A Randomized Controlled Trial to Evaluate the Survivorship Needs Assessment Planning Tool for Head and Neck Cancer Survivor-Caregiver Dyads

项目总结 头颈部癌症(HNC)的照顾者在治疗结束时面临着巨大的挑战，因为他们正在过渡到 家庭环境和对幸存者的照顾，具有毁灭性的晚期和长期治疗效果。总目标 这项研究的目的是通过以下途径改善HNC幸存者及其照顾者的治疗后康复结果 交付基于平板电脑的二元生存需求评估计划(SNAP)工具 治疗结束时的临床工作流程。Snap是一种基于技术的生存护理计划(SCP)系统 它使用自我管理的重点来：1)在照顾者过渡到下一阶段照看时，为他们做好准备 和2)优化护理人员的医疗保健利用(例如，接受推荐的医疗和支持性护理)- 幸存者二人组。 我们的跨学科团队将进行一项随机对照试验，以测试SNAP与 对照顾者和幸存者结局的常规SCP护理(N=176个二元)，并收集关键数据以最佳指导 未来将该系统传播到不同的HNC护理环境的做法。特定目标1将评估 SNAP对照顾者负担、幸存者症状严重程度及心理健康的影响 在6个月大的时候就处于双生子状态。具体目标2将评估SNAP对医疗保健利用吸收的影响， 3个月时未被满足的需求和二人组的自我效能。具体目标3将使用混合方法来表征关键字 在实践结构多样化的HNC医疗保健环境中采用SNAP系统的障碍和促进者， 通过全国HNC医疗保健提供者小组(N=200)的调查，得出患者数量和城乡状况 与美国东南部的HNC中心进行了5次深入的案例研究访问，以指导SNAP的完善 计划交付策略和工具。 Snap的创新之处在于，它专注于使用技术来构建诊所基础设施，以自动化医疗实践以进行评估， 在治疗结束时，解决和支持HNC照顾者-幸存者二人组的生存需求。Snap投资 在照顾者发挥关键作用方面，他们采取了一种循序渐进的二元方法，以加速康复。结果将 提供关键证据，最终确定适用于多个站点的可持续、由技术支持的护理规划系统 实施研究。

PROJECT SUMMARY Head and neck cancer (HNC) caregivers face significant challenges at the end of treatment as they transition to the home setting and care for survivors with devastating late and long-term treatment effects. The overall goal of this research is to improve post-treatment recovery outcomes in HNC survivors and their caregivers through the delivery of a tablet-based, dyadic survivorship needs assessment planning (SNAP) tool implemented into clinic workflow at the end of treatment. SNAP is a technology-enabled survivorship care planning (SCP) system that uses a self-management focus to: 1) prepare caregivers as they transition to the next phase of caregiving and 2) optimize healthcare utilization (e.g., receipt of recommended medical and supportive care) in caregiver- survivor dyads. Our interdisciplinary team will conduct a randomized controlled trial to test the effects of SNAP compared to usual SCP care on caregiver and survivor outcomes (N=176 dyads) and gather crucial data to guide best practices for disseminating the system to diverse HNC care settings in the future. Specific Aim 1 will evaluate the effects of SNAP on caregiver burden in caregivers, symptom severity in survivors and psychological well- being in dyads at 6 months. Specific Aim 2 will evaluate the effects of SNAP on healthcare utilization uptake, unmet needs and self-efficacy in dyads at 3 months. Specific Aim 3 will use mixed methods to characterize key barriers and facilitators to SNAP system adoption in HNC healthcare settings diverse by practice structure, patient volume and rural/urban status using surveys in a national panel of HNC healthcare providers (N=200) and 5 in-depth case study visits with HNC centers in the southeastern United States to guide refinement of SNAP program delivery strategies and tools. SNAP is novel in its focus on using technology to build a clinic infrastructure to automate care practices to assess, address and support survivorship needs in HNC caregiver-survivor dyads at the end of treatment. SNAP invests in the critical roles played by caregivers through a stepped, dyadic approach to accelerate recovery. Results will provide critical evidence to finalize this sustainable, technology-enabled care planning system for a multi-site implementation study.