Improving the prostate cancer survivorship care of veterans

改善退伍军人前列腺癌生存护理

• 批准号: 8485370
• 负责人: Ted Albert Skolarus
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-12-01 至 2018-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8485370
• 关键词: Address; Adverse effects; Androgens; Arts; Behavior; Bone Density; Cancer Survivor; Cancer Survivorship; Caring; Chronic Disease; Consensus; Data; Development; Diagnosis; Disease; Disease Management; Evaluation; Focus Groups; Fracture; Future; Goals; Group Interviews; Guidelines; Incontinence; Intervention; Interview; Leadership; Left; Life; Malignant Neoplasms; Malignant neoplasm of prostate; Measurable; Measures; Medical Oncologist; Methods; Modeling; Osteoporosis; PSA screening; Perception; Performance; Planning Theory; Population; Positioning Attribute; Preparation; Primary Health Care; Prostate; Provider; Quality Indicator; Quality of Care; Research; Research Methodology; Research Training; Rest; Role; Specialist; Structure; Surveys; Survivors; Testing; Time; Training Programs; Urologist; Variant; Veterans; base; cancer care; cancer recurrence; care seeking; comparative effectiveness; deprivation; design; health administration; implementation science; improved; men; older men; programs; public health relevance; randomized trial; screening; survivorship; theories; tool; uptake

DESCRIPTION (provided by applicant): The burden of prostate cancer among Veterans is substantial with over 200,000 survivors and 12,000 new diagnoses annually. Most men live with rather than die from this common disease making prostate cancer survivorship care especially important. Because of its leadership in chronic disease care and the proportion of older men served, the Veterans Health Administration (VHA) is well positioned to become one of the national leaders in prostate cancer survivorship care. However, the quality of Veteran prostate cancer survivorship care is largely unknown. In addition, there is poor consensus about whether primary care providers or cancer specialists should have primary responsibility for ongoing cancer surveillance and management of treatment-related side effects (e.g., incontinence, osteoporosis). Ultimately, the design and implementation of tools to optimize prostate cancer survivorship care rests upon understanding how responsibility for survivorship care is managed and the barriers to good survivorship care. This research program will improve our understanding of Veteran prostate cancer survivorship care and seek to improve it using state-of-the-art implementation science methods. This program has three aims. Aim 1: To examine variation in 2 key quality indicators of prostate cancer survivorship care. Using national VHA data (2005-2011), we will examine variation in the quality of prostate cancer survivorship care for cancer surveillance and bone density testing. Aim 2: To assess barriers and facilitators to delivering high quality prostate cancer survivorship care. Guided by theory, we will perform focus groups and interviews with primary care providers and prostate cancer specialists to better understand how to improve survivorship care. Aim 3: To develop, implement and pilot a theory-based intervention to improve the quality of prostate cancer survivorship care. We will use our findings to pilot an intervention that addresses quality gaps in cancer surveillance and bone density testing uncovered in Aim 1, in preparation for a randomized trial. Due to the expanding population of Veteran prostate cancer survivors, optimizing their quality of survivorship care is of the utmost importance. Our findings will inform models for cancer survivorship care across VHA and guide future implementation efforts to improve the quality of cancer care.

描述（由申请人提供）： 退伍军人中前列腺癌的负担相当沉重，每年有超过 200,000 名幸存者和 12,000 名新诊断病例。大多数男性患有这种常见疾病而不是死于这种疾病，因此前列腺癌生存护理尤为重要。由于退伍军人健康管理局 (VHA) 在慢性病护理方面的领导地位以及所服务的老年男性比例，它完全有能力成为前列腺癌生存护理方面的全国领导者之一。然而，退伍军人前列腺癌生存护理的质量在很大程度上尚不清楚。此外，对于初级保健提供者或癌症专家是否应该对持续的癌症监测和治疗相关副作用（例如失禁、骨质疏松症）的管理负有主要责任，尚未达成共识。最终，优化前列腺癌生存护理的工具的设计和实施取决于了解如何管理生存护理的责任以及良好生存护理的障碍。 该研究计划将提高我们对退伍军人前列腺癌生存护理的理解，并寻求使用最先进的实施科学方法来改进它。该计划有三个目标。目标 1：检查前列腺癌生存护理的 2 个关键质量指标的变化。使用国家 VHA 数据（2005-2011 年），我们将检查癌症监测和骨密度测试的前列腺癌生存护理质量的变化。 目标 2：评估提供高质量前列腺癌生存护理的障碍和促进因素。在理论的指导下，我们将进行焦点小组讨论并采访初级保健提供者和前列腺癌专家，以更好地了解如何改善生存护理。目标 3：开发、实施和试点基于理论的干预措施，以提高前列腺癌生存护理的质量。我们将利用我们的研究结果来试点一项干预措施，以解决目标 1 中发现的癌症监测和骨密度测试中的质量差距，为随机试验做准备。由于退伍军人前列腺癌幸存者人数不断增加，优化他们的幸存者护理质量至关重要。我们的研究结果将为整个 VHA 的癌症生存护理模型提供信息，并指导未来提高癌症护理质量的实施工作。