Enhancing Cancer care of rural dwellers through telehealth and engagement (ENCORE): protocol to evaluate effectiveness of a multi-level telehealth-based intervention to improve rural cancer care delivery.
Enhancing Cancer care of rural dwellers through telehealth and engagement (ENCORE): protocol to evaluate effectiveness of a multi-level telehealth-based intervention to improve rural cancer care delivery.
复制标题
DOI：
10.1186/s12885-021-08949-4
复制
发表时间：
2021-11-23
期刊：
影响因子：
3.8
通讯作者：
Friedman DL
中科院分区：
文献类型：
--
作者：
Pal T;Hull PC;Koyama T;Lammers P;Martinez D;McArthy J;Schremp E;Tezak A;Washburn A;Whisenant JG;Friedman DL
尽管癌症发病率较低，但农村居民的癌症死亡率高于城市居民。患者，提供者和机构层面的因素导致这些差异。本研究的总体目标是利用来自学术癌症中心的多学科，多专业肿瘤学团队，以便在农村医疗中心的患者和提供者层面提供全面的癌症护理。我们的具体目标是：1）评价多级远程医疗干预的临床有效性，包括提供者获得分子肿瘤委员会专业知识沿着患者获得支持性护理干预，以改善癌症护理服务; 2）确定未来更大规模传播和实施多级干预的促进因素和障碍。由国家癌症研究所指定的综合癌症中心协调，这项研究将包括两个大型医疗保健系统中几个诊所的提供者和患者，为农村社区提供服务。使用基于远程保健的分子肿瘤委员会，审查测序结果，讨论预测和预后标志物，并在肿瘤专家和农村提供者之间制定治疗计划。同时，农村患者将随机接受为期6周的循证自我管理支持性护理计划，癌症繁荣和生存，与教育关注对照。主要结局将是提供者对分子肿瘤委员会建议的接受和患者治疗依从性。将从患者和提供者那里收集由实施研究综合框架指导的混合方法，该方法结合了定性关键线人访谈和定量调查，以确定实施多层次干预的促进者和障碍。这项研究将利用信息技术支持的、基于团队的护理提供模式，为农村和/或服务不足的人群提供全面、协调和高质量的癌症护理。同时关注机构，提供者和患者层面的障碍，以提供优质的护理将为我们提供机会，广泛分享肿瘤学专业知识，并制定传播和实施战略，将提高癌症护理提供给居住在服务不足的农村社区的患者。Clinicaltrials.gov，NCT 04758338。2021年2月17日注册-追溯注册，http://www.clinicaltrials.gov/在线版本包含补充材料，可通过10.1186/s12885-021-08949-4获取。
Despite lower cancer incidence rates, cancer mortality is higher among rural compared to urban dwellers. Patient, provider, and institutional level factors contribute to these disparities. The overarching objective of this study is to leverage the multidisciplinary, multispecialty oncology team from an academic cancer center in order to provide comprehensive cancer care at both the patient and provider levels in rural healthcare centers. Our specific aims are to: 1) evaluate the clinical effectiveness of a multi-level telehealth-based intervention consisting of provider access to molecular tumor board expertise along with patient access to a supportive care intervention to improve cancer care delivery; and 2) identify the facilitators and barriers to future larger scale dissemination and implementation of the multi-level intervention. Coordinated by a National Cancer Institute-designated comprehensive cancer center, this study will include providers and patients across several clinics in two large healthcare systems serving rural communities. Using a telehealth-based molecular tumor board, sequencing results are reviewed, predictive and prognostic markers are discussed, and treatment plans are formulated between expert oncologists and rural providers. Simultaneously, the rural patients will be randomized to receive an evidence-based 6-week self-management supportive care program, Cancer Thriving and Surviving, versus an education attention control. Primary outcomes will be provider uptake of the molecular tumor board recommendation and patient treatment adherence. A mixed methods approach guided by the Consolidated Framework for Implementation Research that combines qualitative key informant interviews and quantitative surveys will be collected from both the patient and provider in order to identify facilitators and barriers to implementing the multi-level intervention. The proposed study will leverage information technology-enabled, team-based care delivery models in order to deliver comprehensive, coordinated, and high-quality cancer care to rural and/or underserved populations. Simultaneous attention to institutional, provider, and patient level barriers to quality care will afford the opportunity for us to broadly share oncology expertise and develop dissemination and implementation strategies that will enhance the cancer care delivered to patients residing within underserved rural communities. Clinicaltrials.gov, NCT04758338. Registered 17 February 2021 – Retrospectively registered, http://www.clinicaltrials.gov/ The online version contains supplementary material available at 10.1186/s12885-021-08949-4.
登录
查看更多内容
影响因子：
4.7
作者：
Jaglal, Susan B.;Haroun, Vinita A.;Bereket, Tarik
通讯作者：
Bereket, Tarik
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
6.3
作者：
Kennedy, Anne;Reeves, David;Rogers, Anne
通讯作者：
Rogers, Anne
影响因子：
24.9
作者：
Henley, S. Jane;Anderson, Robert N.;Richardson, Lisa C.
通讯作者：
Richardson, Lisa C.
影响因子：
5.5
作者：
Brady TJ;Murphy L;O'Colmain BJ;Beauchesne D;Daniels B;Greenberg M;House M;Chervin D
通讯作者：
Chervin D