Reducing Racial Disparities in Advance Care Planning within Neuro-Oncology

减少神经肿瘤学预先护理计划中的种族差异

• 批准号: 10386210
• 负责人: Adela Wu
• 金额: $ 6.86万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2023-09-23
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10386210
• 关键词: Reducing; Racial; Disparities; Advance; Care

Project Summary: Reducing Racial Disparities in Advance Care Planning within Neuro-Oncology The Agency for Healthcare Quality and Research has called for research that improves care planning in racial/ethnic minorities as well as priority patient populations, which includes those who require end-of-life care. Advance care planning (ACP) involves discussion and documentation of patients’ goals and is unfortunately poorly executed for patients from racial and ethnic minority backgrounds. ACP is also especially important in neuro-oncology, as patients have poor prognoses and often suffer from progressive cognitive decline interfering with decision-making capacity. The proposed project’s central hypothesis is that identifying the racial and cultural barriers to implementing timely ACP will enhance goal-concordant care in terminal neuro- oncologic disease and reduce racial and ethnic disparities in end-of-life care. The rationale is that timely ACP is a key component of goal-concordant care delivery for neuro-oncologic patients. This proposal will utilize rigorous quantitative and qualitative research methods to answer the following innovative Aims: 1) to define current ACP implementation patterns within a tertiary-care health system and analyze patient-level factors contributing to the existing timing and content of ACP; 2) to identify patient- and provider-specific attitudes, barriers and other factors involved in ACP implementation; and 3) to identify the most feasible and practically implementable strategy available for addressing challenges and reducing disparities in ACP implementation in the neuro-oncologic patient population. Dr. Adela Wu is a neurosurgery resident physician at Stanford interested in improving end-of-life care for neuro-oncologic and neurosurgical patients. She seeks to receive rigorous training in quantitative and qualitative research design, methodology, and planning necessary to become an independent surgeon-scientist and a leader in neurosurgical oncology and palliative care with K award and other career development funding. Under the close supervision of the mentorship team led by nationally-renowned experts in palliative care and implementation science (Dr. Karl Lorenz), palliative care and patient-centered outcomes (Dr. Rebecca Aslakson), biomedical ethics and communication (Dr. David Magnus) and neuro-oncology management (Dr. Michael Lim), Dr. Wu will achieve the proposed research Aims. The training plan includes regular mentorship meetings, formal didactic courses, and seminars to deepen understanding of core research skills Dr. Wu will need to earn further career development funding and become a successful, independent investigator. Furthermore, Stanford University is a highly regarded center for biomedical research, with the oldest palliative care fellowship program nationwide, t he Stanford Palliative Care Center of Excellence, and a clinically busy neuro-oncology service and outpatient clinic at the Stanford Cancer Center.

项目摘要：减少神经肿瘤学预先护理计划中的种族差异 医疗保健质量和研究机构呼吁开展研究以改善护理计划 少数种族/族裔以及优先患者群体，其中包括需要临终关怀的患者。 预先护理计划 (ACP) 涉及对患者目标的讨论和记录，不幸的是 对于来自种族和少数民族背景的患者执行效果不佳。 ACP 在以下方面也尤为重要： 神经肿瘤学，因为患者预后不佳，并且经常出现进行性认知能力下降 干扰决策能力。拟议项目的中心假设是确定种族 及时实施 ACP 的文化障碍将增强终末神经系统疾病患者的目标一致护理 肿瘤疾病并减少临终关怀方面的种族和民族差异。理由是及时的 ACP 是为神经肿瘤患者提供目标一致护理的关键组成部分。本提案将利用 严格的定量和定性研究方法来回答以下创新目标：1）定义 三级医疗保健系统中当前 ACP 实施模式并分析患者层面的因素 为 ACP 的现有时间安排和内容做出贡献； 2) 确定患者和提供者的具体态度， ACP 实施中涉及的障碍和其他因素； 3）确定最可行和最实用的方案 可用于应对挑战并减少 ACP 实施中的差异的可实施战略 神经肿瘤患者群体。 Adela Wu 博士是斯坦福大学神经外科住院医师 对改善神经肿瘤和神经外科患者的临终关怀感兴趣。她寻求接收 定量和定性研究设计、方法和规划方面的严格培训是必要的 与 K 一起成为一名独立的外科医生兼科学家以及神经外科肿瘤学和姑息治疗领域的领导者 奖和其他职业发展资金。在导师团队的密切监督下 全国知名的姑息治疗和实施科学专家（Karl Lorenz 博士）、姑息治疗和 以患者为中心的结果（Rebecca Aslakson 博士）、生物医学伦理与沟通（David Magnus 博士） 和神经肿瘤管理（Michael Lim 博士），Wu 博士将实现拟议的研究目标。这 培训计划包括定期指导会议、正式教学课程和研讨会以加深 了解吴博士需要获得进一步的职业发展资金并成为核心研究技能 一位成功的独立调查员。此外，斯坦福大学是备受推崇的中心 生物医学研究，拥有全国最古老的姑息治疗奖学金计划，t 斯坦福姑息治疗中心 卓越中心，以及斯坦福大学癌症中心临床繁忙的神经肿瘤服务和门诊诊所 中心。