Lay Coach-led Early Palliative Care for Underserved Advanced Cancer Caregivers

为服务不足的晚期癌症护理人员提供非专业教练主导的早期姑息治疗

基本信息

项目摘要

Many of the 2.8 million family caregivers (FCGs) of persons with advanced cancer are underserved, particularly African-Americans and rural-dwellers in the Southern U.S.. Most have poor access and awareness of community-based palliative care services and have received no formal support or training despite providing assistance to their relatives an average of 8 hrs/day. Providing intense care and witnessing a close friend or family member struggle with advanced cancer can result in FCGs experiencing marked distress, particularly as their care recipients near end of life (EOL). Reports from NCI and NINR caregiving summits, systematic reviews, and the National Academy of Medicine have highlighted major limitations of cancer caregiver interventions, including a lack of attention to underserved populations and cost, poor scalability, over reliance on highly-trained professionals (e.g., nurses, psychologists, behavioral therapists), lengthy sessions over a short duration, and a lack of demonstrated impact on patient outcomes and healthcare utilization. To address this gap, we have developed and tested feasibility and acceptability of a lay navigator-led early palliative care intervention called ENABLE Cornerstone for rural and minority family caregivers of persons with advanced cancer in the Southern U.S.. Evolving out of our prior trials and community stakeholder formative evaluation work, this multicomponent intervention is based on Pearlin’s Stress-Health Process Model where lay navigators, overseen by an interdisciplinary outpatient palliative care team, employ health coaching techniques and caregiver distress screening to behaviorally activate and reinforce psychoeducation on managing stress and coping, getting and asking for help, improving caregiving skills, and decision-making/advance care planning over 6 brief in-person/telephonic sessions plus monthly follow-up from diagnosis through early bereavement. This proposed hybrid type I randomized effectiveness-implementation trial will determine whether ENABLE Cornerstone compared to usual care can improve family caregiver (Aim 1) and patient outcomes (Aim 2) and will evaluate implementation costs, cost effectiveness and healthcare utilization (Aim 3), over 24 weeks with 294 family caregivers and their patients with newly-diagnosed advanced cancer. To maximize recruitment, we will recruit from two community cancer centers in Birmingham, AL and Mobile, AL. Our theory-driven, standardized approach is innovative because it uses lay navigators in collaboration with a palliative care interdisciplinary team to promote caregiver activation, skills and knowledge enhancement, as opposed to other difficult-to-implement intervention models that rely mostly on delivery of services by advanced practice professionals providing lengthy sessions over a short duration. If effectiveness is established, the ENABLE Cornerstone intervention offers a highly scalable and reproducible model of formal caregiver support that would be primed for dissemination and implementation.
在280万晚期癌症患者的家庭照护者中,许多人得不到充分的服务。

项目成果

期刊论文数量(0)
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James N. Dionne-Odom其他文献

Neonatal Palliative Care in the United States Deep South: Exploration of Patterns of Care and Health Disparities
  • DOI:
    10.1016/j.jpainsymman.2018.10.417
  • 发表时间:
    2018-12-01
  • 期刊:
  • 影响因子:
  • 作者:
    Erin Currie;Renee Boss;Joanne Wolfe;James N. Dionne-Odom;Deborah Ejem;Marie Bakitas
  • 通讯作者:
    Marie Bakitas
Oncology Providers’ Perceptions of Early/Concurrent Palliative Care (S727)
  • DOI:
    10.1016/j.jpainsymman.2015.12.030
  • 发表时间:
    2016-02-01
  • 期刊:
  • 影响因子:
  • 作者:
    Dilip Babu;James N. Dionne-Odom;Lisa Zubkoff;Tasha Smith;Marie Bakitas
  • 通讯作者:
    Marie Bakitas
Developing a “Toolkit” for Implementing Early, Concurrent Palliative Care in Community Cancer Centers (S733)
  • DOI:
    10.1016/j.jpainsymman.2015.12.036
  • 发表时间:
    2016-02-01
  • 期刊:
  • 影响因子:
  • 作者:
    Marie Bakitas;James N. Dionne-Odom;Dilip Babu;Elizabeth Kvale;Lisa Zubkoff
  • 通讯作者:
    Lisa Zubkoff
Context Matters: Exploring Intervention Dose and Dose-Related Outcomes in a Palliative Care Intervention for Patients with Heart Failure (SCI910)
  • DOI:
    10.1016/j.jpainsymman.2021.01.073
  • 发表时间:
    2021-03-01
  • 期刊:
  • 影响因子:
  • 作者:
    Rachel Wells;James N. Dionne-Odom;Harleah Buck;Andres Azuero;Sally Engler;Konda Keebler;Sheri Tims;Marie Bakitas
  • 通讯作者:
    Marie Bakitas
Family Caregiver Grief and Depression Outcomes from the ENABLE III Randomized Controlled Trial (FR440B)
  • DOI:
    10.1016/j.jpainsymman.2015.12.218
  • 发表时间:
    2016-02-01
  • 期刊:
  • 影响因子:
  • 作者:
    James N. Dionne-Odom;Andres Azuero;Kathleen Lyons;Jay Hull;Marie Bakitas
  • 通讯作者:
    Marie Bakitas

