Scalable TELeheaLth Cancer CARe: The STELLAR Program to Treat Cancer Risk Behaviors

可扩展的 TELEheaLth 癌症护理：治疗癌症危险行为的 STELLAR 计划

• 批准号: 10454615
• 负责人: Sofia F. Garcia
• 金额: $ 109.85万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10454615
• 关键词: Address; Adult; Behavior; Behavior Therapy; Behavior assessment; Behavioral; Cancer Center; Cancer Patient; Clinic; Clinical; Clinical Services; Code; Custom; Data; Disease; Elderly; Fostering; Funding; Goals; Health; Health Promotion; Health Services Accessibility; Health system; Healthcare; Hospitals; Informal Social Control; Institute of Medicine (U.S.); Intervention; Link; Longevity; Malignant Neoplasms; Medicine; Minority; Obesity; Oncology; Outcome; Pathway interactions; Patient Outcomes Assessments; Patients; Persons; Pilot Projects; Policies; Provider; Quality of Care; Quality of life; Recurrence; Registries; Reporting; Research; Resources; Risk; Risk Behaviors; Risk Factors; Self Assessment; Services; Smoking; Symptoms; System; Techniques; Technology; Testing; Time; Tobacco use; Training; Treatment Cost; Treatment Protocols; Treatment Side Effects; Universities; Vision; arm; base; behavior change; cancer care; cancer risk; cancer therapy; care delivery; care providers; clinical decision-making; clinical practice; cost; dashboard; design; digital; evidence base; health care delivery; health care service utilization; health training; improved; patient oriented; patient-clinician communication; physical inactivity; pragmatic trial; programs; ranpirnase; remote delivery; response; screening; shared decision making; side effect; smoking cessation; social; survivorship; symptom management; telehealth; tool; treatment as usual; treatment program; treatment response

Abstract The proposed research center for Scalable TELeheaLth Cancer CARe (STELLAR) is grounded in the Institute of Medicine (IOM) vision that quality cancer care includes not only treatment of the disease, but also promotion of the patient’s long-term health and quality of life. Cancer risk behaviors (e.g., smoking, physical inactivity, obesity1) are associated with poor treatment response, treatment-related side effects, heightened recurrence risk, decreased longevity, diminished quality of life (QOL), and increased treatment cost for many cancers2-8. These risk behaviors are at least as prevalent in cancer patients as they are in healthy adults, but referral pathways to treat them are not routinely integrated into cancer care. By integrating cancer risk behavior assessment into the EHR and automating referral, we plan to make telehealth-enabled treatment of health risk behaviors (a clinical service called health promotion) accessible to cancer providers and patients throughout Northwestern’s clinical practice network in a manner that is affordable, improves care quality, and is minimally disruptive to clinical workflow. The MPIs of this proposal have developed, and are experts at, remotely assessing patient symptoms and delivering effective, inexpensive, telehealth treatment of cancer’s most prevalent and potent, behavioral risk factors. physical inactivity9, obesity10, smoking11 Our preliminary data suggest that telehealth, as compared to in-person cancer care, may make treatment more accessible to older adults and minorities. With Cancer Moonshot and other funds, we have collectively developed patient-reported assessment, symptom management, and shared decision-making tools that are integrated into the single EHR (Epic) system that links the Northwestern Memorial HealthCare Corporation’s (NMHC)11-hospital healthcare delivery system. We also developed a smoking cessation program offered throughout NMHC. In response to demand from NM’s Cancer Quality Improvement group, we now propose to implement, optimize, evaluate, and disseminate a more comprehensive, fully integrated, patient-centered, technology-assisted telehealth risk behavior treatment program that proactively addresses physical inactivity, obesity, and tobacco use for cancer patients in the NMHC system. We plan a pragmatic trial to test its impact on equitable care access, health outcomes, care quality, care utilization, provider-patient communication, patient-reported outcomes, and cost. The STELLAR program will foster patients’ long-term health and quality of life by refining, disseminating, and sustaining the first cancer-specific telehealth treatment program for multiple risk behaviors to be fully integrated into quality cancer care.

摘要 拟议中的可扩展远程癌症护理研究中心（STELLAR）位于该研究所 医学部（IOM）的愿景是，高质量的癌症护理不仅包括疾病的治疗， 患者的长期健康和生活质量。癌症风险行为（例如，吸烟，缺乏运动， 肥胖1）与治疗反应差、治疗相关副作用、复发率升高有关 风险，寿命缩短，生活质量下降（QOL），以及许多癌症的治疗费用增加2 -8。 这些危险行为在癌症患者中至少与健康成年人一样普遍， 治疗它们的途径并没有常规地整合到癌症护理中。通过整合癌症风险行为 评估到电子健康记录和自动转诊，我们计划使远程医疗启用治疗的健康风险 癌症提供者和患者在整个过程中都可以获得的行为（一种称为健康促进的临床服务） 西北大学的临床实践网络的方式是负担得起的，提高护理质量， 扰乱临床工作流程。本提案的MPI已开发，并且是远程 评估病人的症状，并提供有效的，廉价的，远程医疗治疗癌症的最 普遍和强有力的行为风险因素。身体不活动，肥胖，吸烟我们的初步数据 这表明，远程保健，与人在癌症护理，可能使治疗更容易获得老年人 成年人和少数民族。通过癌症登月计划和其他基金，我们共同开发了患者报告的 评估、症状管理和共享决策工具，这些工具被集成到单一的EHR中 （史诗）系统，连接西北纪念医疗保健公司（NMHC）的11医院医疗保健 输送系统。我们还制定了一个戒烟计划提供整个NMHC。响应于 从NM的癌症质量改进组的需求，我们现在建议实施，优化，评估， 传播更全面、完全整合、以患者为中心、技术辅助的远程医疗风险 行为治疗计划，积极解决身体不活动，肥胖和烟草使用的癌症 NMHC系统中的患者。我们计划进行一项务实的试验，以测试其对公平获得医疗服务、健康 结果、护理质量、护理利用、提供者-患者沟通、患者报告的结果和成本。 STELLAR计划将通过提炼、传播和改善患者的长期健康和生活质量， 维持第一个针对多种风险行为的癌症特异性远程保健治疗计划，以充分整合 转化为高质量的癌症治疗