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Constructing a Relational Bridge to Achieve High-Quality Prostate Cancer Care for African Americans

构建关系桥梁，为非裔美国人实现高质量的前列腺癌护理

基本信息

批准号：
9753186
负责人：
Nynikka Palmer
金额：
$ 18.47万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-01 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9753186
关键词：
Active Learning Address African American Appointment Awareness Behavior Biopsy California Cancer Patient Cancer Survivor Caring Communication Communication Barriers Communities Complex Comprehension Conscious Data Decision Aid Decision Making Development Diagnosis Disease Elements Emotional Ethnography Evidence based intervention Excess Mortality Failure Familiarity Fostering General Hospitals Goals Health Communication Health Status Healthcare Systems Hearing Impotence Incidence Incontinence Individual Internal Medicine Intervention Interview Knowledge Learning Life Light Low income Malignant Neoplasms Malignant neoplasm of prostate Medical Mentors Methods Operative Surgical Procedures PSA screening Participant Patients Periodicity Physicians Procedures Process Prostate Cancer therapy Protocols documentation Provider Public Hospitals Quality of Care Quality of life Radiation Radiation Oncology Randomized Controlled Trials Reporting Research Research Activity Research Personnel Resources San Francisco Societies Structure Survivors System Targeted Research Testing Time Training Training Activity Translating Trust Universities Urology Ursidae Family active method base cancer care cancer risk cancer therapy career design disorder risk empowerment experience grasp health literacy improved informant literacy malignant breast neoplasm man men mortality optimal treatments overtreatment patient engagement patient oriented peer professor programs prostate cancer risk racism safety net satisfaction side effect therapy development treatment planning uptake

项目摘要

PROJECT SUMMARY/ABSTRACT Prostate cancer (PCa) imposes a disproportionate burden on African American men, who have a 63% higher incidence, are more often diagnosed with aggressive disease, and have more than twice the mortality rate of White men. Among the causes of excess mortality is failure to receive definitive treatment (e.g., surgery and radiation) when it would be most beneficial (under-treatment). In addition, over-treatment of low-risk disease (therapies that may not be beneficial yet have serious side effects) contributes to disparities in quality of life, as African American men report more treatment-related side effects that translate to lower quality of life. All of these disparities are most pronounced among low income African American men, many of whom have low health literacy, and receive treatment in low resource settings (e.g., public hospitals and other safety net systems), underscoring the need for targeted research in this setting. PCa treatment options present daunting communication challenges even for high literacy patients, as there are complex trade-offs between survival and quality of life that are very personal. To mitigate this perfect storm of complex treatment options and constraints in communication, we will construct a relational bridge between low income African American men and equal PCa treatment by anchoring the evidence-based intervention of peer navigation in the relational concept of African American brotherhood as a means to foster trust and empowerment, and thus to optimize patient-centered communication and quality of care. Our specific aims are to: (1) develop a multi-dimensional understanding of current PCa care and treatment decision processes among African American safety net patients; (2) adapt an existing peer navigation intervention to empower African American PCa patients as partners in high quality patient-centered PCa care; and (3) pilot test the adapted peer navigation protocol for feasibility and acceptability, and for impact on patient centeredness and treatment chosen. This K01 project will have significant impact by directly targeting multiple elements of PCa treatment quality in a single integrated approach. The candidate, Nynikka Palmer, DrPH, MPH, is an Assistant Professor in General Internal Medicine at San Francisco General Hospital, University of California, San Francisco with secondary appointments in the Departments of Urology and Radiation Oncology. With support from an exceptional mentoring team, and execution of interconnected training and research activities, Dr. Palmer will carry out formal coursework, independent mentored learning, and experiential learning that converge around three key topics: (1) depth in cultural understanding and methods via ethnography, (2) patient-centered health communication intervention development and implementation, and (3) design and conduct of randomized controlled trials. This K01 project will facilitate Dr. Palmer's long-term career goal to become an independent investigator who develops, implements, and disseminates culturally meaningful interventions to improve the quality of cancer care and reduce the burden of PCa among African American men.

项目总结/文摘