Community-led Action Research in Oncology: Pandemic-appropriate Radiotherapy Innovations Evaluated for LMICs

摘要 社区主导的肿瘤学大流行适时放射治疗创新行动研究 针对LMIC进行评估(Claro Parte针对LMIC) 本申请是为了回应被确认为非CA-CA的特殊利益通知(NOSI)而提交的 21-033。这项参与性行动研究(PAR)研究将评估合作伙伴的放射治疗(RT)创新。 与拉丁美洲和加勒比(LAC)的肿瘤学专业人员合作。我们将利用全球经验和 社区领导的肿瘤学行动研究(Claro)全球肿瘤学研究团队的关系 诺里斯·科顿癌症中心(NCCC)并让整个LAC的RT专业人员参与评估“节俭” 创新“是在新冠肺炎大流行期间发展起来的，定义为创造 意想不到的解决方案，更简单、更具颠覆性的替代方案，可在可及范围内提供足够的医疗保健 所有人(Tran等人2016)。我们的总体目标是识别节约型创新并对其安全性进行评估， 效率、质量、可行性、可接受性和潜在潜力，以评估未来使用的适应性 大流行或其他突发公共卫生事件。第一阶段涉及在项目中召集LAC RT专业人员 ECHOTM(社区卫生保健成果推广)远程指导伙伴关系共享节俭 他们的诊所在新冠肺炎大流行期间设计的创新。拉丁美洲和加勒比地区 医学肿瘤学会(SLACOM)将为参加电话会议的RT专业人员小组提供便利。 在第二阶段，在放射肿瘤学和创新方面经验丰富的医生和科学家将评估 创新的病毒控制效果，维持临床操作，并通过 采用国际标准的多学科团队。符合标准的创新将晋级到 第三阶段，回到LAC RT专业人员小组，与会者将达成德尔福共识- 建立评估可行性、在其背景下的可接受性和潜在潜力的过程。高度依赖 参与性和迭代过程，这是参与性行动研究(PAR)的标志，我们将 从数据收集和反思转向行动和改进，利用NCCC之间的关系 克拉罗和斯拉科姆。最终，我们将开发一本可伸缩的节约型RT创新手册，适用于 大流行中的LMIC。创新将按主题进行组织：路由、卫生、通风、个人防护和 调度等，并进一步按高/低影响和高/低成本组织成矩阵。

ABSTRACT Community-led Action Research in Oncology – Pandemic-appropriate Radiotherapy Innovations Evaluated for LMICs (CLARO PARTE for LMICs) This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 21-033. This participatory action research (PAR) study will assess radiotherapy (RT) innovations in partnership with oncology professionals in Latin America and the Caribbean (LAC). We will leverage global experience and relationships of the Community-led Action Research in Oncology (CLARO) global oncology research team at Norris Cotton Cancer Center (NCCC) and involve RT professionals throughout LAC in evaluating “frugal innovations,” which were developed during the COVID-19 pandemic and are defined as the creation of unexpected solution that are simpler and disruptive alternatives to provide adequate healthcare within reach of everyone (Tran et al. 2016). Our overall goal is to identify frugal innovations and evaluate them for safety, efficiency, quality, feasibility, acceptability, and potential potency, to assess adaptability for use in future pandemics, or other public health emergencies. Phase 1 involves convening LAC RT professionals in a Project ECHOTM (Extension for Community Healthcare Outcomes) tele-mentoring partnership to share frugal innovations devised by their clinics during the COVID-19 pandemic. The Latin-American and Caribbean Society for Medical Oncology (SLACOM) will facilitate a panel of RT professionals joining the teleconferences. In Phase 2, physicians and scientists experienced in radiation oncology and innovation will evaluate innovations for effects on virus control, maintenance of clinical operations, and continuance of quality care by a multidisciplinary team applying international standards. The innovations that meet standards will advance to Phase 3, returning to the panel of LAC RT professionals where participants will engage in a Delphi consensus- building process to assess feasibility, acceptability within their setting, and potential potency. Relying on highly participatory and iterative processes, which are the hallmarks of Participatory Action Research (PAR), we will move from data collection and reflection to action and improvement, leveraging relationships between NCCC’s CLARO and SLACOM. Ultimately, we will develop a manual of scalable frugal RT innovations suitable for LMICs in a pandemic. Innovations will be organized topically: routing, hygiene, ventilation, PPE, and scheduling, etc. and further organized in matrixes by high/low impact and high/low cost.