权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Fidelity and adaptation of breast cancer resource-stratified treatment guidelines in Botswana

博茨瓦纳乳腺癌资源分层治疗指南的保真度和适应性

基本信息

批准号：
10557090
负责人：
Yehoda Marteki Martei
金额：
$ 13.81万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-05-14 至 2024-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10557090
关键词：
Africa South of the Sahara Area Botswana Breast Breast Cancer Patient Breast Cancer Treatment Breast Cancer therapy Cancer Burden Cancer Control Cancer Etiology Caring Cessation of life Clinical Research Complement Country Data Developed Countries Disparity Dose Drug Prescriptions Enrollment Evidence based intervention Fatality rate Frequencies Funding Goals Guideline Adherence Guidelines HIV Health Priorities Health system Healthcare Systems Incidence Individual Inferior Intervention Intervention Trial Life Literature Logistic Regressions Malignant Neoplasms Measurement Measures Medicine Mentors Methods National Cancer Institute North America Oncologist Outcome Patients Pennsylvania Pharmacoepidemiology Prevalence Procedures Public Health Public Hospitals Regression Analysis Reporting Research Research Personnel Research Project Grants Research Training Resource-limited setting Resources Risk Sampling Science Severities Study Skills Systemic Therapy Testing Time Training Treatment outcome Universities Variant Woman Work World Health Organization anticancer research barrier to care cancer care care delivery career chemotherapy clinical epidemiology community based participatory research cost effective cost effective intervention design evidence base experience global health implementation design implementation fidelity implementation intervention implementation outcomes implementation science implementation strategy improved intervention mapping low and middle-income countries malignant breast neoplasm mortality multidisciplinary neoplasm resource provider-level barriers skills sociocultural determinant socioeconomics survival outcome therapy design treatment comparison treatment guidelines treatment stratification

项目摘要

Project Summary Breast cancer is the leading cause of cancer mortality among women globally with over 626,000 deaths reported in 2018. Despite substantial reductions in breast cancer mortality in developed countries, low- and middle- income countries (LMICs) continue to experience a high fatality rate. The disparity is more pronounced in Sub Saharan Africa (SSA) and in HIV prevalent regions, where HIV-infected (HIV+) breast cancer patients have a significantly increased risk of all-cause mortality. The “World Health Organization-Choosing Interventions that are Cost-Effective” team assessed systemic treatment for breast cancer at 95% coverage in SSA as cost-effective. Subsequently robust evidence-based resource-stratified guidelines have been developed to promote high quality breast cancer therapy delivery in SSA. However critical real-world data are lacking on the treatment fidelity and the implementation of guideline-based care. These data are critical to understanding whether inferior outcomes are related to the quality or extent of guideline implementation or other unrelated factors. If interventions that maximize treatment fidelity and minimize random variability are implemented, targeted outcomes will likely be achieved. The long-term goal is to improve survival outcomes in HIV+ and HIV- breast cancer patients in SSA by designing targeted interventions to increase high-quality therapy delivery. The objectives of this application are to allow Dr. Martei to formally train to become an independent investigator in implementation science in cancer care delivery in SSA, and to obtain practical skills through the following research aims: 1) compare treatment fidelity between HIV+ and HIV- breast cancer patients receiving curative intent therapy and identify HIV modifiers of fidelity; 2) using mixed methods design and a deviance sample of patients with high and low fidelity identify socioeconomic and cultural modifiers of fidelity; and 3) using the collaborative intervention planning framework to identify targets for guideline adaptation and develop a menu of implementation strategies and intervention trials to promote treatment fidelity. This study in Botswana builds upon 15 years of collaborative research between Botswana and the University of Pennsylvania, including a multidisciplinary group of US- and Botswana-based senior mentors, and the strong publicly-funded healthcare system for HIV and breast cancer. This is aligned with the National Cancer Institute Center for Global health priority areas of “Strengthening Global Cancer Research and Resource-Appropriate Cancer Control Strategies” to promote cancer research and control efforts that are evidence-based and sustainable in LMICs.

