Precision Lung Cancer Survivorship Care Intervention: A Randomized Controlled Trial Serving Rural Survivors and Communities

精准肺癌幸存者护理干预：服务农村幸存者和社区的随机对照试验

• 批准号: 10445228
• 负责人: Jerod Lynn Stapleton
• 金额: $ 59.26万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-06 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10445228
• 关键词: Acute; Address; Advocate; Appalachian Region; Area; Bibliotherapy; Cancer Burden; Cancer Care Facilities; Cancer Etiology; Cancer Survivor; Cancer Survivorship; Caregivers; Caring; Cessation of life; Clinical; Collaborations; Communities; Data; Development; Distress; Early Diagnosis; Early treatment; Economics; Educational Status; Fostering; Foundations; Goals; Guidelines; Health behavior; Health behavior change; Health behavior outcomes; Health care facility; Illness impact; Incidence; Individual; Infrastructure; Intervention; Kentucky; Malignant neoplasm of lung; Measures; Methods; Modeling; Oncology; Outcome; Patient-Centered Care; Play; Population; Poverty; Prevention; Quality of Care; Quality of life; Randomized Clinical Trials; Randomized Controlled Trials; Research; Role; Rural; Rural Community; Survivors; Symptoms; Thoracic Oncology; Tobacco; Treatment Efficacy; Treatment Side Effects; United States National Institutes of Health; Wages; acceptability and feasibility; base; behavior change; burden of illness; cancer care; care delivery; care outcomes; comparative efficacy; cost effective; cost effectiveness; cost-effectiveness evaluation; experience; feasibility trial; health care availability; implementation design; improved; improved outcome; informal caregiver; innovation; intervention program; lung cancer prevention; mortality; motivational enhancement therapy; novel; optimism; patient engagement; pilot trial; preference; programs; psychologic; psychological distress; psychosocial wellbeing; recruit; rural America; rural area; rural cancer care; screening; shared decision making; social; social stigma; socioeconomic disadvantage; socioeconomics; survivorship; symptom management; symptom treatment; treatment as usual; trial comparing; underserved community

PROJECT SUMMARY Among the devastating illnesses impacting rural America, few exact the physical, social, psychological, and economic toll of lung cancer. Lung cancer is the leading cause of cancer death in rural America, and the levy is particularly acute in Kentucky – a state that not only leads the nation in lung cancer incidence and mortality but is a global epicenter of lung cancer. Despite the prevailing nihilism regarding lung cancer care, lung cancer survivors are living longer. Innovations in prevention, early detection, and treatment, have created substantial optimism and opportunities for long-term lung cancer survivorship. These dramatic changes in the lung cancer care landscape have invigorated the need for quality lung cancer survivorship interventions. The overarching goal of the Kentucky LEADS Collaborative Lung Cancer Survivorship Care program is to reduce the burden of lung cancer by offering an innovative survivorship care approach that improves lung cancer quality of life, overcomes lung cancer stigma, and helps survivors engage with care. Using a novel precision survivorship approach and developed in collaboration with rural community stakeholders, the program's foundation incorporates principles of patient-centered care, shared decision making, and motivational interviewing to build survivor engagement. A large acceptability and feasibility trial conducted in collaboration with nine lung cancer care facilities in Kentucky with lung cancer survivors (N=140) demonstrated the acceptability of the intervention among survivors, caregivers, and lung cancer care clinicians. The study also revealed the feasibility of conducting the proposed study methods in rural cancer care facilities. The proposed project continues this program of research by conducting a two-group parallel randomized clinical trial comparing the impact of the Kentucky LEADS Collaborative Lung Cancer Survivorship Care program (KLCLCSC) among lung cancer survivors (N=300) against an enhanced usual care condition (bibliotherapy+assessment) on quality of life outcomes. Rural-residing lung cancer survivors will be recruited from ten oncology care facilities throughout Kentucky. The project's first aim compares the efficacy of the interventions with regard to lung cancer quality of life among survivors as measured by the FACT-L and other rigorous assessments of patient engagement, symptom burden, psychosocial well-being, and behavior change. The project's second aim evaluates the moderating impact of including caregivers as intervention partners on survivor quality of life outcomes. A third aim evaluates the cost-effectiveness of the KLCLCSC intervention in comparison to the enhanced usual care condition. Based on highly encouraging pilot data collected in collaboration with oncology care programs in Kentucky, this research holds credible potential to establish a new paradigm for addressing the challenges associated with lung cancer and for delivering quality survivorship care to rural-residing, economically distressed lung cancer survivors.

项目摘要 在影响美国农村的毁灭性疾病中，很少有身体，社会，心理和 肺癌的经济损失。肺癌是美国农村癌症死亡的主要原因，征税是 在肯塔基州特别敏锐 - 这个州不仅领导着肺癌的发病率和死亡率，而且 是肺癌的全球中心。尽管关于肺癌护理，肺癌的虚无主义 幸存者的寿命更长。预防，早期检测和治疗的创新已经创造了大量 长期肺癌生存的乐观和机会。肺癌的这些戏剧性变化 护理景观激发了对优质肺癌生存干预措施的需求。总体 肯塔基州领导协作肺癌生存护理计划的目标是减少 通过提供创新的生存护理方法来改善肺癌的负担 生活质量，克服肺癌的污名，并有助于生存。使用小说 精确生存方法，并与农村社区利益相关者合作开发 计划的基金会纳入了以患者为中心的护理，共享决策和 励志面试以建立生存参与。大规模的可接受性和可行性试验 证明了与肯塔基州的九个肺癌护理机构的合作（n = 140） 生存，护理人员和肺癌护理临床医生中干预的可接受性。研究 还揭示了在农村癌症护理设施中进行拟议的研究方法的可行性。这 提议的项目通过进行两组平行的随机临床来继续这项研究计划 试验比较肯塔基州领导协作肺癌生存护理计划的影响 （KLCLCSC）在肺癌存活中（n = 300），以增强的常规护理状况 （书目疗法+评估）关于生活质量的结果。将招募农村保留肺癌幸存 来自肯塔基州的十个肿瘤护理设施。该项目的第一个目标比较了 关于肺癌生活质量的干预措施，如事实-L和其他 严格评估患者参与，症状伯恩，社会心理健康和行为 改变。该项目的第二个目标评估包括护理人员作为干预的调节影响 生存质量成果的合作伙伴。第三个目标评估了KLCLCSC的成本效益 与增强的通常护理状况相比，干预措施。基于强烈鼓励的飞行员数据 该研究与肯塔基州的肿瘤学护理计划合作收集，具有可靠的潜力 建立一个新的范式来应对与肺癌相关的挑战并提供质量 生存护理至大致保留，经济困扰的肺癌生存。