Improving Pain Management in Cancer Care in Latinos

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DESCRIPTION (provided by applicant): This application proposes the development of HouseCalls Latino, a scientifically based and culturally appropriate assessment and intervention program in Spanish for Hispanics/Latinos with cancer. HouseCalls Latino will be integrated with an English version of HouseCalls. Both versions utilize the latest Interactive Voice Response (IVR) technology so that patients can indicate pain and symptom levels in between office visits, as well as receive critical educational and self-care information for common cancer-related problems. An administrative application also allows clinicians, researchers, and support staff to access customizable reports depicting patients' pain and symptom levels over time. The system is designed to address the increasing treatment of cancer on an outpatient basis, while also helping healthcare providers meet emerging guidelines that call for the "routinization" of pain and symptom assessments. The development of the HouseCalls Latino system will make these goals possible even when Hispanic/Latino patients are working with non-Spanish speaking providers. Phase I involved development of Alpha versions of the system's core assessment modules and proof of concept research to demonstrate product acceptability. Phase II will involve confirmation of the psychometric properties of all assessment modules proposed for HouseCalls Latino, as well as production and testing of completed educational and other patient support services. Even though pain and other distressing symptoms are extremely widespread among cancer patients, numerous studies have shown that these symptoms, significantly affecting quality of life, are insufficiently recognized and poorly documented by providers. Although new guidelines by JCAHO and other regulatory agencies requiring the 'routinization' of pain have been implemented, providers are becoming overwhelmed by the multitude of disease management guidelines that are surfacing. This need for improved pain management and palliative care is even more urgent among Hispanic cancer patients, who often face cultural and linguistic barriers. By bridging the physical, cultural, and linguistic gaps between health care providers and Latino cancer patients and simultaneously making pain assessments more accurate and cost-effective, the HouseCalls Latino system is designed to help address this important problem.