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Culturally Competent Communication Intervention to Improve Latinos' Engagement in Advance Care Planning

具有文化能力的沟通干预可提高拉丁美洲人对预先护理计划的参与

基本信息

批准号：
10531352
负责人：
Megan Johnson Shen
金额：
$ 17.23万
依托单位：
FRED HUTCHINSON CANCER CENTER
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-07-01 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10531352
关键词：
Culturally Competent Communication Intervention Improve

项目摘要

PROJECT SUMMARY Compared to whites, Latinos are much less likely to engage in various forms of advance care planning (ACP), including completing advance directives and having end-of-life (EOL) discussions. ACP is critical to provision of quality EOL care, as it has been associated with greater likelihood of patients' EOL wishes being followed. Latino advanced cancer patients are also significantly more likely than their white counterparts to receive futile and burdensome aggressive care at the end-of-life, to die in the ICU, and to have care that runs counter to their preferences and values. Dr. Shen's pilot work, along with the current literature, suggests that targeting ACP may help improve Latinos' EOL care. As such, the proposed project will develop and pilot-test a culturally competent communication (CCC) intervention. First, the CCC intervention will be developed based on results from a questionnaire embedded into a current R01 (MPIs: Prigerson, Maciejewski) assessing Latinos' cultural, familial, and religious beliefs as well as their knowledge, motivation (readiness), and action to engage in ACP (n=200). Next, the developed CCC intervention will be vetted among Latino stakeholders and field-tested among Latino advanced cancer patients, using an iterative approach (n=40) to guide the finalization of the intervention. Finally, a pilot randomized trial will examine the feasibility, acceptability, and potential efficacy of the CCC intervention at improving engagement in ACP. Participants (n=50) will be randomly assigned to the intervention (n=25) or attention control group (n=25). Results will provide timely insight into a potentially effective, low burden intervention designed to improve Latinos' engagement in ACP. Dr. Shen is the ideal candidate to spearhead this line of research given her academic background in social psychology and communication research. Dr. Shen's long-term career goal is to lead a program of social scientific research that develops social psychological interventions designed to improve EOL communication and care, with expertise in interventions targeting racial/ethnic minorities. To achieve this goal, as part of her K07, Dr. Shen will receive intensive training in five key areas: (1) EOL care research; (2) clinical intervention development; (3) technology-based health interventions; (4) health disparities, and (5) professional development. The K07 will provide Dr. Shen with several avenues to achieve her training and research goals and enhance her expertise. Dr. Shen will have ongoing meetings with mentors and expert advisors and participate in formal coursework, didactics, workshops, conferences, interactive trainings, and guided research experience. The proposed K07 will form the foundation for a program of research that focuses on developing social psychological interventions to improve EOL communication and care. At the end of the K07 funding period, Dr. Shen will submit an R01 application, based on the results of the present study. Overall, the K07 will provide Dr. Shen with the research experience, intensive training, and mentorship needed to become a successful independent researcher.

项目总结与白人相比，拉丁裔参与各种形式的提前护理计划(ACP)的可能性要小得多，包括完成预先指令和进行生命周期终止(EOL)讨论。机场核心计划对资源调配至关重要高质量的EOL护理，因为它与患者EOL愿望得到满足的可能性更大相关。拉丁裔晚期癌症患者也明显比白人患者更有可能接受无用的治疗以及繁重的攻击性护理，在生命的尽头，死在重症监护室，并得到与他们的喜好和价值观。沈博士的试点工作以及目前的文献表明，靶向非加太计划可能有助于改善拉美裔人的EOL护理。因此，拟议的项目将开发和试行一种文化胜任沟通(CCC)干预。首先，将根据结果制定CCC干预措施从嵌入当前R01(MPIs：Prigerson，Maciejeski)的评估拉美裔文化的问卷中，家庭、宗教信仰以及他们参与非加太计划的知识、动机(准备)和行动 200例。接下来，将在拉丁裔利益相关者中审查制定的CCC干预措施，并进行实地测试在拉丁裔晚期癌症患者中，使用迭代方法(n=40)指导最终确定干预。最后，一项先导性随机试验将检验该方案的可行性、可接受性和潜在疗效。 CCC在提高机场核心计划参与度方面的干预。参与者(n=50)将被随机分配到干预组(n=25)和注意对照组(n=25)。结果将及时洞察潜在的有效、低负担的干预措施，旨在提高拉美裔人对非加太的参与度。沈博士是理想中的考虑到她在社会心理学方面的学术背景和传播研究。沈博士的长期职业目标是领导一个社会科学研究项目开发旨在改善EOL沟通和护理的社会心理干预措施，在针对种族/少数族裔的干预方面的专门知识。为了实现这一目标，作为她K07的一部分，沈博士将接受五个关键领域的强化培训：(1)EOL护理研究；(2)临床干预开发；(3) 以技术为基础的健康干预措施；(4)健康差距；(5)职业发展。K07将会为沈博士提供几种途径，以实现她的培训和研究目标，并提高她的专业知识。沈博士将与导师和专家顾问进行持续的会议，并参加正式的课程工作，教学、研讨会、会议、互动培训和指导性研究体验。建议的K07 将形成一个研究项目的基础，该项目的重点是发展社会心理干预以改善EOL的沟通和护理。在K07资助期结束时，沈博士将提交R01 应用，根据本研究的结果。总体而言，K07将为沈博士提供研究要成为一名成功的独立研究人员，需要经验、密集的培训和指导。

项目成果

期刊论文数量（16）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Association between immigrant status and advanced cancer patients' location and quality of death.

移民状况与晚期癌症患者的位置和死亡质量之间的关联。

DOI：
10.1002/cncr.34385
发表时间：
2022-09-15
期刊：
CANCER
影响因子：
6.2
作者：
Tergas, Ana, I;Prigerson, Holly G.;Shen, Megan J.;Dinicu, Andreea, I;Neugut, Alfred, I;Wright, Jason D.;Hershman, Dawn L.;Maciejewski, Paul K.
通讯作者：
Maciejewski, Paul K.

The Intersectionality of Stigmas among Key Populations of Older Adults Affected by HIV: a Thematic Analysis.

DOI：
10.1080/07317115.2018.1456500
发表时间：
2019-03
期刊：
Clinical gerontologist
影响因子：
2.8
作者：
Johnson Shen M;Freeman R;Karpiak S;Brennan-Ing M;Seidel L;Siegler EL
通讯作者：
Siegler EL

Incorporating shared decision making into communication with older adults with cancer and their caregivers: Development and evaluation of a geriatric shared decision-making communication skills training module.

DOI：
10.1016/j.pec.2020.04.032
发表时间：
2020-11
期刊：
Patient education and counseling
影响因子：
3.5
作者：
Shen MJ;Manna R;Banerjee SC;Nelson CJ;Alexander K;Alici Y;Gangai N;Parker PA;Korc-Grodzicki B
通讯作者：
Korc-Grodzicki B

Planning for Your Advance Care Needs (PLAN): A Communication Intervention to Improve Advance Care Planning among Latino Patients with Advanced Cancer.