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Suicide risk detection and mitigation in patients with head and neck cancer

头颈癌患者的自杀风险检测和缓解

基本信息

批准号：
10678649
负责人：
Nosayaba Osazuwa-Peters
金额：
$ 16.13万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10678649
关键词：
Accident and Emergency department Address Adjustment Disorders Adopted Alcohols Automobile Driving Cancer Etiology Cancer Patient Cancer Survivor Caring Cause of Death Chronic Disease Clinical Consolidated Framework for Implementation Research Data Depression screen Detection Diagnosis Distress Effectiveness Electronics Evaluation Feedback Feeling suicidal Future Goals Head and Neck Cancer Head and neck structure Health Individual Intervention Interview Investigation Knowledge Learning Link Literature Longitudinal Studies Malignant Neoplasms Measures Mental Depression Mentors Methods Modeling Morbidity - disease rate Nurse Practitioners Nurses Oncologist Oncology Outcome Patient Recruitments Patient risk Patients Persons Population Positioning Attribute Prevalence Prevention strategy Prospective cohort Provider Psychiatric epidemiology Public Health Questionnaires Reporting Research Research Design Research Methodology Research Personnel Risk Management Sampling Screening procedure Severities Site Spouses Substance abuse problem Suicide Suicide attempt Suicide prevention Survivors System Testing Thermometers Training Triage United States Food and Drug Administration United States National Institutes of Health University Hospitals Work cancer diagnosis career chronic pain clinical practice design effectiveness evaluation effectiveness testing effectiveness/implementation hybrid evidence base follow-up head and neck cancer patient health care settings high risk ideation implementation facilitators implementation framework implementation science informant insight novel patient population patient screening patient subsets preventive intervention psychiatric comorbidity psychosocial public health relevance routine care routine screening screening suicidal suicidal behavior suicidal morbidity suicidal patient suicidal risk suicide model suicide mortality suicide rate tool

项目摘要

PROJECT SUMMARY/ABSTRACT The goal of this K01 proposal is to provide the candidate with formal training and mentoring in psychiatric epidemiology, psycho-oncology and implementation science; training needed to pursue an independent career in implementing interventions to detect and mitigate suicide risks among head and neck (HNC) cancer patients. Suicide is the 10th leading cause of death, and 1 person dies by suicide every 11 minutes in the US. Among individuals at higher risk of suicide are chronic disease sufferers, including cancer survivors. The suicide mortality rate for HNC patients is 63.4 per 100,000 person-years, which is four times more than the general US population. Clearly, suicide is an important public health crisis in the US and is considered a leading health indicator by the Healthy People initiative. Screening for suicidal ideation is an evidence-based suicide prevention and mitigation strategy. Several studies have demonstrated that it is feasible and effective to screen patients for suicidal ideation and behavior in various clinical settings, including general, non-psychiatric emergency room settings. The Food and Drug Administration (FDA) has endorsed the Columbia Suicide Severity Rating Scale (C-SSRS) as the tool of choice for screening for suicidal ideation and behavior. However, suicide screening interventions among HNC patients are lacking, in part due to the gaps in our understanding of the multilevel barriers associated with screening HNC patients for risks of suicide. To address this gap, the candidate will utilize the C-SSRS to characterize suicide risk among HNC patients, and test effectiveness and potential implementability of the C- SSRS as a routine suicide screening tool in HNC care. Using informant interviews with key stakeholders, candidate will identify patient, provider and other barriers that could underlie the suboptimal investigation of suicidal ideation among HNC patients in Aim 1. In Aim 2, candidate will administer the C-SSRS to a group of HNC patients, providing insights on suicidal ideation and severity among HNC patients in the US. In addition, a risk management/triage system will be developed to provide follow-up care when suicide risk is detected. Aim 3 will involve a mixed-method evaluation with a subset of patients who received the C-SSRS from Aim 2 to elicit feedback on the administration of the C-SSRS, and a debrief with providers to assess future implementability of the C-SSRS as routine part of HNC care. This research will have scientific impact by enhancing our enhancing our knowledge of the barriers to screening for suicide in the HNC setting. It will have significant clinical impact through the novel utilization of the C-SSRS in HNC care. Lessons learned will be adopted for future studies in HNC and across the cancer continuum. The training objective is to address the candidate’s scientific gaps in psychiatric epidemiology, psycho-oncology, qualitative/mixed methods research design, and implementation science. Completion of this proposal and training will position the candidate as a transdisciplinary, independent investigator in implementing interventions to decrease psychosocial morbidity in the HNC population.

