CANCER PREVENTION & CONTROL INNOVATIONS IN PRIMARY CARE

缺乏对初级保健实践的了解，限制了以前加强提供癌症早期检测和预防服务的努力。作为nci资助的独立研究者，申请人已经开发了创新的新方法来理解和加强社区初级保健实践中的癌症预防和控制。此外，作为nci指定的综合癌症中心的预防、控制和人口研究副主任，以及三个新资助的家庭实践研究中心之一的主任，他与初级研究人员建立了指导关系，研究以患者为导向的方法，以提高初级保健实践的癌症预防和控制效果。拟议的以患者为导向研究的职业中期研究者奖将采用多方法研究方法，从4个方面推进社区初级保健实践中的癌症预防和控制：1)对nci资助的初级保健实践直接观察（DOPC）研究生成的丰富现有数据集进行扩展分析，在新的理论模型的指导下，将提供对现实世界实践中影响癌症预防服务提供的先前未预料到的因素的见解。2)在正在进行的通过理解实践加强预防研究（STEP- UP）中收集和分析有关高性能实践的新数据将确定将确定影响对预防干预反应的实践的价值、结构和过程。3)这些新的数据收集和分析将用于确定新的干预方法，以增加癌症研究人员开发创新的新干预措施，将以患者为导向的癌症筛查、健康习惯咨询、家族风险识别和选择性癌症遗传筛查，以及将人群和临床方法整合到初级保健实践中进行癌症预防和早期发现。该提案建立在一系列强有力的正在进行的研究和研究人员的基础上，以创造一个以患者为导向的研究人员的临界质量。这一举措可能产生的创新见解将推动实现癌症预防和控制初级保健实践的最大潜力的知识库。

A lack of understanding of primary care practice has limited previous efforts to enhance delivery of cancer early detection and prevention services. As an NCI-funded independent investigator, the applicant has developed innovative new approaches to understanding and enhancing cancer prevention and control in community primary care practice. Moreover, an Associate Director for Prevention, Control and Population Research at an NCI-designated Comprehensive Cancer Center, and as a director of one of 3 newly-funded family practice research centers, he has established mentoring relationships with junior investigators studying patient-oriented approaches to advancing the cancer prevention and control effectiveness of primary care practice. The proposed Midcareer Investigator Award in Patient-Oriented Research will use a multi-method research approach to advance cancer prevention and control in community primary care practice in 4 ways: 1) Expanded analysis of a rich existing dataset generated from the NCI-funded Direct Observation of Primary Care Practice (DOPC) Study, guided by a new theoretical model, will provide insights into previously unanticipated factors affecting cancer preventive service delivery in real world practice. 2) Collection and analysis of new data on high performing practices in the ongoing Study to Enhance Prevention by Understanding Practice (STEP- UP) will identify will identify practices' values, structures and processes that affect response to a prevention intervention. 3) These new data collection and analyses will be used to identify new intervention approaches to increase cancer investigators to develop innovative new interventions that integrate patient-oriented cancer screening, health habit counseling, familial risk identification and selective cancer genetic screening, and integration of population and clinical approaches to cancer prevention and early detection in primary care practice. This proposal builds on a strong set of ongoing investigations and investigators to create a critical mass of patient-oriented researchers. The innovative insights that are likely to spring from this initiative will advance the knowledge base for achieving the vas potential of primary care practice for cancer prevention and control.