EL-CENTRO: Engaging Latinos in the Center of Cancer Treatment Options

EL-CENTRO：让拉丁裔参与癌症治疗选择中心

• 批准号: 9355121
• 负责人: ANA CRISTINA TERRA DE SOUZA LINDSAY
• 金额: $ 10.06万
• 依托单位: UNIVERSITY OF MASSACHUSETTS BOSTON
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9355121
• 关键词: Advance Care Planning; Advanced Malignant Neoplasm; Advocate; Attention; Benefits and Risks; Boston; Cancer Center; Cancer Patient; Caregivers; Cessation of life; Chemotherapy-Oncologic Procedure; Clip; Cognitive; Collaborations; Colorectal Cancer; Communication; Communities; Consent Forms; Dana-Farber Cancer Institute; Decision Making; Disease; Disseminated Malignant Neoplasm; Educational Materials; Ensure; Equilibrium; Face; Failure; Focus Groups; Fostering; Funding; Hispanics; Hospitals; Individual; Inequality; Informed Consent; Institution; Intervention; Interview; Language; Latino; Linguistics; Malignant Neoplasms; Malignant neoplasm of gastrointestinal tract; Malignant neoplasm of pancreas; Massachusetts; Minority; Oncologist; Pamphlets; Patient Education; Patients; Pharmaceutical Preparations; Phase; Physicians; Population; Process; Qualitative Research; Quality of Care; Recruitment Activity; Regimen; Reporting; Research; Research Infrastructure; Research Methodology; Research Personnel; Resources; Risk; Students; Testing; Universities; Voice; Work; cancer care; cancer health disparity; cancer therapy; chemotherapy; end of life; end of life care; expectation; experience; health disparity; hospice environment; improved; next generation; outcome forecast; palliative chemotherapy; patient oriented; programs; racial and ethnic disparities; randomized trial; response; satisfaction; skills; tool; treatment center; treatment choice

Summary: The objective of the study is to improve the quality of advanced cancer care and treatment decision-making for Latinos by developing a tailored video intervention to better inform patients about their illness, prognosis, and chemotherapy risks/benefits. Latinos with incurable cancer harbor markedly optimistic expectations of prognosis, and often receive palliative chemotherapy without understanding that it is unlikely to cure. Such misconceptions are much more prevalent among Latinos than Whites, and may contribute to Latino/non-Latino disparities in end-of-life (EOL) care such as lower rates of advance care planning, underutilization of hospice and greater intensity of EOL care. Latino advanced cancer patients face formidable cultural, linguistic, and structural barriers to accessing critical information about their disease and treatment options. Nevertheless, interventions to enhance Latinos' understanding are few and underdeveloped. Prior to starting treatment, oncologists typically discuss the risks and benefits of chemotherapy, and patients sign written informed consent. This proposal capitalizes on the chemotherapy informed consent (IC) process as a strategic opportunity to equip Latinos with a better understanding of their illness and treatment options. In prior work, Drs. Schrag and Enzinger (DF/HCC) developed a suite of videos and booklets to support IC for common chemotherapy regimens used to treat advanced GI cancers, which balance attention to risks and benefits, offer context about the underlying cancer, and include patient voices. Leveraging Dr. Lindsay's (UMass Boston) skills in Latino community engagement, mixed methods research, and Latino health disparities, the team will adapt the videos to attend to the needs of Latinos-both Spanish and English speakers. In Aim 1) the study team will use a four-phase qualitative research process to ensure that IC tools meet the informational, cultural, and linguistic needs of Latinos with advanced GI cancer. In Aims 2 & 3) the resulting Spanish-English suite of IC tools will be tested to determine its effect on Latino patients' and caregivers' decision-making about cancer treatment and EOL care, and their satisfaction with communication processes and cancer care. This will be accomplished through a multicenter randomized trial involving 116 Latinos with advanced GI cancers and their caregivers, recruited from seven academic and community cancer centers serving diverse Latino populations. This intervention is practical, scalable and has immense potential to impact the quality of cancer care provided to Latinos. This project aligns with the U54 Partnership as it aims to reduce cancer disparities by improving communication with Latinos. The project prioritizes involvement of Latino students to foster the next generation of URM researchers and more fully harmonize the research with the needs and perspectives of the broader Latino community. Finally, this project forges and solidifies relationships with Latino communities, and harnesses the complementary expertise of its DF/HCC and UMass Boston investigators, thereby laying the groundwork for a sustainable partnership for cross-cutting cancer disparities research.

总结：本研究的目的是提高晚期癌症护理和治疗的质量 通过开发量身定制的视频干预，更好地告知患者他们的 疾病、预后和化疗风险/益处。患有无法治愈的癌症的拉丁裔人非常乐观 预后的预期，并经常接受姑息化疗，而不了解它是不可能的， 疗方这种误解在拉丁美洲人中比白人更普遍，可能有助于 拉丁裔/非拉丁裔在临终关怀方面的差异，如提前护理计划的比例较低， 临终关怀利用不足，临终关怀强度加大。拉丁裔晚期癌症患者面临着巨大的 文化、语言和结构性障碍，阻碍他们获取有关疾病和治疗的关键信息 选项.然而，加强拉丁美洲人理解的干预措施很少，而且不发达。之前 开始治疗时，肿瘤学家通常会讨论化疗的风险和益处， 书面知情同意书。该提案利用化疗知情同意（IC）过程作为 这是一个战略机会，使拉丁美洲人更好地了解他们的疾病和治疗方案。于过往 Schrag和Enzinger博士（DF/HCC）开发了一套视频和小册子，以支持IC， 用于治疗晚期胃肠道癌症的化疗方案平衡了风险和益处，提供了 关于潜在癌症的背景，包括病人的声音。利用博士.林赛的（马萨诸塞大学波士顿分校） 拉丁裔社区参与，混合方法研究和拉丁裔健康差距的技能，该团队将 调整视频，以满足拉丁美洲人的需求，无论是西班牙语还是英语。（1）研究 研究小组将采用四阶段定性研究过程，以确保IC工具满足信息、文化 和语言的需求。在目标2和3）由此产生的西班牙语-英语套件 将测试IC工具，以确定其对拉丁美洲患者和护理人员关于癌症的决策的影响 治疗和终末期护理，以及他们对沟通过程和癌症护理的满意度。这将是 这项研究是通过一项多中心随机试验完成的，该试验涉及116名患有晚期GI癌症的拉丁美洲人， 护理人员，从七个学术和社区癌症中心招募，为不同的拉丁裔人口服务。 这种干预是实用的，可扩展的，并具有巨大的潜力，影响所提供的癌症护理的质量 对拉丁美洲人。该项目与U 54合作伙伴关系保持一致，因为它旨在通过改善 与拉丁美洲人沟通。该项目优先考虑拉丁裔学生的参与，以培养下一代 URM的研究人员，更充分地协调研究与更广泛的需求和观点， 拉丁裔社区。最后，这个项目锻造和巩固与拉丁裔社区的关系， 利用其DF/HCC和麻省大学波士顿分校调查人员的互补专业知识，从而奠定了 为跨领域癌症差异研究的可持续伙伴关系奠定基础。