Improving Care at the End of Life for Latinos:A Cultural Navigator Intervention

改善拉丁裔临终关怀：文化导航干预

• 批准号: 7152137
• 负责人: STACY M FISCHER
• 金额: $ 16.87万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-15 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7152137
• 关键词: Hispanic Americans; behavioral /social science research tag; clinical research; clinical trials; community health services; cost effectiveness; family structure /dynamics; focus groups; health care cost /financing; health care service evaluation; health care service utilization; health disparity; health economics; health services research tag; hospices; hospital patient care; human old age (65+); information systems; medical records; medically underserved population; neoplasm /cancer; outcomes research; patient care planning; patient oriented research; racial /ethnic difference; terminal patient care; therapy compliance

DESCRIPTION (provided by applicant): Candidate: The candidate, Stacy M. Fischer, MD, is committed to becoming an independently-funded researcher in the area of cross-cultural end-of-life care. Her background includes previous work with underserved populations, experience in the clinical and research aspects of end-of-life care, with a specific focus on elderly patients, and training in Internal Medicine and Geriatrics. Currently, Dr. Fischer is supported by the National Brookdale Fellowship Program and an NCI/NIA P20 pilot grant and completing a qualitative and quantitative study of cultural preferences for end-of-life care. The NIA/Beeson K23 Career Development Award will provide her the protected time and the resources to study the efficacy of implementing a cultural navigator intervention designed to improve end-of-life care for elderly Latinos. Environment: The mentorship and institutional resources available to Dr. Fischer are exceptional. Jean Kutner, MD, MSPH, the sponsor, and Andrew Kramer, MD, Al Marcus, PhD, and Angela Sauaia, MD, PhD, the co-sponsors, will impart their respective expertise in end-of-life care, geriatrics, health services research, patient-navigation interventions, behavioral science, and cross-cultural research. Research Plan: The overall goal of the proposed study is to improve end-of-life care for seriously ill older. Latinos through a cultural navigator, or guia, delivering a culturally tailored intervention. The first step of the project is to develop, through a multi-step process involving community members and experts in the field, the materials needed for the intervention and to train the guia. The next phase of the project is a vanguard randomized controlled trial of the cultural navigator intervention, targeting Latinos with advanced cancer. The intervention is designed to assess the feasibility of conducting a fully powered randomized controlled trial of the intervention by determining withdraw rates, and estimating rates of Advance Care Planning, improved pain management, and utilization of hospice care. The proposed study also includes development of a method to assess the cost-effectiveness of the intervention versus usual care.

描述（由申请人提供）：候选人：候选人，斯泰西M。Fischer博士致力于成为跨文化临终关怀领域的独立资助研究人员。她的背景包括以前的工作与服务不足的人群，在临终关怀的临床和研究方面的经验，特别关注老年患者，并在内科和老年医学培训。目前，Fischer博士得到了国家布鲁克代尔奖学金计划和NCI/NIA P20试点资助的支持，并完成了对临终关怀文化偏好的定性和定量研究。NIA/Beeson K23职业发展奖将为她提供受保护的时间和资源，以研究实施旨在改善老年人临终关怀的文化导航干预的有效性。环境：Fischer博士可获得的指导和机构资源是特殊的。申办者Jean Kutner（医学博士，MSPH）和Andrew克雷默（医学博士，Al Marcus，PhD）和Angela Sauaia（医学博士，PhD）， 共同赞助者将传授他们各自在临终关怀、老年医学、卫生服务 研究、患者导航干预、行为科学和跨文化研究。 研究计划：拟议研究的总体目标是改善重病老年人的临终关怀。通过一个文化导航员，或吉亚，提供一个文化定制的干预。该项目的第一步是通过一个由社区成员和该领域专家参与的多步骤进程，制定干预所需的材料，并培训吉亚。该项目的下一阶段是一个先锋随机对照试验的文化导航干预，针对拉丁美洲晚期癌症。 该干预措施旨在通过确定退出率、估计提前护理计划、改善疼痛管理和利用临终关怀的比率，评估进行干预措施的全把握度随机对照试验的可行性。拟议的研究还包括开发一种方法来评估干预与常规护理的成本效益。