Working to Eliminate Care Disparities in Liver Cancer in Southeast Asian Americans: Transportation and Other Social Determinants of Health.

努力消除东南亚裔美国人肝癌护理差异：交通和其他健康的社会决定因素。

• 批准号: 10710050
• 负责人: Nguyen H Tran
• 金额: $ 16.36万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-25 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10710050
• 关键词: Affect; American; Antiviral Therapy; Arizona; Asian Americans; Caring; Centers for Disease Control and Prevention (U.S.); Child Care; Clinic; Communities; Coupled; Data; Death Rate; Development Plans; Diagnosis; Disparity; Early Diagnosis; Education; Equity; Ethnic Origin; Florida; Future; General Population; Goals; Grant; Health; Health Services Accessibility; Health system; Healthcare; Incidence; Infrastructure; Intervention; Interview; Iowa; Knowledge; Learning; Malignant Neoplasms; Malignant neoplasm of liver; Manuscripts; Medical; Medical Oncologist; Mentors; Minnesota; Outcome; Patients; Persons; Physicians; Play; Positioning Attribute; Prevention; Primary carcinoma of the liver cells; Principal Investigator; Prospective cohort; Qualitative Methods; Qualitative Research; Race; Research; Research Personnel; Resources; Running; Rural; Screening for Hepatocellular Cancer; Site; Social Distance; Surveys; Testing; Therapeutic; Transportation; Travel; Unemployment; United States; Vietnamese; Viral hepatitis; Wisconsin; Work; Writing; cancer care; cancer health disparity; cancer therapy; career; career development; community based practice; disparity elimination; experience; health disparity; improved; innovation; insight; interest; mortality; multidisciplinary; novel; pragmatic intervention; rurality; screening; skills; social determinants; social health determinants; southeast Asian; statistics; tertiary care

PROJECT ABSTRACT Southeast Asian (SEA) Americans are diagnosed with hepatocellular cancer (HCC) at 8 times the rate of the general population and at twice the rate of other Asian Americans. Poignantly, most of these patients are never treated for their cancer. These troubling observations – coupled with the candidate/her mentoring team’s preliminary data which point to persistent, contemporaneous disparities in cancer care among SEA Americans – provide the impetus for this K23 mentored career development application. This proposal is the logical next step to support Dr. Tran’s long-term goal of becoming an independent investigator in disparity research in HCC. The current proposal includes one of the first comprehensive approaches that focuses on social determinants of health; builds on this team’s prior data on transportation/distance to cancer care to explain the foregoing disparities; leverages resources from within the multi-site Mayo Clinic (Minnesota, Arizona, Florida) and the 3-state (Minnesota, Wisconsin, Iowa), community-based Mayo Clinic Health System; and capitalizes on Dr. Tran’s passionate interests and growing expertise in HCC and disparities and on the capabilities of her 5 well-established mentors. This 2-aim proposal first seeks to characterize the social determinants of health – specifically travel-limiting access to cancer care as well as other determinants including joblessness, trouble finding childcare, limited education, and others – among Hmong and Vietnamese Americans and non-Asian Americans. Dr. Tran will create and maintain a prospective cohort of patients with HCC – enriched with those of SEA American heritage – to investigate the relationships between social determinants of health, ethnicity/race, the rendering of cancer therapy, and cancer outcomes. Then, in aim 2, to understand barriers to access of cancer care among SEA Americans with HCC, she will conduct one-on-one qualitative interviews to learn directly from patients how to overcome barriers to the receipt of cancer care. She will also use these interviews to explore low rates of viral hepatitis treatment and low rates of HCC screening. During the 5-year grant period, Dr. Tran will acquire new skills in qualitative methods, statistics, and survey research through coursework and hands-on experience. She will work closely with her outstanding multi-disciplinary team of mentors (a medical oncologist, health disparity researchers, statistician, and qualitative researcher); develop and hone skills in managing a multi-site team; acquire greater expertise in writing manuscripts, grants and become more adept in presenting her data. The long-term impact of this research is to further understand and obtain strong preliminary data on the social determinants of health in SEA Americans with liver cancer and to position Dr. Tran to implement novel and feasible interventions in a future R01 application with the goal of eliminating these disparities in SEA Americans with HCC.

