Development and Pilot Testing of a Collaborative Agenda-Setting Intervention to Promote Patient-Centered Communication in Ovarian Cancer Care

开发和试点测试协作议程设定干预措施，以促进卵巢癌护理中以患者为中心的沟通

• 批准号: 10589475
• 负责人: Rachel Pozzar
• 金额: $ 13.44万
• 依托单位: DANA-FARBER CANCER INST
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-15 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10589475
• 关键词: Address; Adherence; Aftercare; Behavior assessment; Caregivers; Caring; Categories; Characteristics; Clinic Visits; Clinical; Clinical Trials; Clinical Trials Design; Code; Communication; Complex; Dana-Farber Cancer Institute; Data; Development; Development Plans; Documentation; Emotional; Emotions; Enrollment; Feasibility Studies; Fostering; Goals; Health; Health Technology; Human; Individual; Intervention; Interview; Leadership; Libraries; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of ovary; Manuals; Measurement; Measures; Mentors; Methods; Mission; Modeling; National Institute of Nursing Research; Natural Language Processing; Nurses; Outcome; Outcome Measure; Outcomes Research; Participant; Patient Care; Patients; Personal Satisfaction; Postdoctoral Fellow; Process; Protocols documentation; Public Health Schools; Randomized; Randomized, Controlled Trials; Recurrent Malignant Neoplasm; Research; Research Personnel; Resources; Roter; Sampling; Scientist; Self Efficacy; Specificity; Surveys; Survival Rate; System; Systems Analysis; Text; Training; Transcript; Visit; arm; cancer care; cancer recurrence; career development; communication behavior; design; efficacy trial; expectation; experience; health related quality of life; implementation science; improved; improved outcome; innovation; medical schools; meetings; novel; patient oriented; person centered; physical symptom; pilot test; preference; prevent; provider behavior; psychological distress; randomized trial; skills; social; treatment as usual; trial comparing; usability

PROJECT SUMMARY / ABSTRACT Patients with advanced ovarian cancer experience a complex array of physical symptoms and bear a disproportionately high burden of psychological distress. Patient-centered communication (PCC) is associated with better health-related quality of life (HRQoL) in patients with cancer and is essential to high-quality gynecologic cancer care. However, few communication interventions have improved HRQoL in patients with cancer. One possible explanation is that most communication interventions have limited scalability. To date, no known intervention has aimed to assist patients with ovarian cancer and their clinicians to routinely engage in PCC. Without such an intervention, the potential for PCC to improve health outcomes may go unrealized. Another obstacle to developing interventions to promote PCC is that optimal assessment of PCC includes objective ratings of patient and clinician behavior. Investigators typically rely on trained coders to identify PCC behaviors during audio-recorded clinic visits. This resource-intensive approach lacks feasibility for studies with large samples. Novel methods for assessing PCC behaviors are needed to advance the field. Natural language processing (NLP) is approximately ten times faster than manual coding and may identify information that human coders miss. However, the feasibility of using NLP to assess PCC behaviors is unknown. The overall objective of the proposed research is to refine and pilot test a collaborative agenda-setting intervention (CASI) to facilitate PCC in ovarian cancer care. The specific aims of this project are to (1) assess the usability and acceptability of the CASI and identify barriers to its implementation; (2) assess the feasibility of a randomized controlled trial (RCT) comparing the CASI to usual care; and (3) assess the feasibility of using NLP to assess PCC behaviors. Data will be collected through think-aloud interviews, usability and acceptability surveys, and a two-arm, parallel-group pilot RCT. The proposed career development plan will prepare me to advance toward independence by (a) applying principles of implementation science to enhance intervention scalability; (b) gain experience designing, conducting, and analyzing and disseminating data resulting from randomized trials; (c) develop expertise in using NLP to analyze unstructured text; (d) strengthening skills in grantsmanship, scientific communication, and leadership; and (e) building a network of interdisciplinary mentors and collaborators. These objectives will be achieved through a combination of mentored research experiences; didactic training; and scientific meetings at Dana-Farber Cancer Institute, Harvard Medical School, and the Harvard School of Public Health. The proposed research and training plan relates directly to the mission of the National Institute of Nursing Research. This project will (a) pilot test an innovative health technology to improve HRQoL, (b) use a person- centered perspective to implement new models of care, and (c) train the nurse scientists of the 21st century.

项目总结/摘要 晚期卵巢癌患者会经历一系列复杂的身体症状， 不成比例的心理压力。以患者为中心的沟通（PCC） 在癌症患者中具有更好的健康相关生活质量（HRQoL），并且对于高质量的 妇科癌症护理。然而，很少有沟通干预改善了患有以下疾病的患者的HRQoL： 癌一个可能的解释是，大多数沟通干预措施的可扩展性有限。至今没有 已知的干预旨在帮助卵巢癌患者和他们的临床医生常规地参与 PCC。如果没有这样的干预，PCC改善健康结果的潜力可能无法实现。 制定促进PCC的干预措施的另一个障碍是，对PCC的最佳评估包括 患者和临床医生行为的客观评级。调查人员通常依靠训练有素的编码员来识别PCC 在语音记录的诊所访问期间的行为。这种资源密集的方法缺乏可行性， 大样本。需要用于评估PCC行为的新方法来推进该领域。自然语言 自然语言处理（NLP）比人工编码快大约十倍，并且可以识别人类需要的信息。 编码员失误。然而，使用NLP来评估PCC行为的可行性是未知的。 拟议研究的总体目标是完善和试点测试一个协作的平台设置 干预（CASI），以促进PCC在卵巢癌护理。该项目的具体目标是：（1）评估 CASI的可用性和可接受性，并确定其实施的障碍;（2）评估可行性， 比较CASI与常规护理的随机对照试验（RCT）;（3）评估使用CASI的可行性 NLP评估PCC行为。将通过有声思维访谈、可用性和可接受性收集数据 调查和一个两组平行试验RCT。 拟议的职业发展计划将使我通过（a）申请为走向独立做好准备 实施科学的原则，以提高干预的可扩展性;（B）获得设计经验， 进行、分析和传播随机试验的数据;（c）发展使用 NLP分析非结构化文本;（d）加强语法、科学交流和 （e）建立跨学科导师和合作者网络。这些目标将 通过结合指导研究经验、教学培训和科学会议， 丹娜-法伯癌症研究所、哈佛医学院和哈佛公共卫生学院。 拟议的研究和培训计划直接关系到国家护理研究所的使命 Research.该项目将（a）试点测试一种创新的健康技术，以改善HRQoL，（B）使用一个人- 中心的观点，以实施新的护理模式，（c）培养21世纪的护理科学家。