Sexual Orientation and Gender Identity Data Collection in Community Oncology Practice

摘要 本申请是为了响应特别利益通知（NOSI）而提交的，该通知被确定为 NOT-CA-23-032。该补充的目标是描述组织和提供者层面的因素， 区分收集和使用性取向和性别认同（SOGI）的社区肿瘤学实践 数据来自那些没有。性和性别少数群体（SGM;例如，女同性恋男同性恋双性恋变性人 雌雄同体等）受到癌症研究的关注有限，部分原因是大规模的研究工作 由于在肿瘤学实践中缺乏一致的SOGI数据收集而受到阻碍。肿瘤学实践可能不会收集 由于组织和提供者层面的障碍，SOGI数据，即使SGM癌症患者通常希望 披露SOGI，SOGI的披露与SGM患者的更好结局相关，多个国家 组织建议肿瘤学实践收集SOGI数据，作为减少SGM差异的努力的一部分。 NCI社区肿瘤学研究计划（NCORP）是评估导致癌症的因素的理想网络。 不同肿瘤学环境中的SOGI数据收集。在2022年对271个NCORP实践的调查中，我们发现， 不到一半的实践（42%）持续收集SOGI数据。在一项对257名肿瘤患者的单独调查中， 由美国临床肿瘤学会（ASCO）支持的供应商，我们发现SOGI的收集 肿瘤学实践中的数据与领导支持、数据收集资源和对 收集SOGI数据的重要性。更详细地探讨SOGI数据的障碍和促进因素 需要收集信息，以便为不同社区肿瘤学实践中的SOGI实施干预提供信息。 在这项研究中，我们将使用实施研究的综合框架（CFIR）来评估 实施因素，如NCORP实践所在地法律的地缘政治背景， 影响SOGI数据收集（“外部环境”），实践和提供者的特征和背景 （“内部设置”和“个人”），以及在每个实践的临床流程中实施SOGI数据的策略 （“创新”和“过程”）。在强有力的初步数据的基础上，我们将有目的地抽样16个NCORP 实践在地理、实践环境和当前SOGI数据收集方面存在差异。我们将深入完成3个 在每个实践中进行访谈，每个访谈与直接护理提供者（例如，肿瘤学家，护士，高级实践 提供者）、管理员和负责摄入数据的人（例如，前台工作人员、IT专家）。我们 具体目标是：1）评估哪些实施因素是收集和使用 使用定性专题分析和基于布尔逻辑的配置分析的社区肿瘤学SOGI数据 分析，2）探讨如何在社区肿瘤学实践中收集SOGI数据，目的是整理 实践驱动的数据收集建议，以及3）探索如何在社区中使用SOGI数据 肿瘤学实践，目的是为未来的干预提供信息，以改善SGM患者的癌症护理。

ABSTRACT This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-23-032. This supplement’s goal is to characterize organizational and provider-level factors that differentiate community oncology practices that collect and use sexual orientation and gender identity (SOGI) data from those that do not. Sexual and gender minority people (SGM; e.g., lesbian, gay, bisexual, transgender, intersex, etc.) have received limited cancer research attention, in part because large-scale research efforts are hampered by lack of consistent collection of SOGI data in oncology practices. Oncology practices may not collect SOGI data due to organizational- and provider-level barriers, even though SGM cancer patients often want to disclose SOGI, disclosure of SOGI is correlated with better outcomes among SGM patients, and multiple national organizations recommend that oncology practices collect SOGI data as part of efforts to reduce SGM disparities. The NCI Community Oncology Research Program (NCORP) is the ideal network to assess factors leading to SOGI data collection in diverse oncology settings. In a survey of 271 NCORP practices in 2022, we found that less than half of practices (42%) were consistently collecting SOGI data. In a separate survey of 257 oncology providers supported by the American Society of Clinical Oncology (ASCO), we found that collection of SOGI data at an oncology practice was associated with leadership support, resources for data collection, and belief in the importance of collecting SOGI data. More detailed exploration of barriers and facilitators to SOGI data collection is needed to inform SOGI implementation interventions across diverse community oncology practices. In this study, we will use the Consolidated Framework for Implementation Research (CFIR) to assess implementation factors such as the geopolitical context of laws where NCORP practices are located that influence SOGI data collection (“Outer Setting”), the characteristics and contexts of the practices and providers (“Inner Setting” and “Individuals”), and strategies for implementing SOGI data within each practice’s clinical flow (“Innovation" and “Processes”). Building on strong preliminary data, we will purposively sample 16 NCORP practices diverse in geography, practice setting, and current SOGI data collection. We will complete 3 in-depth interviews at each practice, one each with a direct care provider (e.g., oncologist, nurse, advanced practice provider), an administrator, and a person responsible for intake data (e.g., front desk staff, IT specialist). Our specific aims are: 1) To assess which implementation factors are difference-makers in the collection and use of SOGI data in community oncology using qualitative thematic analysis and Boolean-logic-based configurational analysis, 2) To explore how SOGI data are collected in community oncology practices, with the goal of collating practice-driven recommendations for data collection, and 3) To explore how SOGI data are used in community oncology practices, with the goal of informing a future intervention to improve cancer care for SGM patients.