James N. Dionne-Odom的其他文献

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{{ truncateString('James N. Dionne-Odom', 18)}}的其他基金

Decision Support Training for Advanced Cancer Family Caregivers: The CASCADE Factorial Trial
晚期癌症家庭护理人员的决策支持培训:CASCADE 析因试验
  • 批准号:
    10451589
  • 财政年份:
    2021
  • 资助金额:
    $ 55.3万
  • 项目类别:
Decision Support Training for Advanced Cancer Family Caregivers: The CASCADE Factorial Trial
晚期癌症家庭护理人员的决策支持培训:CASCADE 析因试验
  • 批准号:
    10633116
  • 财政年份:
    2021
  • 资助金额:
    $ 55.3万
  • 项目类别:
Decision Support Training for Advanced Cancer Family Caregivers: The CASCADE Factorial Trial
晚期癌症家庭护理人员的决策支持培训:CASCADE 析因试验
  • 批准号:
    10271543
  • 财政年份:
    2021
  • 资助金额:
    $ 55.3万
  • 项目类别:
Decision Support Training for Advanced Cancer Family Caregivers: The CASCADE Factorial Trial
晚期癌症家庭护理人员的决策支持培训:CASCADE 析因试验
  • 批准号:
    10770967
  • 财政年份:
    2021
  • 资助金额:
    $ 55.3万
  • 项目类别:
Lay Coach-led Early Palliative Care for Underserved Advanced Cancer Caregivers
为服务不足的晚期癌症护理人员提供非专业教练主导的早期姑息治疗
  • 批准号:
    10524204
  • 财政年份:
    2020
  • 资助金额:
    $ 55.3万
  • 项目类别:
Lay Coach-led Early Palliative Care for Underserved Advanced Cancer Caregivers
为服务不足的晚期癌症护理人员提供非专业教练主导的早期姑息治疗
  • 批准号:
    10652356
  • 财政年份:
    2020
  • 资助金额:
    $ 55.3万
  • 项目类别:
Lay Coach-led Early Palliative Care for Underserved Advanced Cancer Caregivers
为服务不足的晚期癌症护理人员提供非专业教练主导的早期姑息治疗
  • 批准号:
    10039631
  • 财政年份:
    2020
  • 资助金额:
    $ 55.3万
  • 项目类别:
Lay Coach-led Early Palliative Care for Underserved Advanced Cancer Caregivers
为服务不足的晚期癌症护理人员提供非专业教练主导的早期姑息治疗
  • 批准号:
    10377774
  • 财政年份:
    2020
  • 资助金额:
    $ 55.3万
  • 项目类别:
Lay Coach-led Early Palliative Care for Underserved Advanced Cancer Caregivers
为服务不足的晚期癌症护理人员提供非专业教练主导的早期姑息治疗
  • 批准号:
    10449129
  • 财政年份:
    2020
  • 资助金额:
    $ 55.3万
  • 项目类别:
An Upstream Palliative Care Intervention for Rural Family Caregivers
针对农村家庭护理人员的上游姑息治疗干预措施
  • 批准号:
    9752668
  • 财政年份:
    2018
  • 资助金额:
    $ 55.3万
  • 项目类别:

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