项目摘要乳腺癌是全球女性癌症死亡的主要原因， 2018年报告了626，000例死亡。尽管乳腺癌死亡率在2010年大幅下降，发达国家、低收入和中等收入国家（LMICs）继续经历高增长，死亡率这种差距在撒哈拉以南非洲和艾滋病毒感染者中更为明显流行地区，其中艾滋病毒感染（艾滋病毒+）乳腺癌患者有显着全因死亡的风险增加。世界卫生组织-选择干预措施 “具有成本效益”的研究小组评估了乳腺癌的系统性治疗， SSA具有成本效益。随后，强有力的循证资源分层指南旨在促进SSA的高质量乳腺癌治疗。无论多么关键缺乏关于治疗保真度和基于指南的实施的真实数据在乎这些数据对于理解较差的结果是否与准则实施的质量或程度或其他无关因素。如果干预措施，最大化治疗保真度和最小化随机变异性，可能会取得成果。长期目标是改善HIV+和HIV-乳腺癌患者的生存结局通过设计有针对性的干预措施，以增加高质量的治疗提供。的本申请的目的是让Martei博士正式培训成为一名独立的研究人员在实施科学在癌症护理提供在SSA，并获得实际的通过以下研究目标的技能：1）比较艾滋病毒+和艾滋病毒-之间的治疗保真度接受治疗性治疗的乳腺癌患者，并确定保真度的HIV修饰剂; 2）采用混合方法设计和高、低保真度患者的偏离样本确定忠诚的社会经济和文化修饰符;和3）使用协作制定干预规划框架，以确定适应指南的目标并制定菜单实施战略和干预试验，以促进治疗的保真度。本研究博茨瓦纳建立在博茨瓦纳和大学之间15年的合作研究基础上包括一个由美国和博茨瓦纳高级导师组成的多学科小组，以及强大的公共资助的艾滋病和乳腺癌医疗保健系统。这与国家癌症研究所全球健康优先领域中心“加强全球癌症研究和资源适当的癌症控制策略”，以促进癌症在中低收入国家开展循证和可持续的研究和控制工作。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Impact of COVID-19 on Cancer Care Delivery in Africa: A Cross-Sectional Survey of Oncology Providers in Africa.

DOI：
10.1200/go.20.00569
发表时间：
2021-03
期刊：
JCO global oncology
影响因子：
4.5
作者：
Martei YM;Rick TJ;Fadelu T;Ezzi MS;Hammad N;Quadri NS;Rodrigues B;Simonds H;Grover S;Incrocci L;Vanderpuye V
通讯作者：
Vanderpuye V

Essential medicines list in national cancer control plans: a secondary analysis from a global study.

国家癌症控制计划中的基本药物清单：全球研究的二次分析。

DOI：
10.1016/s1470-2045(21)00706-3
发表时间：
2022
期刊：
The Lancet. Oncology
影响因子：
0
作者：
Razis,Evangelia;Kassapian,Marie;Andriakopoulou,Charitini;Martei,YehodaM;Zurn,ShaliniJayasekar;Hammad,Nazik;Romero,Yannick;Dafni,Urania;Ilbawi,AndréM;Trapani,Dario
通讯作者：
Trapani,Dario

Shortages and price variability of essential cytotoxic medicines for treating children with cancers.

DOI：
10.1136/bmjgh-2020-003282
发表时间：
2020-11
期刊：
BMJ global health
影响因子：
8.1
作者：
Martei YM;Iwamoto K;Barr RD;Wiernkowski JT;Robertson J
通讯作者：
Robertson J

Access to and Affordability of World Health Organization Essential Medicines for Cancer in Sub-Saharan Africa: Examples from Kenya, Rwanda, and Uganda.

DOI：
10.1093/oncolo/oyac143
发表时间：
2022-11-03
期刊：
The oncologist
影响因子：
0
作者：
通讯作者：

Development, acceptability and usability of culturally appropriate survivor narrative videos for breast cancer treatment in Botswana: a pilot study.

DOI：
10.1136/bmjopen-2023-073867
发表时间：
2024-01-30
期刊：
BMJ OPEN
影响因子：
2.9
作者：
Martei, Yehoda M.;Mokokwe, Lebogang;Ngwako, Ngwao;Kebuang, Keaobaka;Setlhako, Dipho, I;Gabaatlhole, Goitsemang;Baaitse, Bontswanetse;Segadimo, Tumisang;Shulman, Lawrence N.;Barg, Frances;Gaolebale, Babe E.
通讯作者：
Gaolebale, Babe E.