Improving Survivorship Care for Diverse Cancer Patients Cared for in Safety-net Settings

项目摘要 美国有近1500万癌症幸存者，生存护理是一个日益令人担忧的问题。这个 人口老龄化、癌症早期发现和改进的治疗方法都是癌症增加的原因 生存能力。癌症幸存者有与晚期治疗并发症、风险相关的特定卫生保健需求 对于癌症复发，以及对心理健康的影响。在癌症的程度上有很大的差异 专家和初级保健提供者管理癌症幸存者的护理，并相互协调。 这些因素可能导致护理方面的差距，进而可能导致不良后果。安全网--医疗保健 照顾低收入和脆弱人群的系统在提供最佳癌症方面面临挑战 由于严重和持续的资源限制，包括专科护理短缺而造成的生存护理 以及缺乏卫生信息技术(HIT)基础设施。这份申请书建议你的职业生涯为5年。 在以患者为导向的研究中为候选人制定发展计划，以扩大她的早期指导工作 职业研究人员专注于为不同人群服务的安全网环境中的癌症生存护理。在……里面 与指导计划相一致，该提案概述了三个具体的研究目标：1)描述 使用根本原因分析遗漏监测的根本原因；2)调查生存护理的作用 为患有结直肠癌、前列腺癌和乳腺癌的不同患者制定计划；以及3)实施 以科学方法收集利益相关者对不同疾病治疗后/生存护理挑战的意见 在加州各地的安全网环境中接受治疗的患者，并启动健康信息的开发 技术支持的护理协调工具。这项提案将利用现有的联邦资金资源来 加强以患者为中心的癌症生存差异研究的指导和实施 科学。这项提案的发现将为为所有癌症幸存者提供最佳护理奠定基础， 包括那些面临健康差距风险的人和那些在资源有限的安全网健康中得到照顾的人 系统。

Project Abstract With nearly 15 million cancer survivors in the United States (U.S.), survivorship care is a growing concern. The aging population, early cancer detection, and improved therapies have all contributed to the increase in cancer survivorship. Cancer survivors have specific health care needs related to late complications of treatment, risk for cancer recurrence, and mental health impact. There is significant variation in the extent to which cancer specialists and primary care providers manage care for cancer survivors and coordinate with each other. These factors can lead to gaps in care, which can in turn lead to adverse outcomes. Safety-net health care systems, which care for low-income and vulnerable populations, face challenges in providing optimal cancer survivorship care due to severe and ongoing resource constraints, including a shortage of subspecialty care and a lack of health information technology (HIT) infrastructure. This application proposes a 5-year career development plan in patient-oriented research for the candidate to expand her mentoring work with early career researchers focused on cancer survivorship care in safety net settings serving diverse populations. In alignment with mentoring plans, the proposal outlines three specific research aims: 1) Characterize the underlying causes of missed monitoring using root cause analysis; 2) Investigate the role of survivorship care plans for diverse patients living with colorectal, prostate, and breast cancers; and 3) Employ implementation science methods to gather stakeholder input on challenges in post-treatment/ survivorship care for diverse patients treated in safety-net settings across California and initiate development of a health information technology-enabled care coordination tool. This proposal will leverage existing federally-funded resources to enhance mentoring in patient-oriented research in cancer survivorship disparities and implementation sciences. Findings from this proposal will lay the groundwork to provide optimal care for all cancer survivors, including those at risk for health disparities and those cared for in resource-constrained safety-net health systems.