Minority-Based Community Clinical Oncology Program

描述（由申请人提供）：少数民族人口在获得适当的医疗保健方面存在多种障碍，这种差异在癌症预防和治疗方面没有任何意义。非裔美国人的总体癌症死亡率高于所有其他族裔群体，以黑人与白色人癌症相关死亡率的比率衡量，1979年至1998年期间，男女之间的差距甚至更大。考虑到这些事实，显然需要为少数群体作出更大的努力。这项工作必须包括增加癌症治疗（CT）和癌症预防和控制（CPC）试验，其中少数群体的代表性大大不足，甚至校正了高加索人群的相对频率。该提案旨在建立一种机制，以增加CT和CPC试验中少数民族患者的数量，让少数民族社区的初级保健中心参与其中，并评估整个过程的障碍。该提案的具体目标是通过将大量少数民族患者纳入NCI批准的CT和CPC研究，扩大少数民族人群获得癌症治疗研究的机会;增加社区执业医生参与NCI批准的研究;并将新技术转让给照顾少数民族和服务不足人群的医疗保健提供者。此外，该提案将研究少数群体中CPC的障碍，并审查MBCCOP试验性能的问题，包括招募，应计和方案性能。Meharry医学院（MMC）基于少数民族的社区临床肿瘤学计划（MBCCOP）基于MMC的双重使命：1）教育少数民族医生，2）治疗少数民族和服务不足的人群。MMC将作为MBCCOP的核心，基于其在大都会戴维森县（MDC）集水区的积极和不断增加的癌症治疗试验计划，少数民族人口约占总人口的33%。MBCCOP的CT部分将是集水区最大的多医生肿瘤学实践（TN肿瘤学），在临床试验研究中已经非常活跃。MBCCOP医生将占集水区所有医学肿瘤学家的56%。这两个小组照顾MDC中的大量少数民族患者，并且都有将患者置于NCI批准的方案上的良好记录。MMC在研究少数民族社区的卫生保健差距和改善卫生保健方面有着悠久而辉煌的历史。MMC和范德比尔特大学正在进行广泛的CT和CPC研究，这些研究将作为基础，扩大到研究基地的其他NCI批准的试验。CPC的组成部分将是一个已经建立的初级保健诊所联盟，重点是少数民族和服务不足的人。这一“安全网”联合会由医疗保健和儿童方案的一名成员领导，鼓励研究和提供保健服务。这组医疗保健诊所，以及一种新的和经过验证的方法，以增加社区参与医疗保健将被用来招募患者到CPC研究。MBCCOP的设计，以及组件和既定的患者护理方法，将允许大量患者进入NCI的CT和CPC研究。

DESCRIPTION (provided by applicant): Minority populations have multiple impediments to proper health care and this disparity is nowhere more meaningful than in cancer prevention and treatment. The overall cancer death rate for African-Americans is greater than for all other ethnic groups and the disparity, measured as the ratio of black:white cancer related mortality, has even worsened from 1979 to 1998 for both males and females. Considering these facts, it is clear that greater efforts are required for minority populations. This effort must include accrual to cancer therapy (CT) and cancer prevention and control (CPC) trials where minority populations are substantially underrepresented, even correcting for relative frequency to Caucasian populations. This proposal aims to establish a mechanism to accrue greater numbers of minority patients onto CT and CPC trials, to involve primary care health care centers in the minority community and to evaluate impediments for the overall process. The specific goals of this proposal are to broaden access to cancer treatment studies for minority populations by entering substantial numbers of minority patients onto NCI approved CT and CPC studies; to increase community practicing physician participation on NCI approved studies; and to transfer new technology to health care providers caring for minority and underserved populations. Additionally, the proposal will study barriers to CPC in minority populations and examine issues in MBCCOP performance for trials including recruitment, accrual and protocol performance. The Meharry Medical College (MMC) Minority-Based Community Clinical Oncology Program (MBCCOP) is based on the dual mission of MMC to 1) educate minority physicians and 2) to treat minority and the underserved populations. MMC will serve as the centerpiece of the MBCCOP based on its active and increasing cancer treatment trials program in the catchment region of Metropolitan Davidson County (MDC) where minority populations make up approximately 33% of the entire population. The CT component of the MBCCOP will be the catchment areas largest multi-physician oncology practice (TN Oncology) already very active in clinical trials research. MBCCOP physicians will constitute 56% of all medical oncologists in the catchment area. These two groups care for large numbers of minority patients in MDC and both have a proven track record for placing patients on NCI approved protocols. MMC has a long and illustrious history in studying health care disparity and improving health care in the minority community. MMC and Vanderbilt University have extensive ongoing CT and CPC research that will serve as a foundation to expand accrual to other NCI approved trials of the research base(s). The CPC component will be an already established consortium of primary care health clinics that focus on minority and the underserved. This "Safety-Net" consortium is directed by a member of the MBCCOP and encourages research and health care delivery. This group of health care clinics, together with a novel and validated method to increase community participation in health care will be used to accrue patients onto CPC studies. The design of the MBCCOP, together with the components and established patient care methods, will allow for substantial numbers of patients to be entered onto CT and CPC studies of the NCI.