Increasing Engagement in Patient Reported Outcome Measurement to Address Breast Cancer Care Disparities using Health Information Technology in Community Cancer Settings

提高患者报告结果测量的参与度，以在社区癌症环境中使用健康信息技术解决乳腺癌护理差异

• 批准号: 10801375
• 负责人: Maria Orlando Edelen
• 金额: $ 81.77万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-21 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10801375
• 关键词: Address; Advocate; Association of Community Cancer Centers; Baltimore; Baptist Church; Benchmarking; Black race; Boston; Breast Cancer Patient; Cancer Biology; Cancer Center; Cancer Patient; Caring; Collection; Communities; Continuity of Patient Care; Data; Data Collection; Diagnosis; Disparity; Equity; Evaluation; Failure; Feedback; Fostering; Future; Geography; Goals; Health; Health Disparities Research; Healthcare; Healthcare Systems; Hospitals; Institutional Racism; Intervention; Knowledge; Learning; Malignant Neoplasms; Maryland; Medical center; Methodist Church; Methods; Modeling; National Institute on Minority Health and Health Disparities; Neighborhood Health Center; Oncology; Outcome; Outcome Measure; Patient Outcomes Assessments; Patients; Phase; Positioning Attribute; Privacy; Public Health; Quality of life; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Reduce health disparities; Reporting; Research; Resources; Science; Structural Racism; Time; Training; United States; Universities; Woman; Work; black patient; black women; cancer care; care delivery; clinical care; clinical practice; community organizations; community setting; disparity reduction; ethnic minority; experience; flexibility; health care disparity; health equity; health information technology; health outcome disparity; implementation outcomes; implementation science; improved; improved outcome; inattention; innovation; malignant breast neoplasm; member; mortality; multidisciplinary; patient engagement; patient population; patient-clinician communication; preference; programs; racial minority; response; success; symptom management; technology platform; tool

Project Summary/Abstract Major disparities in breast cancer-related outcomes have been widely documented across the cancer care continuum, with Black patients experiencing higher mortality and decreased quality of life (QOL) compared to White patients. Despite compelling evidence that routine patient-reported outcome (PRO) measurement can improve outcomes and patient experiences in oncology, PRO reporting remains low among Black patients and within the community cancer care (CCC) setting where they often receive care. The overall goal of this proposed study is to increase Black breast cancer patient engagement in PRO reporting by establishing flexible and contextually aligned HIT-assisted PRO implementation models in CCCs serving a high proportion of Black patients. Completing this work will set the stage to increase routine use of PROs in clinical care to improve health outcomes and reduce disparities among Black patients. In partnership with the Association of Community Cancer Centers (ACCC), we will develop models for successful implementation of PRO reporting in five CCCs in the ACCC network that serve a high proportion of Black cancer patients (Boston Medical Center, Boston, MA; Baptist Hospital, Memphis TN; Brooklyn Methodist, Brooklyn NY; University of Maryland, Baltimore, MD; Luminis Health, Lanham, MD). The HIT platform for this study will be imPROVE, an Epic- integrated PRO platform with automated feedback and resources (AFR) centered around the preferences, needs and values of Black patients. In line with the priorities of the NCI and NIMHD, we will (Aim 1) identify challenges, barriers, and enablers to HIT-assisted PRO data collection among Black breast cancer patients receiving care in CCCs and develop PRO implementation models that address these factors; (Aim 2) conduct a phased implementation of the PRO data collection models in five CCCs using PDSA cycles to refine models and the RE-AIM framework to evaluate success; and (Aim 3) explore the potential of detecting disparities in outcomes based on PRO data used in clinical care to inform future quality improvement efforts. Our expected outcomes are generalizable knowledge of the factors that trigger or deter Black breast cancer patient engagement, and models with training materials and tools for feasible, pragmatic, and sustainable PRO program implementation across the ACCC network. More than 80% of cancer patients nationwide receive their care at CCCs, and approximately 65% of the nation’s cancer patients are treated by a member of the ACCC network. The completion of this foundational work, with broad dissemination of lessons learned through the ACCC and beyond, will unlock the benefits of PRO reporting to historically underserved patients and advance equitable cancer care. This work will also support a continued program of research to expand implementation and evaluation of PRO programs among other diverse patient populations in oncology, determine the added benefit of AFR, and further the use of PRO data for quality improvement.

项目总结/摘要 乳腺癌相关结局的主要差异已在癌症护理中得到广泛记录 黑人患者的死亡率更高，生活质量（QOL）下降， 白色病人。尽管有令人信服的证据表明，常规的患者报告结局（PRO）测量可以 改善肿瘤学结局和患者体验，黑人患者的PRO报告仍然较低， 在社区癌症护理（CCC）环境中，他们经常接受护理。总的目标是 拟议的研究是通过建立一个新的研究项目， * 在服务于高比例国家的核心承诺中，采用灵活的、符合具体情况的HIT辅助PRO实施模式 黑人患者。完成这项工作将为增加PRO在临床护理中的常规使用奠定基础， 改善健康结果，减少黑人患者之间的差异。在与协会的合作下， 社区癌症中心（ACCC），我们将开发成功实施PRO报告的模式 在ACCC网络中的五个CCC中，为高比例的黑人癌症患者提供服务（波士顿医疗 中心，马萨诸塞州波士顿;浸信会医院，田纳西州孟菲斯;布鲁克林卫理公会，纽约布鲁克林;马里兰州大学， 巴尔的摩，MD; Luminis Health，Lanham，MD）。这项研究的HIT平台将是imPROVE，一个史诗般的- 集成的PRO平台，具有以偏好为中心的自动反馈和资源（AFR）， 黑人患者的需求和价值观。根据NCI和NIMHD的优先事项，我们将（目标1）确定 黑人乳腺癌患者中HIT辅助PRO数据收集的挑战、障碍和推动因素 在核心社区接受护理，并制定处理这些因素的PRO执行模式;（目标2）开展 在五个核心共同体分阶段实施PRO数据收集模式，利用PDSA周期完善模式 和RE-AIM框架，以评估成功;以及（目标3）探索检测 基于临床护理中使用的PRO数据的结果，为未来的质量改进工作提供信息。我们预期的 结果是触发或阻止黑人乳腺癌患者的因素的一般知识 参与，以及培训材料和工具的模型，以实现可行，务实和可持续的PRO 在ACCC网络上实施计划。全国80%以上的癌症患者接受了 在CCCs的护理，大约65%的国家的癌症患者是由ACCC的成员治疗 网络完成这项基础工作，广泛传播通过 ACCC及其他机构将为历史上服务不足的患者释放PRO报告的好处， 公平的癌症治疗这项工作还将支持一项持续的研究计划，以扩大实施范围。 在肿瘤学的其他不同患者人群中进行PRO项目的评估，确定增加的 AFR的好处，并进一步使用PRO数据进行质量改进。