LAKE SUPERIOR RURAL CANCER CARE PROJECT (LSRCCP)

拟议中的苏必利尔湖上级农村癌症护理项目（LSRCCP）是一个 多学科和多机构的方法来测试战略， 改善北方农村地区的癌症诊断和管理 明尼苏达州、威斯康星州西北部和密歇根州北部的西部 通过半岛教育和沟通联系。 远程 该项目的目标如下：（1）加强 农村卫生保健提供者和区域癌症专家，2）增加 扩散和采用最先进的癌症护理的病人， 农村 该项目的具体目标如下：1）提高生存率 农村癌症患者，2）改善癌症的阶段， 3）增加适当分期的癌症患者的比例 在初级治疗之前，4）提高癌症的质量和效率 管理，包括诊断、分期、治疗和治疗后 监测，5）加强农村癌症患者和卫生保健提供者 参与临床试验，6）研究生活质量和旅行 农村癌症患者的负担，7）改善农村卫生保健提供者的 关于标准癌症管理的知识，8）确定相对 外联协商、电信系统和 教育项目。 研究设计包括一组对照农村地点和一组 治疗/干预农村地点。 研究中心将分层 这些国家以前曾接受过区域组织的任何形式的干预， 社区癌症中心 在该项目的教育和 通信连接干预措施，将有一个基线评估， 所有网站。 干预措施将包括对医生进行有针对性的培训， 护士和药剂师，农村地区的咨询诊所， 农村地区的通信联系和质量改进工作。 结果变量将包括诊断时的疾病分期、患者 生存，护理模式分析，通信系统的使用， 患者的生活质量评价，以及患者的知识和行为 接受教育干预的卫生保健专业人员， 接收通信链接。 研究变量的评估将 通过对医疗保健提供者和患者的调查进行了四年多的时间， 病历（住院和门诊）和电话摘要 采访 统计比较将确定 每项干预措施以及 全的努力。 区域社区癌症中心（市区）将由 明尼苏达州杜卢斯的转诊医院，杜卢斯诊所/杜卢斯社区 明尼苏达大学德卢斯学院临床肿瘤学项目 医学院和圣斯科拉斯蒂卡护理学院。 农村 这些地点将包括周围农村地区的18个社区。 一 该项目的最后成果将是将结果传播到 报告、发表的文章、在国家会议上的发言，以及 会议将在项目资金结束时举行。 后 这个示范项目的结论，这是打算 申请组织及其合作组织继续 干预措施显示有效。 来自区域来源的资金将用于 寻求继续在研究中心进行有效干预，扩大 对控制点的干预措施，并提供有效的干预措施 农村地区不包括在这个示范项目。

The proposed Lake Superior Rural Cancer Care Project (LSRCCP) is a multidisciplinary and multiinstitutional approach to test strategies for improving cancer diagnosis and management in rural areas of northern Minnesota, northwest Wisconsin, and the western portion of Michigan's Upper Peninsula through education and communication linkages. The long-range objectives of the project are the following: 1) Enhance links between rural health care providers and regional cancer specialists, 2) increase the diffusion and adoption of state-of-the-art cancer care for patients in rural areas. Specific aims of the project will be the following: 1) Increase survival of rural cancer patients, 2) improve the stage at which cancer is diagnosed, 3) increase the proportion of properly staged cancer patients prior to primary treatment, 4) improve the quality and efficiency of cancer management including diagnosis, staging, treatment, and post-treatment surveillance, 5) enhance rural cancer patient and health care providers' participation in clinical trials, 6) study the quality of life and travel burdens of rural cancer patients, 7) improve rural health care providers' knowledge about standard cancer management, 8) determine the relative effectiveness of outreach consultations, telecommunication systems, and educational programs. The study design incorporates a group of control rural sites and a group of treatment/intervention rural sites. There will be stratification of sites which have previously received any form of intervention from the regional community cancer center. Prior to the project's educational and communication linkage interventions, there will be a baseline assessment of all sites. Interventions will include targeted training of physicians, nurses and pharmacists, consultation clinics in the rural sites, communication linkages and quality improvement efforts in the rural sites. The outcome variables will include staging of disease at diagnosis, patient survival, patterns of care analysis, use of the communication system, patient quality-of-life evaluation, and knowledge and behaviors of the health care professionals undergoing educational interventions and receiving communication linkages. Assessment of study variables will be done over four years through surveys of health care providers and patients, abstraction of medical records (inpatient and outpatient), and telephone interviews. Statistical comparisons will determine the effectiveness of each of the interventions as well as the amount of change effected by the total effort. The regional community cancer center (urban site) will consist of the referral hospitals in Duluth, Minnesota, the Duluth Clinic/Duluth Community Clinical Oncology Program, University of Minnesota-Duluth School of Medicine, and the College of St. Scholastica-School of Nursing. The rural sites will consist of 18 communities in the surrounding rural area. A final outcome of the project will be dissemination of the results in reports, published articles, presentations at national conferences, and a conference to be held at the end of the project funding. Following the conclusion of this demonstration project, it is the intention of the applicant organization and its collaborating organizations to continue the interventions shown to be effective. Funding from regional sources will be sought to continue the effective interventions at the study sites, expand the interventions to the control sites, and offer effective interventions to rural sites not included in this demonstration project.