Innovative Breast CA Case Management for the Underserved

为服务不足的人群提供创新的乳腺 CA 病例管理

• 批准号: 7286050
• 负责人: PETER Christian RAICH
• 金额: $ 15.53万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-22 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7286050
• 关键词: Hispanic Americans; behavioral /social science research tag; breast neoplasms; clinical research; counseling; culture; female; health services research tag; human subject; low socioeconomic status; medically underserved population; patient care management; patient oriented research; psychological adaptation; psychological aspect of cancer; social support network; telemedicine

DESCRIPTION (provided by applicant): Adjustment to the diagnosis and treatment of breast cancer is a complex process that unfolds over time, with medical, psychological, social, and functional factors impacted differentially through the continuum of care and follow-up. Women with breast cancer commonly report feeling overwhelmed by having to integrate large amounts of medical information and having to make decisions about treatment benefits, as well as immediate and long-term impact on their quality of life. There is an urgent need to develop and test interventions that mitigate psychosocial distress, provide guidance through treatment decision-making, and address the myriad cultural and logistical barriers to care that exist especially for low-income women with breast cancer. The Breast CARES program is proposed to specifically meet this need. The overall goal of this R21 proposal is to address a national priority in cancer control research by developing and conducting a feasibility study of a new and innovative model of an interdisciplinary case management program for underserved women with newly diagnosed breast cancer, including those who are Spanish-speaking. Three specific aims will guide this exploratory study: (1) design an interdisciplinary case management program, integrating two additional elements-on-site navigation and counselor-initiated telephone calls--into the traditional nurse-oriented case management model, for patients at strategic points before, during and after breast cancer treatment; (2) conduct a feasibility study of the Breast CARES program, using a one-group, intervention-only research design with specific focus on process evaluation, in the setting of an urban "safety net" health care system; and (3) utilize these essential process evaluation data to prepare and submit a research proposal for a large Phase III multi-institution randomized clinical trial to test the efficacy, cost-effectiveness, and exportability of this comprehensive information, navigation and psychosocial support program.

描述（由申请人提供）：调整乳腺癌的诊断和治疗是一个随着时间的流逝而展开的复杂过程，医学，心理，社会和功能因素通过护理和随访的连续性对差异影响。患有乳腺癌的妇女通常报告要整合大量的医疗信息并必须对治疗益处做出决定以及对其生活质量的立即和长期影响而感到不知所措。迫切需要开发和测试干预措施，以减轻社会心理困扰，通过治疗决策提供指导，并解决尤其是对于低收入乳腺癌妇女而存在的无数文化和后勤障碍。提出了乳腺照顾计划，以特别满足这一需求。 该R21提案的总体目标是通过开发和进行可行性研究，以针对针对新诊断的乳腺癌的不足妇女（包括西班牙语的人）进行新的创新模型来解决癌症控制研究的国家优先事项。三个具体目的将指导这项探索性研究：（1）设计一个跨学科的病例管理计划，整合了两个在现场导航和辅导员发起的电话中 - 在乳腺癌治疗之前，之中和之后，在战略上为患者提供了传统的面向护士的病例管理模型； （2）在城市“安全网”卫生保健系统的设置中，使用一组纯干预的研究设计对乳腺护理计划进行可行性研究； （3）利用这些基本过程评估数据来准备和提交一项大型III阶段多机构随机临床试验的研究建议，以测试此全面信息，导航和心理社会支持计划的疗效，成本效益和出口性。

项目成果

Feasibility of a psychosocial and patient navigation intervention to improve access to treatment among underserved breast cancer patients.

社会心理和患者导航干预的可行性，以改善服务不足的乳腺癌患者获得治疗的机会。

• DOI: 10.1007/s00520-014-2176-5
• 发表时间: 2014
• 期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
• 作者: Madore,Shannon;Kilbourn,Kristin;Valverde,Patricia;Borrayo,Evelinn;Raich,Peter
• 通讯作者: Raich,Peter