Scanable TELeheaLth Cancer CARe: The STELLAR Program to Treat Cancer Risk Behaviors

项目摘要 本申请是响应特别利益通知(NOSI)NOT-CA-23- 041.在父母的资助中，我们正在开发一项远程医疗治疗计划，以解决癌症幸存者的 危险行为(星级)。作为这项工作的一部分，在早期的谈话中，临床医生表示有兴趣 通过STELLAR跟踪患者的进展，并在此过程中给予鼓励。因此，这 该项目的重点是创建报告，以促进患者与提供者就患者的主要信息进行沟通 进展，以及对这些关于患者健康结果的报告的评估。 大多数肿瘤学家不会与癌症幸存者讨论危险行为。时间限制和不足 处理危险行为的培训是这一重要沟通的两个普遍障碍。正在激活 这种沟通是支持癌症幸存者健康行为改变的关键一步，特别是当他们 通过量身定做的干预取得进展。我们将采用以用户为中心的设计(UCD)方法来开发 关注临床医生优先事项的报告，可轻松实施到现有的临床工作流程中。 患者与提供者之间的沟通与患者健康结果之间的关联一直很好 在文学中确立了。然而，很少有研究着眼于解释沟通如何影响 健康。Stella提供了测试已定义和明确的通信路径的机会，包括 近期和中期结果。通过这次评估，我们将能够更好地确定 肿瘤学家沟通导致癌症危险行为减少和 开发未来的通信支持工具，专注于激活这些特定的途径。 通过在试点试验中使用UCD方法和研究通信路径，我们将确定 总结癌症幸存者通过Stella的进展的EMR报告的有效性。我们的目标是： 1.确定肿瘤学家希望在医疗记录中看到的支持类型 与癌症幸存者交流他们的危险行为和惊人的进展。我们会 使用以用户为中心的设计流程来创建易于使用的报告，并确保我们解决 临床医生的需求和偏好。 2.评估电子病历修改的使用影响患者提供者的途径 沟通和随后的健康结果。在恒星飞行员试验期间，我们将收集和 分析数据以评估电子病历报告的使用是否以及如何改变患者与提供者的沟通和 结果改善了健康状况。我们将比较：1)互动式自我引导干预，2) 与人类教练的互动干预，以及3)关于PASC的数字信息，而不是疾病 不确定性干预。我们将比较登记在STELLAR介入ARM(提供商)中的患者 将收到电子病历通知)发送给控制臂中的人员(提供者不会收到电子病历通知)。

Project Summary This application is being submitted in response to the Notice of Special Interest (NOSI) NOT-CA-23- 041. In the parent grant, we are developing a telehealth treatment program for addressing cancer survivors' risk behaviors (STELLAR). In early conversations as a part of this work, clinicians have indicated interest in following patients' progress through STELLAR and providing encouragement along the way. Therefore, this project focuses on the creation of reports to facilitate patient-provider communication about patients' STELLAR progress, and an evaluation of these reports on patient health outcomes. Most oncologists do not discuss risk behaviors with cancer survivors. Time constraints and insufficient training in addressing risk behaviors are two widespread barriers to this important communication. Activating this communication is a critical step in supporting cancer survivors' health behavior change, especially as they progress through a tailored intervention. We will employ user-centered design (UCD) methods to develop reports that focus on clinicians' priorities and can be easily implemented into existing clinical workflows. The association between patient-provider communication and patient health outcomes has been well established in the literature. However, little research has looked at explaining how communication impacts health. STELLAR provides an opportunity to test defined and explicit communication pathways including proximal and intermediate outcomes. Through this evaluation, we will be able to better determine the mechanisms through which oncologist communication results in a reduction of cancer risk behaviors and develop future communication support tools that focus on activating these specific pathways. By using UCD methods and studying communication pathways in the pilot trial, we will determine the effectiveness of EMR reports that summarize cancer survivors' progress through STELLAR. Our aims are to: 1. Identify the type of support that oncologists want to see within the medical record to facilitate communication with cancer survivors about their risk behaviors and STELLAR progress. We will use a user-centered design process to create easy to use reports and to ensure we are addressing the needs and preferences of clinicians. 2. Evaluate pathways through which use of the EMR modification influences patient-provider communication and subsequent health outcomes. During the STELLAR pilot trial we will collect and analyze data to evaluate if and how EMR report use changes patient-provider communication and results in improved health outcomes. We will compare: 1) the interactive self-guided intervention, 2) the interactive intervention with human coaching, and 3) digital information about PASC, without an illness uncertainty intervention. We will compare patients enrolled in the STELLAR intervention arm (providers will receive EMR notifications) to those in the control arm (providers will not receive EMR notifications).