TEAMSPORT to Community TEAMSPORT: Validating and Adapting a Precision Oncology Reflex Testing Team Intervention to Reduce Rural Disparities in Cancer Care Delivery

TEAMSPORT 到社区 TEAMSPORT：验证和调整精准肿瘤学反射测试团队干预，以减少癌症护理服务方面的农村差异

• 批准号: 10663973
• 负责人: Shellie Dawn Ellis
• 金额: $ 34.75万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 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/10663973
• 关键词: Address; Adherence; Administrator; Adopted; Adoption; Advanced Malignant Neoplasm; American; Cancer Patient; Caring; Cognition; Communication; Communities; Community Clinical Oncology Program; Community Surveys; Diagnosis; Diagnostic; Disease; Disparity; Early treatment; Effectiveness of Interventions; Elements; Eligibility Determination; Ensure; FDA approved; Failure; Feedback; Focus Groups; Fostering; Future; Genomics; Geography; Goals; Guideline Adherence; Guidelines; Harm Reduction; Health; Infrastructure; Institution; Interruption; Intervention; Job Satisfaction; Knowledge; Malignant Neoplasms; Measurement; Measures; Medical Oncologist; Medical Records; Molecular; Monitor; Oncologist; Oncology; Outcome; Pathologist; Pathology; Patient Care; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Positioning Attribute; Problem Solving; Process; Professional Organizations; Protocols documentation; Provider; Public Health; Quality of Care; Quasi-experiment; Readiness; Recommendation; Reflex action; Reporting; Research; Role; Rural; Sampling; Science; Scientific Advances and Accomplishments; Scientist; Series; Somatic Mutation; Specialist; Standardization; Surveys; System; Team Process; Technology; Testing; Time; Variant; Work; cancer care; cancer health disparity; cancer therapy; care delivery; care providers; clinical practice; community engagement; community setting; comparison group; effectiveness testing; evidence base; experience; feasibility testing; geographic disparity; implementation facilitation; improved; improved outcome; molecular marker; mortality; multidisciplinary; novel; oncology program; precision medicine; precision oncology; programs; randomized trial; rural disparities; rural patients; rural setting; targeted cancer therapy; targeted delivery; targeted treatment; time use; tumor; unnecessary treatment; uptake

PROJECT SUMMARY/ABSTRACT Each year >500,000 Americans diagnosed with cancer have tumors that could be targeted with an FDA- approved drug to treat their disease more effectively. However, there is wide variation in use of these treatments in clinical practice. Rural patients, who are more likely to die from cancer than their non-rural counterparts, are less likely to receive targeted cancer therapies and could benefit greatly from interventions to address this quality gap. This study will test the effectiveness of our Multi-TEAM Systems Framework Precision Oncology Reflex Testing (TEAMSPORT) intervention to standardize delivery of targeted cancer therapy and adapt it for use in rural and non-rural community cancer programs, where the majority of cancer patients receive their care. Our experienced multidisciplinary team of molecular pathologists, medical oncologists, rural implementation scientists, and team system scientists will be augmented by a Community Advisory Board of community-based pathologists, oncologists, cancer program administrators, and cancer network leaders representing approximately 1,000 community oncology programs. Together they will ensure the most cutting-edge, evidence- based precision oncology science will be supported by best practices in effective inter-team coordination and packaged for optimal uptake by rural and non-rural community cancer programs. In this modular R01, responsive to NCI priorities to evaluate geographic disparities in technology dispersion and further team system science, we will conduct an interrupted time series study to test the effectiveness of the TEAMSPORT intervention on guideline-concordant genomic testing and team coordination. We will simultaneously work with community collaborators to adapt the intervention to community settings and test its acceptability, feasibility, appropriateness, and adoptability among a large sample of community cancer programs. This scientific study will result in: 1) An evidence-based toolkit to increase appropriate use of genomic testing and targeted cancer therapy, suitable for rural and non-rural community cancer programs 2) One of the first tests of the effectiveness of a multi-team system intervention, and the impact of relational coordination, a validated measure of team connectedness, on quality of care 3) Effect sizes of a multi-team system intervention for use in future practice-randomized trials 4) Locally-endorsed, best practice protocols for precision oncology testing and reporting 5) A novel audit and feedback platform for institutions to assess adherence to national guideline recommended precision oncology practices Ultimately, this study has potential to lead to greater job satisfaction among cancer care providers; wider and more timely use of genomic testing and appropriate cancer therapies; better cancer outcomes for patients; reduced harms from unnecessary treatment; and a reduction in rural-urban cancer disparities.

项目概要/摘要 每年有超过 500,000 名被诊断患有癌症的美国人患有 FDA 可以针对的肿瘤 批准药物更有效地治疗他们的疾病。然而，这些治疗方法的使用存在很大差异 在临床实践中。农村患者比非农村患者更有可能死于癌症 接受靶向癌症治疗的可能性较小，并且可以从解决这一质量的干预措施中受益匪浅 差距。这项研究将测试我们的多团队系统框架 Precision Oncology Reflex 的有效性 测试 (TEAMSPORT) 干预，以标准化靶向癌症治疗的实施并使其适用于 农村和非农村社区癌症计划，大多数癌症患者在那里接受护理。 我们经验丰富的多学科团队由分子病理学家、肿瘤内科医师、农村实施人员组成 科学家和团队系统科学家将得到以社区为基础的社区咨询委员会的加强 病理学家、肿瘤学家、癌症项目管理者和代表癌症网络的领导者 大约 1,000 个社区肿瘤学项目。他们将共同确保最前沿的、证据- 基于精准肿瘤学的科学将得到有效团队间协调和最佳实践的支持 为农村和非农村社区癌症项目的最佳吸收而包装。 在这个模块化 R01 中，响应 NCI 的优先事项，评估技术分散和 进一步团队系统科学，我们将进行间断时间序列研究来测试团队系统的有效性 TEAMSPORT 对符合指南的基因组测试和团队协调进行干预。我们将 同时与社区合作者合作，使干预措施适应社区环境并测试其效果 大样本社区癌症项目的可接受性、可行性、适当性和可采用性。 这项科学研究将产生： 1) 一个基于证据的工具包，以增加基因组测试和靶向癌症治疗的适当使用， 适用于农村和非农村社区癌症项目 2) 多团队系统干预的有效性以及关系的影响的首批测试之一 协调是团队连通性和护理质量的有效衡量标准 3) 用于未来实践随机试验的多团队系统干预的效果大小 4) 当地认可的精准肿瘤学测试和报告的最佳实践方案 5) 为机构提供一个新颖的审计和反馈平台，以评估对国家推荐指南的遵守情况 精准肿瘤学实践 最终，这项研究有可能提高癌症护理人员的工作满意度；更广泛和 更及时地使用基因组测试和适当的癌症治疗；为患者带来更好的癌症结果； 减少不必要治疗造成的伤害；城乡癌症差异的缩小。