Advancing the Quality of Cancer Care through Behavioral Economics and Implementation Science

宾夕法尼亚大学癌症控制实施科学中心（Penn ISC 3）所面临的重大挑战是： 应用行为经济学的见解，加快癌症循证实践的步伐， 护理被部署以改善癌症患者的结果。宾夕法尼亚大学提供了一个独特的环境， 进行这种范式转换的工作，鉴于我们在实施科学，行为经济学， 和创新的癌症护理服务。三个MPI的互补和多学科专业知识（Bei- das、Bekelman、Schnoll），加上宾夕法尼亚大学现有的资源，包括宾夕法尼亚大学癌症护理中心 创新[PC3I]，健康激励和行为经济学中心[CHIBE]，以及宾夕法尼亚大学实施- 心理学科学中心在伦纳德戴维斯研究所[PISCE@LDI]，代表了一个独特的机会，广告- 万斯癌症治疗的质量。由Beidas、Bekelman和Schnoll博士领导的行政核心将确保 宾夕法尼亚大学ISC 3的活动是协调的，协同的，并与时间表一致。执行 由Bekelman博士和Shulman博士领导的实验室代表了一个多元化的生态系统，包括五家医院， 与200多名肿瘤学家建立了联系，每年为15，000多名新患者提供服务。我们的研究 由Beidas博士和Buttenheim博士领导的该计划将监督实施战略的开发和测试， 在我们的实施实验室中，以患者和临床医生为目标，以“轻推”为中心的概念 以实现最佳实施和有效性成果。该研究计划包括研究人员与前- 在实施科学，行为经济学，癌症护理提供研究，医疗创新， 测量和混合方法。在头两年，我们提出了三个签名试点项目和两个 方法项目与快速学习的承诺，将使宾州ISC 3是最佳的灵活性。签名 试点项目1（Jenssen/Leone）测试以患者和临床医生为导向的实施战略，以增加转诊 癌症患者的戒烟计划。签名试点项目2（贝克曼/帕特尔）测试病人- 和临床医生指导的实施策略，以增加高价值的骨修饰剂的患者， 乳腺癌肺癌和前列腺癌共同的方法和措施相互联系，以便汇集数据， 以实现我们的目标，测试多层次的实施战略和机制，在上下文。 我们的探索性和高回报的签名试点项目3（Bekelman/Rendle）将测试一个患者导向的实施方案， 利用人工智能和机器学习来促进口服化疗的策略， 遗传和症状管理。两个方法项目，以支持项目，将推动科学 的实施方法。方法项目1将开发一个应用快速循环方法的工具包 (Asch/Buttenheim）;方法项目2将使用定性比较分析来表征多层次的对比。 文本变异（Barg/Rendle）。Penn ISC 3有潜力识别新的、可传播的和可扩展的 提高癌症护理质量和改善癌症患者健康结果的方法。 PHS 398/2590（Rev.06/09）

The grand challenge addressed by the Penn Implementation Science Center in Cancer Control (Penn ISC3) is to apply insights from behavioral economics to accelerate the pace at which evidence-based practices for cancer care are deployed to improve outcomes for individuals with cancer. Penn offers a unique environment in which to conduct this paradigm-shifting work, given our expertise in implementation science, behavioral economics, and innovative cancer care delivery. The complementary and multi-disciplinary expertise of the three MPIs (Bei- das, Bekelman, Schnoll), coupled with existing Penn resources, including the Penn Center for Cancer Care Innovation [PC3I], the Center for Health Incentives and Behavioral Economics [CHIBE], and the Penn Imple- mentation Science Center at the Leonard Davis Institute [PISCE@LDI], represent a unique opportunity to ad- vance the quality of cancer care. The Administrative Core, led by Drs. Beidas, Bekelman, and Schnoll, will ensure that the activities of Penn ISC3 are coordinated, synergistic, and congruent with timelines. The Implementation Laboratory, led by Drs. Bekelman and Shulman, represents a diverse ecosystem that includes five hospitals and linked clinical sites, with over 200 oncologists that serve over 15,000 unique new patients annually. Our Research Program, led by Drs. Beidas and Buttenheim, will oversee the development and testing of implementation strat- egies that target patients and clinicians within our Implementation Lab and are centered on the idea of ‘nudging’ for optimal implementation and effectiveness outcomes. The Research Program includes investigators with ex- pertise in implementation science, behavioral economics, cancer care delivery research, healthcare innovation, measurement, and mixed methods. In the first two years, we propose three Signature Pilot Projects and two Methods Projects with a commitment to rapid learning that will allow Penn ISC3 to be optimally nimble. Signature Pilot Project 1 (Jenssen/Leone) tests patient- and clinician-directed implementation strategies to increase referral to tobacco cessation programs among cancer patients. Signature Pilot Project 2 (Bekelman/Patel) tests patient- and clinician-directed implementation strategies to increase higher-value bone modifying agents in patients with breast, lung, and prostate cancer. Common methods and measures are linked to allow for pooling of data and to accomplish our objectives of testing multilevel implementation strategies and mechanisms across contexts. Our exploratory and high-reward Signature Pilot Project 3 (Bekelman/Rendle) will test a patient-directed imple- mentation strategy that leverages artificial intelligence and machine learning to promote oral chemotherapy ad- herence and symptom management. Two methods projects, in support of the Projects, will advance the science of implementation methods. Methods Project 1 will develop a toolkit for the application of rapid cycle approaches (Asch/Buttenheim); Methods Project 2 will use qualitative comparative analysis to characterize multilevel con- textual variation (Barg/Rendle). The Penn ISC3 has the potential to identify novel, disseminable, and scalable ways to advance the quality of cancer care and improve the health outcomes for individuals with cancer. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page