项目摘要 东南亚（SEA）美国人被诊断患有肝细胞癌（HCC）的比率是美国人的8倍。 这一比例是其他亚裔美国人的两倍。令人痛心的是，这些患者中的大多数都是 从未接受过癌症治疗这些令人不安的观察-加上候选人/她的指导团队的 初步数据表明，SEA美国人在癌症治疗方面存在持续的、同时存在的差异， - 为这个K23指导的职业发展应用程序提供动力。这个提议是合乎逻辑的下一步 步骤，以支持博士Tran的长期目标，成为一个独立的研究人员在差异研究， HCC。当前的提案包括第一批专注于社会的综合方法之一 健康的决定因素;基于该团队先前关于癌症护理的交通/距离的数据， 上述差异;利用多站点马约诊所（明尼苏达州、亚利桑那州、佛罗里达）内部的资源 和三个州（明尼苏达州、威斯康星州、爱荷华州），以社区为基础的马约诊所卫生系统; Tran博士的热情兴趣和不断增长的HCC和差异方面的专业知识，以及她的能力， 5位优秀的导师这一有两个目标的提案首先试图描述健康的社会决定因素- 特别是旅行限制获得癌症治疗以及其他决定因素，包括失业，麻烦， 找到托儿服务，有限的教育，和其他-苗族和越南裔美国人和非亚洲人 美国人Tran博士将创建并维持一个HCC患者的前瞻性队列， 美国传统-调查健康的社会决定因素之间的关系， 种族/人种、癌症治疗的效果和癌症结果。然后，在目标2中，为了理解 为了在患有HCC的SEA美国人中获得癌症护理，她将进行一对一的定性访谈， 直接向患者学习如何克服接受癌症治疗的障碍。她也会用这些 访谈以探讨病毒性肝炎治疗率低和HCC筛查率低的问题。在5年 赠款期间，陈博士将获得定性方法，统计和调查研究的新技能，通过 课程和实践经验。她将与她优秀的多学科团队密切合作， 导师（医学肿瘤学家，健康差距研究人员，统计学家和定性研究人员）;开发 并磨练管理多站点团队的技能;获得撰写手稿，赠款和 更善于展示她的数据这项研究的长期影响是进一步了解和 获得关于SEA美国肝癌患者健康的社会决定因素的强有力的初步数据， 让Tran博士在未来的R 01应用中实施新颖可行的干预措施，目标是 消除SEA美国人HCC患者的这些差异。

项目成果

A Unicorn Disease: The Large Duct Variant of Invasive Ductal Adenocarcinoma of the Pancreas.

• DOI: 10.7759/cureus.41430
• 发表时间: 2023-07
• 期刊: Cureus
• 作者: Elhariri A;Starr JS;Bagaria S;Tran N;Babiker H
• 通讯作者: Babiker H

"It's Like You Stuck a Pin in It:" African American/Black Patients Describe Cutaneous Toxicity From Epidermal Growth Factor Receptor Inhibitors.

“就像你在里面扎了一根别针：”非裔美国人/黑人患者描述表皮生长因子受体抑制剂的皮肤毒性。

• DOI: 10.1177/10499091221092698
• 发表时间: 2023
• 期刊: The American journal of hospice & palliative care
• 作者: Tran,NguyenH;Nguyen,PhuongL;Martin,NicholeA;Asiedu,Gladys;Le-Rademacher,JenniferG;Jatoi,Aminah
• 通讯作者: Jatoi,Aminah

Social Determinants of Health: A Need for Evidence-Based Guidelines on How to Capture Data on Underserved Patients.

健康的社会决定因素：需要关于如何获取服务不足的患者数据的循证指南。

• DOI: 10.21203/rs.3.rs-2451501/v1
• 发表时间: 2023
• 期刊: Research square
• 作者: Tran,NguyenH;Almodallal,Yahya;Batheja,Mashal;Martin,Nicole;Le-Rademacher,Jennifer;Ridgeway,Jennifer;Sia,IreneG;Jatoi,Aminah
• 通讯作者: Jatoi,Aminah

Postpartum related intrahepatic cholangiocarcinoma with FGFR2 fusion and severe hyperbilirubinemia with response to FGFR inhibitor pemigatinib: case report and review.

• DOI: 10.21037/jgo-23-693
• 发表时间: 2023-12-31
• 期刊: JOURNAL OF GASTROINTESTINAL ONCOLOGY
• 影响因子: 2.1
• 作者: Washburn, Leslie;Mahipal, Amit;Jatoi, Aminah;Kottschade, Lisa;Tran, Nguyen
• 通讯作者: Tran, Nguyen

Pembrolizumab near the end of life in patients with metastatic pancreatic cancer: a multi-site consecutive series to examine survival and patient treatment burden.

• DOI: 10.1007/s00262-023-03397-4
• 发表时间: 2023-07
• 期刊: CANCER IMMUNOLOGY IMMUNOTHERAPY
• 影响因子: 5.8
• 作者: Storandt, Michael H.;Tran, Nguyen;Martin, Nichole;Jatoi, Aminah
• 通讯作者: Jatoi, Aminah