Patient Navigator Program

描述(由申请人提供)： 消除癌症差距是国家的当务之急，需要创造可获得和有益的干预措施。佛罗里达州中西部的坦帕湾地区就是这一挑战的缩影，那里的教育水平低(20%没有高中教育)，贫困程度高(12.5%生活在贫困线以下)，人口文化多元化(18%是西班牙裔，15%是非裔美国人)，癌症发病率和死亡率很高。我们的假设是，在佛罗里达州的坦帕湾地区，可以实施一种文化上合适的患者导航员计划，以可接受和经济高效的方式减少癌症诊断和治疗的延误。我们的计划基于合作伙伴关系，其中包括NCI指定的综合性癌症中心(H.Lee Moffitt癌症中心和研究所)、社区医院和诊所、美国癌症协会和HealthChoice Network。在第一阶段，我们将与我们的社区合作伙伴密切合作，进行形成性研究，以开发可接受、有吸引力和适当的患者导航计划/在第一阶段，我们还将通过图表摘要获得癌症护理的及时性和成本方面的基线数据。第二阶段是一组随机对照试验，用于评估患者导航器计划。我们将重点关注我们参与网络中被诊断为乳腺癌或结直肠癌筛查异常的患者。四个中心将接受导航员计划，三个中心将接受干预，但被推迟。在发现异常筛查时，以及在1个月、6个月、1年和2年收集数据，以监测护理的及时性、护理的适当性、患者的满意度和生活质量。第三阶段要求在坦帕湾地区以外的地区传播这项研究的结果。我们将使用研究结果数据，包括成本效益分析的结果，以及关键利益相关者(参与者和提供者)的投入来制定计划，以长期传播和维持该计划。这项研究预计将对患者导航员计划在癌症护理质量、患者满意度、生活质量和成本效益方面进行全面评估。这些知识对于在2015年前降低死亡率和罹患癌症方面的改进至关重要

DESCRIPTION (provided by applicant): The elimination of cancer disparities is a national imperative that requires the creation of accessible and beneficial interventions. The Tampa Bay region of west central Florida epitomizes this challenge, with low levels of education (20% without a high school education), high levels of poverty (12.5% living below the poverty line), a culturally diverse population (18 percent Hispanic and 15 percent African American), and high cancer incidence and mortality rates. Our hypothesis is that a culturally appropriate patient navigator program can be implemented in the Tampa Bay region of Florida that .will decrease delay in diagnosis and delivery of cancer care in an acceptable and cost-effective manner. Our plan is based upon a partnership that includes an NCI designated comprehensive cancer center (H. Lee Moffitt Cancer Center & Research Institute), community hospitals and clinics, the American Cancer Society, and HealthChoice Network. In Phase I we will work closely with our community partners to conduct formative research for the development of an acceptable, appealing, and appropriate Patient Navigator Program/During Phase I we will also obtain baseline data, through chart abstraction, on timeliness and cost of cancer care. Phase II is a group randomized controlled trial to evaluate the Patient Navigator Program. We will focus on patients diagnosed with a breast or colorectal cancer screening abnormality within our participating network. Four centers will receive the Navigator Program, and three will receive the intervention, but delayed. Data will be collected at the time of an abnormal screening finding, and at 1 month, 6 month, 1 year and 2 years to monitor timeliness of care, appropriateness of care, and patient satisfaction and quality of life. Phase III calls for the dissemination of the findings from this research outside the Tampa Bay region. We will Use study outcome data, including results of cost-effectiveness analyses plus input from key stakeholders (participants and providers) to develop a plan for long-term dissemination and sustainability of the program. This study is expected to result in a comprehensive evaluation of a Patient Navigator Program on quality of cancer care, patient satisfaction, quality of life and cost-effectiveness. Such knowledge is essential to improvements in reducing the mortality and suffering from cancer by 2015