STATE-OF-THE-ART CANCER MANAGEMENT IN RURAL AREAS

东南癌症控制联盟（S3C）和北卡罗来纳州 北卡罗来纳州大学农村健康研究项目， 查佩尔山和它的健康服务研究中心已经形成了一个 加强最先进癌症转移联盟 区域癌症专家之间的诊断和管理实践 (CCOP社区）和农村卫生保健提供者。长期 目的是改善分期，增加患者比例， 进入临床试验，并使这些患者的治疗， 他们的社区，在适当的时候。这次干预的设计 允许新信息快速传输到14个社区 组成S3C。将建立肿瘤快速报告系统 利用北卡罗来纳州的中央癌症登记处和社区 肿瘤日志将实施护士辅助系统， 日志，跟踪病人，并提供初级保健医生在 干预小组与社区资源可用于肿瘤 在乎此外，护士协调员将协调患者的 接受化疗团队或其他治疗机构的治疗， 社区医院。社区倡导癌症控制计划 将用于通知初级保健医生和 他们所服务的人口对社区资源的使用。的 维克森林大学的综合癌症控制中心将 为护士协调员和化疗护士提供培训。 临床方案的加入将由 癌症中心的化疗协调员，护士协调员， 和地区肿瘤中心的化疗护士。协议 从癌症中心，CALGB，NSABP和RTOG可用于 社区参与。干预将在区域范围内进行 位于北卡罗来纳州韦恩县的戈尔兹伯勒的S3C社区。的 周边农村县的杜普林，卡米尔，格林，约翰斯顿和 桑普森将是这一进程的参与者。对照县 将是S3C社区的格林伍德，南卡罗来纳州及其周边县 萨卢达，纽贝里，劳伦斯，阿本维尔和麦考密克的北 北卡罗来纳大学卡罗莱纳农村健康研究项目 查佩尔山的卡罗莱纳和卫生服务研究中心将 管理数据收集并评估护理模式的变化 这一社区干预的结果。

The Southeast Cancer Control Consortium (S3C) and the North Carolina Rural Health Research Program of the University of North Carolina at Chapel Hill and its health services research center have formed a coalition to strengthen the transfer of state-of-the-art cancer diagnosis and management practices between regional cancer specialists (CCOP communities) and rural health care providers. The long-term objectives are to improve staging, increase the proportion of patients entering clinical trials, and enable the treatment of these patients in their community, whenever appropriate. The design of this intervention allows the rapid transfer of new information to the fourteen communities composing the S3C. A rapid tumor reporting system will be developed utilizing the Central Cancer Registry of North Carolina and community tumor logs. A nurse facilitator system will be implemented to scan the logs, track patients, and provide the primary care physicians in the intervention group with community resources available for oncological care. Further, the nurse facilitator will coordinate the patient's treatment with the chemotherapy team or other treatment facilities at the community hospital. A Community Advocates Cancer Control Program will be utilized to inform both primary care physicians and the populations they serve as to the use of community resources. The Comprehensive Cancer Control Center at Wake Forest University will provide training for both nurse facilitators and chemotherapy nurses. Accession to clinical protocols will be administratively managed by the chemotherapy coordinators of the Cancer Center, the nurse facilitators, and the chemotherapy nurses of the regional oncology centers. Protocols from the Cancer Center, CALGB, NSABP and RTOG are available for community participation. The intervention will be conducted regionally by the S3C community of Goldsboro, located in Wayne County, NC. The surrounding rural counties of Duplin, Lenoir, Greene, Johnston and Sampson will be the participants in this process. The control county will be the S3C community of Greenwood, SC with its surrounding counties of Saluda, Newberry, Laurens, Abbenville and McCormick. The North Carolina Rural Health Research Program of the University of North Carolina at Chapel Hill and the Health Services Research Center will manage data collection and evaluate changes in patterns of care resulting from this community intervention.