Development of an electronic tool to improve access to cancer clinical trials in rural areas

开发电子工具以改善农村地区癌症临床试验的可及性

• 批准号: 10671513
• 负责人: Izumi Okado
• 金额: $ 17.35万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10671513
• 关键词: Development; electronic; tool; improve; access

This is a resubmission application for a K01 AHRQ Mentored Research Scientist Career Development Award. I am a faculty junior researcher at the University of Hawaii Cancer Center who is currently supported by an AHRQ- sponsored F32 National Research Service Award Postdoctoral Fellowship (1F32HS027286-01A1). My long-term research career goal is to develop into an independent health services researcher focused on improving rural cancer healthcare delivery. The protected time supported by this four-year award will allow me to acquire new skills and develop expertise in healthcare delivery interventions and has the following main goals: 1) obtain training in the development and testing of healthcare delivery interventions, interventional clinical trials, and implementation science, and 2) professional development. To achieve these goals, I have established a mentoring team comprised of a senior investigator in cancer clinical research (Dr. Berenberg, primary mentor), a nationally recognized expert in interventional trials (Dr. Hershman), a national leader in cancer health services research (Dr. Holcombe), and faculty with expertise in behavioral intervention (Dr. Cassel) and implementation science (Dr. Okamoto). These mentors and two consulting members will provide guidance on the proposed training and research activities designed to facilitate my transition from a junior researcher to an independent health services researcher. Although advances in treatment have improved overall survival of patients with cancer, death rates from all cancers among rural residents in the United States are 10% higher than those living in urban areas. Higher cancer mortality rates in rural areas are thought to, in part, reflect limited access to specialty cancer care. A potential strategy to reduce these disparities is to increase access to high-quality cancer clinical trial care in rural areas; however, there are numerous barriers to clinical trial enrollment in rural areas. To address these barriers, in collaboration with my mentoring team, I will develop and pilot test CTNow, a multi- component, multilevel interactive electronic tool that combines patient and provider cancer clinical trial education and a real-time videoconference system that enables rural patients and providers to access a clinical trial team for consultation, referral, and clinical trial enrollment. The proposed research has the following aims: 1) conduct a formative mixed-methods evaluation with rural oncology providers and patients to assess capabilities and the contextual factors of the rural intervention settings, 2) develop and pilot test CTNow for rural patients and providers, and 3) identify remaining barriers and facilitators to rural clinical trial participation and strategies to support future implementation of CTNow. My training and research will be conducted at one of the 71 National Cancer Institute-designated cancer centers with a well-established program in cancer care delivery research. During years 3 and 4, I will develop and submit an R01 application to propose a multi-site, hybrid effectiveness- implementation study conducted through rural NCORP sites. My current and future research aims are closely aligned with AHRQ’s mission to improve health care delivery in a high priority population residing in rural areas.

这是一份K01 AHRQ导师研究科学家职业发展奖的重新提交申请。我 我是夏威夷大学癌症中心的初级研究员，目前由AHRQ- 赞助F32国家研究服务奖博士后奖学金(1F32HS027286-01A1)。我的长期生活 研究的职业目标是发展成为专注于改善农村的独立卫生服务研究员 癌症医疗服务。这项为期四年的奖励所支持的保护时间将使我能够获得新的 在医疗保健提供干预方面掌握技能和发展专门知识，并有以下主要目标：1)获得 在开发和测试医疗保健提供干预措施、干预性临床试验和 实施科学，以及2)专业发展。为了实现这些目标，我建立了一个 由一名癌症临床研究高级研究员(主要导师贝伦伯格博士)组成的指导团队， 全国公认的介入试验专家(Hershman博士)，癌症健康服务的全国领导者 研究(霍尔科姆博士)和在行为干预和实施方面有专长的教员(卡塞尔博士) 科学(冈本博士)。这些导师和两名咨询成员将就拟议的 旨在促进我从初级研究员过渡到独立研究员的培训和研究活动 卫生服务研究员。尽管治疗的进步提高了患者的总体存活率 癌症，美国农村居民的所有癌症死亡率比活着的人高10% 在城市地区。农村地区较高的癌症死亡率被认为在一定程度上反映了获得 专门的癌症护理。减少这些差异的一个潜在策略是增加获得高质量癌症的机会 农村地区的临床试验护理；然而，在农村地区进行临床试验登记存在许多障碍。至 为了克服这些障碍，我将与我的指导团队合作，开发并试运行CTNow，这是一款 组件，结合患者和提供者癌症临床试验教育的多级互动电子工具 以及实时视频会议系统，使农村患者和提供者能够访问临床试验团队 用于咨询、转诊和临床试验登记。建议的研究有以下目的：1)进行 与农村肿瘤提供者和患者一起进行形成性混合方法评估，以评估能力和 农村干预环境的背景因素，2)开发和试点CTNow用于农村患者和 供应商，以及3)确定农村临床试验参与的剩余障碍和促进者，以及以下战略 支持CTNow未来的实施。我的培训和研究将在71个国家之一进行 癌症研究所-指定癌症中心，在癌症护理提供研究方面拥有完善的计划。 在第3年和第4年中，我将开发并提交R01申请，以提出多站点、混合效果- 通过农村NCORP站点进行的实施研究。我目前和未来的研究目标是密切相关的 与人力厅的使命保持一致，即改善居住在农村地区的高度优先人口的医疗保健服务。