Advancing cancer care and equity through telehealth, communication science, and behavioral economics

通过远程医疗、传播科学和行为经济学促进癌症护理和公平

• 批准号: 10453882
• 负责人: Justin Bekelman
• 金额: $ 113.75万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10453882
• 关键词: Address; Advanced Malignant Neoplasm; American; Area; Award; COVID-19 pandemic; Clinical; Communication; Communication Methods; Continuity of Patient Care; Discipline; Doctor of Philosophy; Effectiveness; Elements; Environment; Faculty; FarGo; Fostering; Foundations; Future; Goals; Grant; Growth; Health; Health Services Accessibility; Healthcare; Improve Access; Individual; International; Intervention; Knowledge; Learning; Malignant neoplasm of lung; Measures; Methods; Mind; Modeling; Molecular; Nurses; Outcome; Palliative Care; Patients; Pennsylvania; Pilot Projects; Randomized Clinical Trials; Recommendation; Research; Research Methodology; Research Personnel; Resources; Science; Secure; Sequential Multiple Assignment Randomized Trial; Telephone; Testing; Text Messaging; Time; Training; Universities; Work; asynchronous communication; behavioral economics; cancer care; cancer health disparity; care delivery; clinical practice; compare effectiveness; design; digital; effectiveness testing; evidence base; health equity; improved; innovation; insight; lung cancer screening; next generation; novel; pragmatic trial; screening; shared decision making; survivorship; symposium; telehealth; tool; trial design; waiver

PROJECT SUMMARY/ABSTRACT (OVERALL) The University of Pennsylvania Telehealth Research Center in Cancer Care (Penn TRC) will apply insights from communication science and behavioral economics to design and test innovative telehealth strategies to improve effectiveness and equity across the cancer care continuum, with an emphasis on understanding mechanisms of action. The COVID-19 pandemic led to dramatic growth in the use of telehealth for cancer care delivery, fostered by both clinical need and temporary waivers. Telehealth strategies have included both synchronous communication (real-time video or telephone conferencing) and asynchronous communication (sequential health information exchange through text messaging or secure portals). Yet, fundamental knowledge gaps include the extent to which telehealth may be superior to non-telehealth care delivery strategies for access, quality, and outcomes; how telehealth may enhance or detract from achieving health equity in cancer care in the context of the digital divide and persistent cancer disparities; and the impact of telehealth on health care efficiency. The Penn TRC will address an overarching research theme: to apply insights from communication science and behavioral economics to design and test synchronous telehealth strategies, supported by asynchronous elements, to improve access, quality, outcomes, equity, and efficiency across the cancer care continuum. We focus on lung cancer as a model for telehealth across the care continuum, from screening to treatment to survivorship. We bring together a team of international experts in communication science, behavioral economics, cancer care delivery, telehealth, health care innovation, mixed methods, and health equity to achieve the following specific aims: 1) Apply concepts, strategies, tools, and methods from communication science and behavioral economics to design and test synchronous telehealth strategies, supported by asynchronous elements, to improve access, quality, outcomes, equity, and efficiency for patients across the care continuum; 2) Conduct a pragmatic randomized clinical trial to compare the effectiveness of telehealth strategies to increase shared decision making for lung cancer screening using a Sequential Multiple Assignment Randomized Trial (SMART) design; 3) Conduct two rapid-cycle pilot projects, with methods and measures aligned with the pragmatic trial, to design and test the effectiveness of telehealth to improve cancer care, identify multilevel mechanisms of action, and lay the foundation for future, more definitive pragmatic trials; and 4) Build capacity to advance a national telehealth research agenda and train the next generation of investigators with expertise in cancer care, telehealth and health equity. By joining together interdisciplinary faculty across Penn, the Penn TRC will result in novel, scalable, and generalizable disseminated strategies to drive lasting improvements in cancer care and health equity. Penn has an unparalleled environment in which to bring together these areas of study.

项目摘要/摘要(总体) 宾夕法尼亚大学癌症护理远程健康研究中心(Penn TRC)将应用洞察力 从传播学和行为经济学到设计和测试创新的远程医疗策略 提高整个癌症护理连续体系的有效性和公平性，强调理解 行动机制。新冠肺炎大流行导致远程医疗在癌症护理中的使用急剧增长 分娩，由临床需要和临时豁免共同促进。远程医疗战略包括这两项内容 同步通信(实时视频或电话会议)和异步通信 (通过短信或安全门户顺序交换健康信息)。然而，基本面 知识差距包括远程医疗可能在多大程度上优于非远程医疗服务 获取、质量和结果的战略；远程医疗如何增强或削弱实现健康 在数字鸿沟和持续的癌症差距背景下癌症护理的公平性；以及 远程医疗对医疗效率的影响。宾夕法尼亚TRC将解决一个重要的研究主题：应用 传播学和行为经济学对设计和测试同步远程保健的见解 由异步元素支持的战略，以改善获取、质量、结果、公平和效率 在癌症护理的整个过程中。我们将肺癌作为整个医疗保健的远程医疗模式 从筛查到治疗再到生存的连续统一体。我们汇集了一支由国际专家组成的团队 传播学，行为经济学，癌症护理服务，远程医疗，医疗创新，混合 方法和卫生公平，以实现以下具体目标：1)应用概念、战略、工具和 从传播学和行为经济学的角度设计和测试同步远程保健的方法 由异步元素支持的战略，以改善获取、质量、结果、公平和效率 用于整个护理过程中的患者；2)进行务实的随机临床试验，以比较 远程医疗策略的有效性，以增加肺癌筛查的共享决策 序贯多任务随机试验(SMART)设计；3)进行两个快速周期试点项目， 与务实试验相结合的方法和措施，设计和测试远程医疗的有效性 为了改善癌症护理，确定多层次的行动机制，并为未来奠定基础， 最终的务实试验；以及4)建设能力，以推进国家远程保健研究议程，并培训 在癌症护理、远程医疗和健康公平方面拥有专业知识的下一代调查人员。通过联合在一起 整个宾夕法尼亚大学的跨学科教员，宾夕法尼亚大学TRC将产生新颖、可扩展和可推广的 传播战略，以推动癌症护理和卫生公平的持久改善。宾夕法尼亚大学有一个 无与伦比的环境，将这些领域的研究汇聚在一起。