权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

LEADERSHIP/ADMIN CORE

领导/管理核心

基本信息

批准号：
8566783
负责人：
Cosette Marie Wheeler
金额：
$ 1.59万
依托单位：
UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8566783
关键词：
Advisory Committees American Indians Back Biology Caring Center for Translational Science Activities Cervical Cervical Cancer Screening Clinic Clinical Clinical Sciences Code Collaborations Communication Communities Custom Data Decision Making Diagnosis Diagnostic Diagnostic tests Discipline Documentation Effectiveness Electronics Ensure Evaluation Failure Family Planning Family Practice Federally Qualified Health Center Funding Future Goals Guidelines Gynecology Health Health Resources Hispanics Home environment Human Papilloma Virus Vaccine Human Papillomavirus Infection Information Systems Interdisciplinary Study Intervention Leadership Life Link Low income Malignant neoplasm of cervix uteri Maps Measures Medical Records Mexico Monitor Nature New Mexico Outcome Output Patients Performance Population Positioning Attribute Poverty Prevention Preventive Primary Health Care Process Production Progress Reports Provider Public Health Recommendation Records Registries Reporting Research Research Infrastructure Research Personnel Research Project Grants Resource Sharing Resources Risk Rural Schedule Screening procedure Services Site Visit Solutions System Teleconferences Text Therapeutic Effect Transcend Translational Research Travel United States Indian Health Service United States National Institutes of Health Update Vaccinated Woman Work anticancer research base cancer health disparity cancer therapy catalyst cervical cancer prevention clinical practice comparative effectiveness cost experience feeding follow-up functional group health disparity high risk improved innovation meetings multidisciplinary novel operation patient oriented population based programs success treatment center tumor registry uptake vaccine effectiveness web site

项目摘要

Approximately 15 HPV types cause virtually all cervical cancers; however, the current HPV vaccines cover only 2 HPV types causing -70% of invasive cervical cancer and have no therapeutic effect on established infections that place women at risk. Thus, all women will need some kind of routine cervical screening for the foreseeable future. Importantly, the majority of women alive today have not been vaccinated and therefore are at risk for cervical cancer. The US Preventive Services Task Force recommendation on cervical cancer screening have not been updated for nearly a decade and performance measures for cervical cancer screening focus on population coverage rather than on follow-up among women with positive screening and diagnostic tests. Toward improving US cervical cancer prevention, we propose multi-tiered assessments at the statewide, systems, provider and patient levels including targeted medical record review of failures in the screening process; geospatial mapping of population-based screening, diagnosis and treatment; and application of community-based participatory approaches (CBPR) in clinical settings to identify barriers and facilitators across the processes of care including those that may enable novel patient-centered screening options. The cornerstone of our coordinated, multidisciplinary program is the New Mexico HPV Pap Registry which transcends limitations of organizational monitoring by mandating statewide surveillance of all cervical cancer screening, diagnosis and treatment. New Mexico is home to a high proportion of ethnically diverse (i.e., American Indian and Hispanic), rural, impoverished, medically disenfranchised and health-disparate populations at high-risk for cervical cancer. The specific aims of this application are to 1) Establish the New Mexico HPV Outcomes, Practice Effectiveness and Surveillance (NM-HOPES) PROSPR Research Center; 2) Establish a sustainable Screening Process Documentation Unit providing data on patients during their course of cervical cancer screening care; and 3) Integrate and fund 3 research projects with the overarching aim of informing practice and targeted interventions supported by comparative effectiveness evaluations of real-world cervical cancer screening practice and outcomes versus guidelines and innovations.

大约 15 种 HPV 类型几乎可导致所有宫颈癌；然而，目前的 HPV 疫苗涵盖只有 2 种 HPV 类型可导致 -70% 的浸润性宫颈癌，并且对已确定的宫颈癌没有治疗作用使妇女处于危险之中的感染。因此，所有女性都需要进行某种常规宫颈筛查可预见的未来。重要的是，当今大多数女性都没有接种疫苗，因此有患宫颈癌的风险。美国预防服务工作组关于宫颈癌的建议近十年来宫颈癌筛查和绩效衡量指标均未更新筛查的重点是人口覆盖率，而不是对筛查结果呈阳性的女性进行随访诊断测试。为了改善美国宫颈癌的预防，我们建议进行多层次评估全州范围、系统、提供者和患者层面，包括对失败的有针对性的医疗记录审查筛选过程；基于人群的筛查、诊断和治疗的地理空间测绘；和在临床环境中应用基于社区的参与方法（CBPR）来识别障碍和整个护理过程的促进者，包括那些可能实现以患者为中心的新型筛查的促进者选项。我们协调的多学科计划的基石是新墨西哥州 HPV 巴氏涂片登记处通过强制全州范围内对所有宫颈癌进行监测，超越了组织监测的局限性癌症筛查、诊断和治疗。新墨西哥州拥有大量不同种族的人（即美洲印第安人和西班牙裔）、农村、贫困、医疗权利被剥夺以及健康状况参差不齐宫颈癌高危人群。该应用程序的具体目标是 1) 建立新的墨西哥 HPV 结果、实践有效性和监测 (NM-HOPES) PROSPR 研究中心； 2) 建立一个可持续的筛查过程记录单元，提供患者在筛查过程中的数据宫颈癌筛查护理课程； 3) 整合并资助 3 个研究项目旨在为实践和有针对性的干预措施提供信息，并得到比较有效性评估的支持现实世界的宫颈癌筛查实践和结果与指南和创新。