Promoting Healthy Cancer Survivorship in Rural Colorado Primary Health Care Pract

描述（由申请人提供）：癌症幸存者面临着独特的挑战，并有特殊的医疗需求，由于他们的癌症诊断和治疗。最近的证据表明，这些需求目前往往得不到满足，部分原因是随着患者不再需要肿瘤科医生的照顾，他们发现他们的初级保健提供者没有得到充分的培训，无法预测和治疗他们治疗的医疗并发症。该项目的目的是通过制定和实施一个课程来满足这一需求，向科罗拉多农村医疗实践中的初级保健医生讲授癌症幸存者的特殊医疗需求，并使他们能够在实践中识别癌症幸存者，并为他们实施幸存者护理计划。这一目标将通过医生、护士、医生助理和办公室工作人员在自己的实践环境中以及当地社区成员的参与来实现。在项目的第一年， 科学咨询委员会和社区咨询委员会将共同努力，为该项目的癌症生存课程提供反馈和指导。该课程将侧重于癌症护理规划，使用医学研究所的建议，为癌症生存，并转化为一个易于实施的方式为初级保健医生和他们的办公室工作人员。将招募54名实践者参与，并随机分为两组：干预组和对照组，对照组将作为对照组。这一多方面的课程将纳入几种互补的教育方法，包括：（1）在实践环境中进行四次面对面的个性化跨专业小组讨论;（2）由该领域专家每年提供的12次网络研讨会;（3）内容丰富的网站;以及（4）受密码保护的主持人讨论论坛。实践访问将在资助期的第二年至第五年期间进行。此外，研究参与者将获得作为该项目一部分开发的癌症幸存者工具包，其中包括以证据为基础的癌症幸存者护理指南。课程的有效性将通过评估参与者因接触课程而产生的知识变化来评估。将使用作为项目一部分的癌症幸存者的图表审查来衡量课程内容在实践环境中的采用情况（即，乳腺癌、结肠癌、前列腺癌和任何儿童癌症）。该项目在许多方面具有创新性：（1）它为癌症幸存者提供了一种机制，使他们的医疗需求在他们的医疗之家得到满足;（2）它通过将课程直接带到他们的实践环境来吸引初级保健医生;（3）它不仅吸引了医生，而且吸引了实践的所有成员;（4）它不仅让治疗和生存方面的专家参与制定和完善课程，而且让了解农村初级保健做法及其所在社区的人参与，增加被教授的信息将被实施的可能性;和（5）它使用教育干预的随机对照试验设计。

DESCRIPTION (provided by applicant): Cancer survivors face unique challenges and have special medical needs as a result of their cancer diagnosis and treatment. Recent evidence suggests that these needs are often not currently being met, in part because as patients move beyond needing to be cared for by their oncologist they find that their primary care providers are not adequately trained to anticipate and treat the medical complications of their treatment. The purpose of this project is to address that need through development and implementation of a curriculum to teach primary care physicians in rural medical practices in Colorado about the special medical needs of cancer survivors and to empower them to identify cancer survivors in their practice and to implement survivorship care planning for them. This goal will be achieved through engagement of physicians, nurses, physician assistants, and office staff within their own practice setting as well as members of the local community. During the first year of the project, a Scientific Advisory Board and a Community Advisory Board will work together to provide feedback and direction to the project's Cancer Survivorship Curriculum. The curriculum will focus on cancer care planning using the recommendations of the Institute of Medicine for cancer survivorship and be translated into an easily implementable way for primary care practitioners and their office staff. Fifty-four practices will be recruited to participate and the be randomized to one of two groups: an Intervention Group versus a Comparison Group that will serve as a control group. This multi-faceted curriculum will incorporate several complementary educational methods, including: (1) four in-person individualized interprofessional small group discussions within the practice settings; (2) a series of 12 Webinars delivered annually by experts in the field; (3) a content-rich website; and (4) password-protected moderated discussion forums. The practice visits will occur during the second through fifth years of the grant period. Additionally, study participants will be provided with a Cancer Survivorship Toolkit developed as part of this project that includes evidence-based guidelines to care for cancer survivors. The effectiveness of the curriculum will be evaluated by assessing changes in participants' knowledge as a result of exposure to the curriculum. Adoption of the curricular content into the practice setting will be measured using chart reviews of survivors of cancers targeted as part of the Project (i.e., breast, colon, prostate, and any childhood cancer). This project is innovative in a number of ways: (1) it provides a mechanism for cancer survivors to have their medical needs met within their medical home; (2) it engages primary care physicians by bringing the curriculum directly to their practice setting; (3) it engages not only the physicia, but all members of the practice; (4) it involves not only experts in treatment and survivorship in development and refinement of the curriculum, but also people with knowledge of rural primary care practices and the communities in which they practice, increasing the likelihood that the information being taught will be implemented; and (5) it uses a randomized control trial design for an educational intervention.