CANCER PREVENTION & CONTROL INNOVATIONS IN PRIMARY CARE

由于缺乏对初级保健做法的了解，以前加强癌症早期发现和预防服务的努力受到了限制。作为NCI资助的独立研究人员，申请人开发了创新的新方法，以了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预防、控制和人口研究的副主任，作为三个新资助的家庭实践研究中心之一的主任，他与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有效性的初级调查人员建立了指导关系。拟议的以患者为中心的研究生涯中期研究人员奖将使用多方法研究方法，以4种方式推动社区初级保健实践中的癌症预防和控制：1)在新理论模型的指导下，对NCI资助的初级保健实践直接观察(DOPC)研究产生的丰富现有数据集进行扩展分析，将提供对现实世界实践中以前未曾预料到的影响癌症预防服务提供的因素的洞察。2)在正在进行的通过了解实践加强预防的研究(STEP-UP)中，收集和分析关于高绩效做法的新数据，将确定影响对预防干预的反应的做法的价值、结构和过程。3)这些新的数据收集和分析将被用来确定新的干预方法，以增加癌症研究人员，以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基因筛查，以及在初级保健实践中整合人口和临床癌症预防和早期发现的方法。这项建议建立在一系列正在进行的调查和调查人员的基础上，以创造一支以患者为中心的研究人员队伍。这一倡议可能产生的创新见解将推动实现初级保健实践在癌症预防和控制方面的VAS潜力的知识基础。

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.