界中。具体来说，虽然之前的研究已经揭示了关键的文化差异幸存者的经验，我们仍然对适当性、有效性和实施知之甚少来自不同种族/民族、文化和社会经济背景的癌症幸存者中的 SCP。这该提案的首要目标是调查 SCP 在临床护理中的实施程度并在加利福尼亚州不同且服务不足的乳腺癌和结直肠癌幸存者群体中使用。因此，我们利用基于人群的癌症登记处，提出癌症登记处以了解改善幸存者体验 (CRUISE) 项目，该项目采用全面、多层次的方法检查 SCP 的实施情况和患者体验，重点关注服务不足的人群。我们的目标如下：1）检查 SCP 对患者报告结果的使用和有效性大旧金山湾区的乳腺癌和结直肠癌幸存者； 2）调查生存策略和支持的实施和内容，包括在加州健康中使用的 SCP 服务不同癌症患者群体的系统； 3) 召集德尔福利益相关者小组制定交付 SCP 的最佳实践，以满足不同患者群体的需求。目前的该提案将增进我们对 SCP 实施和有效性的理解幸存者和医疗保健系统的观点，特别关注服务不足的患者群体。