A multilevel intervention (Potlako+) to improve timely cancer detection and treatment initiation

多层次干预（Potlako）可改善及时的癌症检测和治疗启动

• 批准号: 10696252
• 负责人: Scott Dryden-Peterson
• 金额: $ 46.95万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-19 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10696252
• 关键词: Accounting; Adult; Advanced Malignant Neoplasm; Affect; Africa South of the Sahara; Age; Anus; Awareness; Botswana; Breast; Breast Cancer Cell; Breast Cancer Early Detection; Cancer Burden; Cancer Detection; Cancer Patient; Caring; Cause of Death; Cervix Uteri; Cessation of life; Clinic; Communities; Complex; Counseling; Country; Diagnosis; Diagnostic; Disease; Early Diagnosis; Education; Effectiveness; Family; Geography; HIV; HIV diagnosis; Head and Neck Squamous Cell Carcinoma; Head and neck structure; Health system; Healthcare; Incidence; Income; Individual; International; Intervention; Knowledge; Limited Stage; Malignant Neoplasms; Medical; Mentors; Modeling; Nurses; Oncology; Pathology; Pathway interactions; Patient advocacy; Patients; Persons; Phase; Physicians; Population; Prevalence; Primary Care; Printed Media; Probability; Provider; Qualitative Research; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Records; Research; Resource-limited setting; Resources; Rural Community; Schedule; Screening for cancer; Self Efficacy; Social Workers; Speed; Symptoms; Syndrome; Time; Transportation; Vagina; Viral; Vital Status; Vulva; aged; cancer care; cancer diagnosis; cancer initiation; cancer risk; cancer survival; cancer therapy; care seeking; cohort; common symptom; curative treatments; effectiveness evaluation; effectiveness testing; effectiveness/implementation trial; family support; implementation evaluation; implementation intervention; improved; innovation; low and middle-income countries; medical care fees; mortality; multidisciplinary; pandemic disease; patient engagement; patient navigation; penis; pilot trial; programs; response; rural dwellers; self help; theories

Project Summary/Abstract The HIV pandemic has intensified the growing burden of cancer in low- and middle-income countries (LMICs), where nearly three-quarters of all cancer deaths occur. The majority of patients in LMICs have advanced cancer stage and limited opportunity for survival. Meaningful improvements in cancer mortality in LMICs will require prompt diagnosis and efficient linkage to care, however research identifying effective strategies has not been conducted. Botswana has key resources in place— free-of-charge medical care including comprehensive cancer care, accessible primary clinics, and an internationally-emulated ART program— yet large gaps in timely cancer care and thus provides a key opportunity to innovate strategies to detect cancer earlier and engage patients in care. The Potlako pilot trial (ORBIT phase IIa), evaluating an intervention targeting diagnostic and pre-treatment intervals in a single district (27 communities) in Botswana, has successfully increased the number of patients entering cancer care and number treated with curative intent compared to historical controls. As a next step, the Potlako+ trial— a community-randomized (26 geographically diverse rural communities, 1:1), pragmatic, ORBIT phase IIb, type 1 hybrid effectiveness-implementation trial— will assess a complex, theory-informed intervention to promote earlier clinic presentation with symptoms suggestive of cancer, enable efficient diagnosis, and facilitate prompt initiation of oncologic treatment. The Potlako+ trial targets high burden cancers accounting for 60% of cancer deaths (breast, cervix, anus, penis, vulva, and head and neck) which are typically curable with early detection of symptoms. We utilize cancer stage at time of treatment initiation, incidence of curative intent treatment, and the duration of Models of Pathways to Treatment intervals as primary effectiveness endpoints. Implementation will be evaluated using the RE-AIM framework. The project will achieve three aims: 1) Assess the effectiveness of cancer symptom awareness intervention with rural residents (persons living with HIV and HIV-uninfected) aged 30 years and older in decreasing time to presentation with moderate and high probability cancer syndromes, 2) Assess impact of a comprehensive cancer patient navigation platform on reducing time to diagnosis and initiation of cancer treatment (diagnostic and pre-treatment intervals), and 3) Evaluate whether the combined multilevel intervention improves early stage treatment and cumulative incidence of curative intent treatment. Understanding the impact and implementation of these interventions will inform strategies of care for LMIC populations at increasing risk of cancer death and contribute to developing models of primary care in resource- constrained environments.

项目总结/文摘

项目成果

Accuracy of Pathologic Diagnosis in Patients With Lymphoma and Survival: A Prospective Analysis From Botswana.

• DOI: 10.1200/go.21.00209
• 发表时间: 2021-09
• 期刊: JCO global oncology
• 影响因子: 4.5
• 作者: Chipidza FE;Kayembe MKA;Nkele I;Efstathiou JA;Chabner BA;Abramson J;Dryden-Peterson SL;Sohani AR
• 通讯作者: Sohani AR

At-home Testing and Risk Factors for Acquisition of SARS-CoV-2 Infection in a Major US Metropolitan Area.

美国主要大都市地区 SARS-CoV-2 感染的家庭检测和风险因素。

• DOI: 10.1101/2022.02.02.22269258
• 发表时间: 2022
• 期刊: medRxiv : the preprint server for health sciences
• 作者: Woolley,AnnE;Dryden-Peterson,Scott;Kim,Andy;Naz-McLean,Sarah;Kelly,Christina;Laibinis,HannahH;Bagnall,Josephine;Livny,Jonathan;Ma,Peijun;Orzechowski,Marek;Shoresh,Noam;Gabriel,Stacey;Hung,DeborahT;Cosimi,LisaA
• 通讯作者: Cosimi,LisaA

Oral Antiviral Therapy Utilization Among Adults with Recent COVID-19 in the United States.

• DOI: 10.1007/s11606-023-08106-6
• 发表时间: 2023-05
• 期刊: JOURNAL OF GENERAL INTERNAL MEDICINE
• 影响因子: 5.7
• 作者: Benchimol-Elkaim, Brandon;Dryden-Peterson, Scott;Miller, Donald R.;Koh, Howard K.;Geller, Alan C.
• 通讯作者: Geller, Alan C.

A Novel Approach to Equitable Distribution of Scarce Therapeutics: Institutional Experience Implementing a Reserve System for Allocation of COVID-19 Monoclonal Antibodies.

稀缺治疗学的公平分布的一种新颖方法：实施储备系统的机构经验，用于分配Covid-19，单克隆抗体。

• DOI: 10.1016/j.chest.2021.08.003
• 发表时间: 2021-12
• 期刊: Chest
• 影响因子: 9.6
• 作者: Rubin E;Dryden-Peterson SL;Hammond SP;Lennes I;Letourneau AR;Pathak P;Sonmez T;Ünver MU
• 通讯作者: Ünver MU

Feasibility and lessons learned on remote trial implementation from TestBoston, a fully remote, longitudinal, large-scale COVID-19 surveillance study.

• DOI: 10.1371/journal.pone.0269127
• 发表时间: 2022
• 期刊: PloS one
• 影响因子: 3.7