A multi-stakeholder health policy study using implementation science to advance access to cancer care and clinical trials for medically vulnerable populations: A focus on our Catchment Community

一项多利益相关者健康政策研究，利用实施科学来促进医疗弱势群体获得癌症护理和临床试验：关注我们的流域社区

• 批准号: 10885732
• 负责人: JOHN D. CARPTEN
• 金额: $ 12.5万
• 依托单位: BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-08-01 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10885732
• 关键词: Address; Advocate; California; Cancer Burden; Cancer Center; Cancer Control; Center Core Grants; Cities; Clinic; Clinical; Clinical Treatment; Clinical Trials; Communication; Communities; Community Outreach; Dissemination and Implementation; Eligibility Determination; Ensure; Equity; Family; Focus Groups; Goals; Guidelines; Health Personnel; Health Policy; Health system; Intervention; Interview; Learning; Linguistics; Medical; Medical Research; Minority; Minority Access; Minority Enrollment; Minority Groups; Modality; Notification; Outcome; Parents; Patients; Policies; Provider; Research; Research Personnel; Science; Statutes and Laws; Strategic Planning; Structure; Underrepresented Minority; Underrepresented Populations; United States National Institutes of Health; Vulnerable Populations; cancer care; cancer health disparity; community engagement; implementation evaluation; implementation facilitators; implementation science; innovation; interest; medical specialties; medical vulnerability; medically underserved population; member; parent grant; response; stakeholder perspectives; treatment trial

PROJECT SUMMARY This application is being re-submitted as a PA-20-272 investigator-initiated request responsive to the Notice of Special Interest (NOSI) identified as NOT-CA-23-044, and in response to our P30-CA033572-40 strategic priority to reduce cancer burden and disparities by increasing underrepresented and minority population access to cancer care and clinical trials. Increasing minority access to specialized cancer care and clinical interventional treatment trials are top priorities for medical research organizations including NIH, NCI, and our City of Hope Cancer Center. The strategic plan of the parent P30 grant, and in particular aim 3 of our Community Outreach and Engagement (COE), prioritizes increasing minority enrollment and addressing cancer disparities. To advance our P30 strategic priorities and our COE aim, we propose a health policy study built on multi-stakeholder engagement to increase access to specialty cancer care and clinical trials for medically vulnerable populations, especially targeting our Catchment Communities. The unacceptably low representation of minorities in cancer control policy studies and clinical trials continue to hamper public benefit of medical advancement and legislation. To address this gap, we propose evaluating the implementation of The California Cancer Care Equity Act (CCEA-SB987) that took effect in January 2023, which expands access to specialized cancer care and clinical trials. By ensuring community responsiveness in CCEA-SB987 implementation, our long-term goal is to rapidly increase minority access to cancer care and clinical trials at NCI Cancer Centers. Our innovative approach will enable patients and families, health care providers, health systems, payors, and community members to better understand guidelines and eligibility, and act upon the information. Guided by dissemination and implementation conceptual frameworks, we aim to: (1) Evaluate patient perspectives of notification strategies payors use to inform patients about CCEA-SB987 guidelines and eligibility, using focus groups with patient advisors. We will explore patient perspectives on payor notification strategies (type and delivery modality), payor notification quality (content, clarity, and cultural and linguistic responsiveness), and eligibility guidelines; and (2) Evaluate organization stakeholder perspectives on CCEA- SB987 implementation, using semi-structured interviews with organization/clinic leaders and providers. We will conduct in-depth qualitative interviews to learn about perspectives on engagement in policy implementation, barriers and facilitators to implementation, and eligibility guidelines. We will use the findings from this policy discovery science research to co-create (advocate, clinician, and researcher) communication strategies for optimal provider and patient activation to increase access to the highest quality cancer care and clinical treatment studies afforded by CCEA-SB987. This outcome has direct relevance to our parent grant that targets underrepresented ethnic minorities for increased access to specialty cancer care, including clinical treatment studies at NCI Cancer Centers.

项目摘要 本申请作为PA-20-272仲裁员发起的请求重新提交，以响应 特殊利益（NOSI）被确定为NOT-CA-23-044，并响应我们的P30-CA 033572 -40战略 优先减少癌症负担和差距，增加代表性不足和少数民族人口 获得癌症治疗和临床试验。增加少数群体获得专门癌症护理和临床治疗的机会 介入治疗试验是包括NIH、NCI在内的医学研究机构的首要任务， City of Hope癌症中心父母P30赠款的战略计划，特别是我们的目标3 社区外展和参与（COE），优先考虑增加少数民族入学率和解决 癌症差异为了推进我们的P30战略优先事项和COE目标，我们提出了一项健康政策研究 建立在多方利益相关者参与的基础上，以增加获得专业癌症护理和临床试验的机会， 医疗弱势群体，特别是针对我们的集水区社区。不可接受的低 少数群体在癌症控制政策研究和临床试验中的代表性继续阻碍公共利益 医学进步和立法的影响。为了解决这一差距，我们建议评估 2023年1月生效的《加州癌症护理公平法案》（CCEA-SB 987），扩大了获得 到专门的癌症治疗和临床试验。通过确保CCEA-SB 987中的社区响应性 我们的长期目标是迅速增加少数群体获得癌症护理和临床试验的机会， NCI癌症中心。我们的创新方法将使患者和家庭，医疗保健提供者，健康 系统，付款人和社区成员，以更好地了解指导方针和资格，并根据 信息.在传播和实施概念框架的指导下，我们的目标是：（1）评估 付款人用于告知患者有关CCEA-SB 987指南的通知策略的患者观点， 资格，使用焦点小组与病人顾问。我们将探讨患者对付款人通知的看法 战略（类型和交付方式），付款人通知质量（内容，清晰度，以及文化和语言 响应性）和资格准则;以及（2）评估组织利益相关者对CCEA的看法- SB 987的实施，使用半结构化的采访组织/诊所的领导者和供应商。我们将 进行深入的定性访谈，以了解参与政策执行的观点， 执行的障碍和促进因素，以及资格准则。我们将利用这项政策的调查结果 发现科学研究，共同创建（倡导者，临床医生和研究人员）沟通策略， 最佳的提供者和患者激活，以增加获得最高质量的癌症护理和临床 CCEA-SB 987提供的治疗研究。这一结果与我们的母基金直接相关， 代表性不足的少数民族，以增加获得专业癌症护理，包括临床治疗 NCI癌症中心的研究。