Improving Adherence to Breast Cancer Treatment Guidelines in Nigeria

提高尼日利亚对乳腺癌治疗指南的遵守率

• 批准号: 10684652
• 负责人: Anya Romanoff
• 金额: $ 19.64万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10684652
• 关键词: Acceleration; Address; Adherence; Adopted; Adoption; Africa South of the Sahara; African; Age; Belief; Breast Cancer Patient; Breast Cancer Treatment; Breast Oncology; Cancer Etiology; Caring; Cessation of life; Clinical Practice Guideline; Collaborations; Combined Modality Therapy; Complex; Consolidated Framework for Implementation Research; Country; Data; Databases; Development; Evaluation; Evidence based treatment; Focus Groups; Foundations; Funding; Goals; Group Interviews; Guideline Adherence; Guidelines; Health Personnel; Health Policy; Health Services Research; Health system; Healthcare; Healthcare promotion; Incidence; Individual; Infrastructure; Institution; Intervention; Interview; Knowledge; Memorial Sloan-Kettering Cancer Center; Methodology; Methods; National Comprehensive Cancer Network; Needs Assessment; Nigeria; Nigerian; Oncology; Oncology Group; Outcome; Participant; Patient-Focused Outcomes; Patients; Pilot Projects; Policy Maker; Practice Guidelines; Provider; Public Health; Questionnaires; Recommendation; Research; Research Activity; Research Infrastructure; Research Personnel; Resource-limited setting; Resources; Review Literature; Standardization; Structure; Surgical Oncologist; Survival Rate; Teaching Hospitals; Training; Training and Education; Universities; Woman; Work; advanced breast cancer; anticancer research; breast surgery; cancer care; cancer health disparity; care delivery; career; clinical practice; design; effective therapy; evidence base; fundamental research; global health; implementation evaluation; implementation framework; implementation science; implementation strategy; improved; improved outcome; intervention mapping; low and middle-income countries; malignant breast neoplasm; medical schools; mortality; multidisciplinary; pilot test; professor; prospective; provider adherence; research and development; tool; treatment guidelines; uptake; user centered design

PROJECT SUMMARY/ABSTRACT Background: Breast cancer is the most common cause of cancer incidence and mortality in women in Nigeria. Survival is poor, in part due to inadequate access to effective treatment. The National Comprehensive Cancer Network (NCCN) Harmonized Guidelines for sub-Saharan Africa (SSA) were developed to promote delivery of evidence-based, context-appropriate breast cancer care. Dr. Romanoff’s prior work shows that receiving multi- disciplinary, guideline-concordant breast cancer care in Nigeria is associated with improved outcomes. Nonetheless, guideline implementation and adherence are sporadic and have not been systematically evaluated. The overall goal of this K08 proposal is to facilitate Dr. Romanoff’s development into an independent investigator in global oncology, focusing on strategies to enhance evidence-based breast cancer care delivery in resource- limited settings. This research aims to develop and evaluate strategies to improve healthcare provider adherence to clinical practice guidelines for breast cancer care in Nigeria. Candidate: Dr. Romanoff is a Breast Surgical Oncologist at the Icahn School of Medicine at Mount Sinai, where she is an Assistant Professor in the Department of Global Health and Health System Design, as well as a Global Cancer Disparities Researcher at Memorial Sloan Kettering Cancer Center (MSK). Aims for candidate development include education and training in: 1) fundamentals of health services research, 2) implementation science, and 3) global breast oncology. With the candidate development and research activities proposed, Dr. Romanoff will develop the tools necessary to become an independent investigator and leader in the field of global oncology, and meet her ultimate goal of improving breast cancer outcomes in resource-limited settings worldwide. Research: This research will use rigorous implementation science frameworks and methodologies to accelerate adherence to the NCCN Harmonized Guidelines for SSA in Nigeria, with the ultimate goal of reducing the evidence-to-practice gap and improving evidence-based breast cancer treatment. To achieve this, Dr. Romanoff will leverage the research infrastructure of the African Research Group for Oncology (ARGO), a research consortium including MSK and 26 Nigerian academic institutions. The overall hypothesis is that implementation of structured, multi-level strategies to enhance adherence to breast cancer care guidelines in Nigeria will be acceptable, appropriate, feasible and adoptable – and show promise to change clinical practice. Study aims are to: 1) identify multi-level barriers to guideline-concordant breast cancer care in Nigeria, 2) develop evidence-based implementation strategies to improve adherence to breast cancer clinical practice guidelines in Nigeria, and 3) rigorously evaluate selected implementation strategies in a pilot study in Nigeria. The rationale that underlies this proposal is that implementation of context-appropriate strategies to promote guideline adherence will improve breast cancer care delivery in Nigeria, and ultimately patient survival.

项目摘要/摘要 背景：乳腺癌是尼日利亚女性癌症发病率和死亡率的最常见原因。 生存差，部分原因是获得有效治疗不足。国家综合癌症 开发了撒哈拉以南非洲（SSA）的网络（NCCN）统一准则，以促进交付 基于证据的，适合上下文的乳腺癌护理。罗曼诺夫博士的先前工作表明，收到多 尼日利亚的纪律，准则结合的乳腺癌护理与改善的预后有关。 但是，指南的实施和依从性是零星的，尚未系统地评估。 该K08提案的总体目标是促进Romanoff博士的发展成为一名独立的调查员 在全球肿瘤学中，专注于增强资源中基于证据的乳腺癌护理的策略 - 有限的设置。这项研究旨在制定和评估策略以提高医疗保健提供者的遵守 在尼日利亚的乳腺癌护理临床实践指南中。候选人：罗曼诺夫博士是乳房外科手术 西奈山伊坎医学院的肿瘤学家，她是该系的助理教授 纪念馆的全球健康与卫生系统设计以及全球癌症差异研究员 斯隆开氏癌中心（MSK）。候选人发展的目标包括：1） 卫生服务研究的基础知识，2）实施科学和3）全球乳房肿瘤学。与 候选人开发和研究活动提议，Romanoff博士将开发必要的工具 成为全球肿瘤学领域的独立调查员和领导者，并实现她的最终目标 在全球资源有限的环境中改善乳腺癌的结果。研究：这项研究将使用 严格的实施科学框架和加速遵守NCCN的方法 尼日利亚SSA的协调指南，其最终目的是减少证据与实践差距和 改善基于证据的乳腺癌治疗。为了实现这一目标，Romanoff博士将利用研究 非洲肿瘤研究小组（ARGO）的基础设施，包括MSK和包括MSK和 26尼日利亚学术机构。总体假设是实施结构化的多层次 提高尼日利亚遵守乳腺癌护理指南的策略将是可以接受的，适当的， 可行和适应性 - 并显示出改变临床实践的希望。研究目的是：1）确定多层次 尼日利亚指南结合乳腺癌护理的障碍，2）发展循证实施 提高尼日利亚遵守乳腺癌临床实践指南的策略，3）严格 在尼日利亚的一项试点研究中，评估了选定的实施策略。该提议基础的基本原理 是实施适合上下文的策略来促进准则的遵守将改善乳房 尼日利亚的癌症护理分娩，最终是患者的生存。