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

项目摘要 头颈癌（HNC）护理人员在治疗结束时面临重大挑战，因为他们过渡到 家庭环境和对幸存者的护理具有毁灭性的后期和长期治疗效果。总目标 这项研究的目的是通过以下措施改善HNC幸存者及其照顾者的治疗后恢复结果： 提供基于平板电脑的二元生存需求评估规划（SNAP）工具， 治疗结束时的临床工作流程。SNAP是一个技术支持的生存护理计划（SCP）系统 它使用自我管理的重点：1）准备照顾者，因为他们过渡到下一阶段的康复 以及2）优化保健利用（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 常规SCP护理对护理者和幸存者结局的影响（N=176对），并收集关键数据，以指导最佳 今后向不同的HNC护理机构传播该系统的做法。具体目标1将评估 SNAP对照顾者的照顾者负担、幸存者的症状严重程度和心理健康的影响。 在六个月大的时候就成了一对儿。具体目标2将评估SNAP对医疗保健利用率的影响， 未满足的需求和自我效能在3个月的二人组。具体目标3将使用混合方法来表征关键 在HNC医疗保健环境中采用SNAP系统的障碍和促进因素， 使用HNC医疗保健提供者国家小组调查的患者数量和农村/城市状况（N=200） 以及对美国东南部HNC中心的5次深入案例研究访问，以指导SNAP的改进 项目交付战略和工具。 SNAP的创新之处在于它专注于使用技术来建立一个诊所基础设施，以自动化护理实践来评估， 在治疗结束时解决和支持HNC患者-幸存者二人组的生存需求。SNAP投资 通过逐步的、二元的方法，护理人员在加速康复方面发挥了关键作用。结果将 提供关键证据，以最终确定这一可持续的、技术支持的多站点护理规划系统 执行研究。

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.