Georgetown University Lombardi Comprehensive Cancer Center Support Grant

乔治城大学隆巴迪综合癌症中心支持补助金

• 批准号: 10409001
• 负责人: Louis M. Weiner
• 金额: $ 14.98万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10409001
• 关键词: Academic Medical Centers; Address; Adherence; Administrator; Adolescent and Young Adult; Adult; Age; Asians; Behavior; Bioinformatics; Cancer Center; Cancer Center Support Grant; Cancer Patient; Caring; Characteristics; Child; Childhood; Clinical; Communities; Community Health; Complex; Comprehensive Cancer Center; Comprehensive Health Care; Computerized Medical Record; Continuity of Patient Care; Diagnosis; Discrimination; Disease; Education; Employment; Epidemiology; Family; Geographic Locations; Goals; Guidelines; Health; Health Personnel; Health Services Research; Health system; Income; Inequality; Infrastructure; Interdisciplinary Study; Intervention; Interview; Knowledge; Late Effects; Latino; Literacy Programs; Longevity; Low income; Malignant Childhood Neoplasm; Malignant Neoplasms; Monitor; Nature; Outcome; Patients; Pediatric Oncology; Personal Satisfaction; Policies; Population; Population Heterogeneity; Population Sizes; Poverty; Primary Health Care; Provider; Research; Research Design; Resources; Retrospective cohort; Risk; Scientist; Service delivery model; Services; Source; Special Population; Specialist; Survivors; System; Testing; Universities; Variant; Washington; anticancer research; base; cancer prevention; cancer therapy; care coordination; care delivery; care outcomes; care providers; care systems; childhood cancer survivor; community engagement; cost; design; disparity reduction; ethnic minority population; follow-up; health data; health disparity; health equity; healthy lifestyle; improved; informant; organizational structure; patient population; programs; racial and ethnic; racism; ranpirnase; screening; social health determinants; survivorship

Cancer Center Organizational Assessment to Eliminate Outcome Disparities Among CCS Continuity of care for childhood cancer survivors (CCS) is essential to promote lifelong health and well-being, as many survivors will confront prolonged late-effects of their disease and treatment. However, there are barriers to CCS equitably accessing follow-up care. Underserved racial/ethnic minorities, especially those who are already facing multiple social determinants of health (SDOH) barriers, are among the most adversely impacted by this inequity. The majority of prior research has focused on the organization and delivery of CCS care in well- resourced and majority groups: gaps remain in studies designed to identify and reduce disparities among vulnerable CCS. The complex and multiply-determined nature of CCS care delivery, along with recognizing the importance of SDOH, inform our research. The goal of this P30 supplement application, submitted on behalf of Georgetown University's Lombardi Comprehensive Cancer Center (Washington, DC) and its NCI-designated research consortium partner John Theurer Cancer Center (Hackensack, NJ), is to better understand and help eradicate disparities and barriers to the receipt of recommended CCS care. This care includes risk-based cancer surveillance, screening, and management, the prevention of cancer late effects, and care coordination. We plan to do this by assessing our cancer centers' internal organizational attributes and behaviors (including both practices and policies) that may inadvertently curtail access to such care among adolescent and young adult (AYA; ages 15-39 years) CCS in our geographic areas. This is important because these AYAs could (and could continue to) be served by our health systems in addressing the needs of this special population. Among the issues we seek to study are: 1) how prevalent underserved AYA CCS are across our systems; 2) what happens if/when they transition from pediatric to adult care (or become lost to follow-up); 3) if they are universally identified and recognized by our systems as CCS in need of CCS services, and; 4) if differences in care outcomes exist and may be attributable to organizational and SDOH factors, among others. We will thoroughly analyze our AYA CCS care systems, determine how to improve their quality, and formulate institutional action plans that will close gaps and remove obstacles to underserved CCS receiving the services they need across the lifespan. These action plans will then be tested and followed-up in subsequent interventional pilot initiatives promoting adherence to cancer treatment or guideline-concordant care. And they will be sustained by resources and a strengthening of our organizational capacity to better serve our catchment's diverse populations of AYA CCS.

癌症中心组织评估以消除CCS之间的结果差异 儿童癌症幸存者的持续护理对于促进终身健康和福祉至关重要， 许多幸存者将面临其疾病和治疗的长期后期影响。然而， 公平地获得后续护理。服务不足的种族/族裔少数群体，特别是那些 已经面临多种健康社会决定因素（SDOH）障碍的人，是受到最不利影响的人之一。 这种不平等。大多数先前的研究都集中在良好的CCS护理的组织和交付- 资源丰富的群体和多数群体：旨在查明和减少少数群体之间差距的研究仍存在差距 脆弱的CCS CCS护理提供的复杂性和多重决定性，沿着认识到 SDOH的重要性，为我们的研究提供信息。此P30补充申请的目标，代表 乔治敦大学的隆巴迪综合癌症中心（华盛顿，DC）及其NCI指定的 研究联盟合作伙伴约翰·特雷尔癌症中心（新泽西州哈肯萨克），是为了更好地了解和帮助 消除在接受建议的CCS护理方面的差距和障碍。这种护理包括基于风险的癌症 监测、筛查和管理，预防癌症晚期效应，以及护理协调。我们计划 通过评估我们癌症中心的内部组织属性和行为（包括 可能无意中减少青少年和年轻人获得这种护理的机会 (AYA年龄15-39岁）CCS在我们的地理区域。这很重要，因为这些AYA可以（并且可以 我们的卫生系统将继续为这些人提供服务，以满足这一特殊群体的需要。中 我们寻求研究的问题是：1）在我们的系统中，服务不足的AYA CCS有多普遍; 2） 如果/当他们从儿科过渡到成人护理（或失访）; 3）如果他们被普遍识别 并被我们的系统识别为需要CCS服务的CCS，以及; 4）如果存在护理结果差异 并且可以归因于组织和SDOH因素等。我们将彻底分析我们的AYA CCS护理系统，确定如何提高其质量，并制定机构行动计划，将关闭 消除差距，消除障碍，使服务不足的CCS在整个生命周期内获得所需的服务。这些 然后，将在随后的干预性试点倡议中对行动计划进行测试和后续行动，以促进遵守 癌症治疗或指南一致的护理。他们将通过资源和加强 我们的组织能力，以更好地为我们的集水区的不同人群的AYA CCS。