Follow-up care and preventive service use among survivors of adolescent and young adult cancer.

青少年和青年癌症幸存者的后续护理和预防服务使用。

• 批准号: 9178444
• 负责人: Chun R. Chao
• 金额: $ 21.77万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-15 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9178444
• 关键词: Address; Adherence; Adolescent and Young Adult; Advisory Committees; Affect; Age; Alabama; Area; Attention; Biometry; Blood Pressure; California; Cancer Patient; Cancer Survivor; Cancer Survivorship; Cardiomyopathies; Caring; Characteristics; Child; Childhood; Chronic; Collaborations; Comorbidity; Comprehensive Health Care; Data; Data Collection; Diagnosis; Educational workshop; Elderly; Electronic Health Record; Epidemiology; Exposure to; Face; Goals; Guidelines; Health Services; Health Services Research; Health Status; Immunization; Incidence; Individual; Institute of Medicine (U.S.); Intervention; Late Effects; Longitudinal Studies; Lung; Malignant Neoplasms; Matched Group; Medical Oncology; Medical center; Mental Depression; Metabolic; Morbidity - disease rate; Organ failure; Osteoporosis; Outcome; Patients; Pattern; Pediatric Oncology; Pediatric Oncology Group; Policies; Population; Preventive care; Preventive service; Provider; Publishing; Race; Recording of previous events; Reporting; Research; Research Personnel; Research Project Grants; Resources; Risk; Risk Factors; Screening for cancer; Second Primary Cancers; Services; Socioeconomic Status; Survivors; System; Testing; Therapeutic; Translations; United States; Universities; Variant; abstracting; active method; age group; anticancer research; base; blood lipid; cancer care; cancer diagnosis; cancer therapy; evidence base; follow-up; health care delivery; health service use; high risk; improved; medical specialties; mortality; multidisciplinary; prevent; response; screening; sex; survivorship; uptake

Project Summary/Abstract Approximately 70,000 adolescents and young adults (AYAs) between the ages of 15 and 39 are diagnosed with cancer each year in the United States. As cancer incidence in AYAs continues to rise and the 5-year survival among most AYA cancers exceeds 80%, the population of survivors of AYA cancer is rapidly expanding. Survivors of AYA cancers, like all other cancer survivors, face risk of detrimental late effects of cancer and its treatment, including second cancers, organ failure, as well as other serious illnesses. Furthermore, as survivors of AYA cancer age, their risk of morbidity and mortality due to chronic comorbidities increase. It is thus prudent that health services to prevent the onset and progression of these chronic comorbidities be part of their integrated survivorship care plan. However, little is known regarding how care is delivered post-cancer diagnosis, particularly for survivors of AYA cancer. Given the need for evidence-based research to inform and improve survivorship care for survivors of AYA cancer, the overarching goal of this study is to advance our understanding on follow-up care for survivors of AYA cancer and identify areas to improve its quality. Our Specific Aims are (1) to examine the adherence to Children’s Oncology Group (COG) Long-Term Follow-up Guidelines (LTFG) by survivors of AYA cancer; (2) to examine the adherence to population preventive care guidelines by survivors of AYA cancer; and (3) to evaluate variations in adherence to COG LTFG and population preventive care guidelines among survivors of AYA cancer by individual-, provider-, and system-level factors. We will employ the rich resources of the Kaiser Permanente Southern California (KPSC), a large integrated healthcare delivery system that covers >1% of the US population. Detailed information regarding cancer therapeutic exposures, health service utilization, and patient-, provider- and system-level characteristics for 5,986 survivors of AYA cancer is available through KPSC’s electronic health records for accomplishing the proposed specific aims. This application leverages collaboration between investigators at KPSC and University of Alabama, with multidisciplinary expertise in cancer survivorship, health service research, epidemiology, biostatistics, and medical oncology. Completion of these aims will: (1) help to determine if survivors of AYA cancer receive appropriate follow-up and preventive services; (2) identify practice gaps that can be improved to deliver comprehensive cancer survivorship care; (3) provide evidence to inform policies to improve the quality of cancer survivorship care overall. Findings from this proposal will also serve as a basis for future research application to develop and test targeted multi-level interventions to directly improve the quality and coordination of care for survivors of AYA cancer.

项目概要/摘要 大约 70,000 名 15 岁至 39 岁之间的青少年和年轻人 (AYA) 被诊断出患有此病 在美国，每年都会有癌症患者。随着 AYA 癌症发病率持续上升，并且 5 年 大多数 AYA 癌症的生存率超过 80%，AYA 癌症的幸存者人数正在迅速增加 扩大。 AYA 癌症的幸存者与所有其他癌症幸存者一样，面临着以下有害后期影响的风险： 癌症及其治疗，包括第二种癌症、器官衰竭以及其他严重疾病。 此外，随着 AYA 癌症幸存者年龄的增长，他们因慢性合并症而发病和死亡的风险也会增加 增加。因此，谨慎的做法是提供卫生服务来预防这些慢性病的发生和进展。 合并症成为其综合生存护理计划的一部分。然而，人们对如何护理却知之甚少 提供癌症后诊断，特别是针对 AYA 癌症幸存者。鉴于需要以证据为基础 旨在为 AYA 癌症幸存者提供信息并改善其生存护理的研究，这是该项目的首要目标 研究旨在增进我们对 AYA 癌症幸存者的后续护理的理解并确定领域 以提高其质量。我们的具体目标是 (1) 检查儿童肿瘤学小组的遵守情况 (COG) AYA 癌症幸存者的长期随访指南 (LTFG)； (2) 检查遵守情况 AYA 癌症幸存者制定的人口预防保健指南； (3) 评估依从性的变化 根据 COG LTFG 和 AYA 癌症幸存者的人口预防保健指南， 提供商级和系统级因素。我们将利用凯撒永久南方医院的丰富资源 加利福尼亚州 (KPSC)，一个大型综合医疗保健服务系统，覆盖超过 1% 的美国人口。 有关癌症治疗暴露、卫生服务利用以及患者、提供者的详细信息 通过 KPSC 的电子系统可以获得 5,986 名 AYA 癌症幸存者的系统级特征 用于实现拟议的具体目标的健康记录。该应用程序利用了之间的协作 KPSC 和阿拉巴马大学的研究人员在癌症生存、健康方面拥有多学科专业知识 服务研究、流行病学、生物统计学和肿瘤医学。完成这些目标将：（1）有助于 确定 AYA 癌症幸存者是否接受适当的随访和预防服务； (2) 识别实践 可以改善的差距，以提供全面的癌症生存护理； （三）提供证据告知 整体提高癌症生存护理质量的政策。该提案的调查结果也将作为 为未来的研究应用奠定基础，以开发和测试有针对性的多层次干预措施，以直接改善 AYA 癌症幸存者的护理质量和协调。