项目概要/摘要本 K01 提案的目标是为候选人提供精神病学方面的正式培训和指导流行病学、心理肿瘤学和实施科学；追求独立职业所需的培训实施干预措施以检测和降低头颈癌 (HNC) 患者的自杀风险。自杀是第十大死因，在美国每 11 分钟就有 1 人死于自杀。之中自杀风险较高的人是慢性病患者，包括癌症幸存者。自杀死亡率 HNC 患者的发病率为每 10 万人年 63.4 例，是美国普通人口的四倍。显然，自杀是美国的一个重要的公共卫生危机，并且被美国认为是一个领先的健康指标。健康人民倡议。自杀意念筛查是一种基于证据的自杀预防和缓解方法战略。多项研究表明，筛查患者自杀意念是可行且有效的以及各种临床环境中的行为，包括一般的非精神科急诊室环境。食物美国和药物管理局 (FDA) 已认可哥伦比亚自杀严重程度评定量表 (C-SSRS) 作为工具筛查自杀意念和行为的首选。然而，HNC 中的自杀筛查干预措施缺乏患者，部分原因是我们对与疾病相关的多层次障碍的理解存在差距。筛查 HNC 患者的自杀风险。为了弥补这一差距，候选人将利用 C-SSRS 描述 HNC 患者的自杀风险，并测试 C- 的有效性和潜在可实施性 SSRS 作为 HNC 护理中的常规自杀筛查工具。通过与主要利益相关者的知情访谈，候选人将识别患者、提供者和其他可能导致次优调查的障碍目标 1 中 HNC 患者的自杀意念。在目标 2 中，候选人将对一组患者实施 C-SSRS HNC 患者，提供有关美国 HNC 患者自杀意念和严重程度的见解。此外，还有一个将开发风险管理/分诊系统，以便在发现自杀风险时提供后续护理。目标 3 将涉及对从目标 2 接受 C-SSRS 的一部分患者进行混合方法评估，以得出对 C-SSRS 管理的反馈，以及向提供商进行汇报以评估未来的可实施性 C-SSRS 作为 HNC 护理的常规部分。这项研究将通过增强我们的能力而产生科学影响我们对 HNC 环境中自杀筛查障碍的了解。将会产生重大的临床影响通过 C-SSRS 在 HNC 护理中的新颖应用。吸取的经验教训将用于今后的研究 HNC 和整个癌症连续体。培训目标是解决候选人在以下方面的科学差距精神病流行病学、心理肿瘤学、定性/混合方法研究设计和实施科学。完成本提案和培训将使候选人成为跨学科的、独立的研究人员实施干预措施以降低 HNC 人群的心理社会发病率。

项目成果

期刊论文数量（13）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Association of Human Papillomavirus Status With Suicide Risk Among Patients With Head and Neck Cancer.

人乳头瘤病毒状态与头颈癌患者自杀风险的关联。

DOI：
10.1001/jamaoto.2022.4839
发表时间：
2023
期刊：
JAMA otolaryngology-- head & neck surgery
影响因子：
0
作者：
Chakoma,Tatenda;Moon,PeterK;Osazuwa-Peters,OyomoareL;Megwalu,UchechukwuC;Osazuwa-Peters,Nosayaba
通讯作者：
Osazuwa-Peters,Nosayaba

Insurance Coverage and Forgoing Medical Appointments Because of Cost Among Cancer Survivors After 2016.

2016 年后癌症幸存者因费用而放弃医疗预约的保险范围。

DOI：
10.1200/op.22.00587
发表时间：
2023
期刊：
JCO oncology practice
影响因子：
4
作者：
Barnes,JustinM;Graboyes,EvanM;AdjeiBoakye,Eric;Schootman,Mario;Chino,JunzoP;Moss,HaleyA;Mowery,YvonneM;Osazuwa-Peters,Nosayaba
通讯作者：
Osazuwa-Peters,Nosayaba

Human papillomavirus vaccine uptake among teens before and during the COVID-19 pandemic in the United States.

DOI：
10.1080/21645515.2022.2148825
发表时间：
2022-12-30
期刊：
Human vaccines & immunotherapeutics
影响因子：
4.8
作者：
通讯作者：

Evidence-Based Medicine in Otolaryngology, Part XIII: Health Disparities Research and Advancing Health Equity.

耳鼻喉科循证医学，第十三部分：健康差异研究和促进健康公平。

DOI：
10.1177/01945998221087138
发表时间：
2022
期刊：
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
影响因子：
0
作者：
Megwalu,UchechukwuC;Raol,NikhilaP;Bergmark,Regan;Osazuwa-Peters,Nosayaba;Brenner,MichaelJ
通讯作者：
Brenner,MichaelJ

Depression and Long-Term Prescription Opioid Use and Opioid Use Disorder: Implications for Pain Management in Cancer.