IMPROVING PROGNOSTIC COMMUNICATION IN PEDIATRIC CANCER

项目摘要/摘要 我的职业目标是开发一个独立的研究项目，专注于改善沟通 为患有晚期癌症的儿童及其家人提供服务。 当父母了解预后时，患有晚期癌症的儿童更有可能接受姑息治疗 以及减轻痛苦的干预措施。大多数患者和父母希望得到明确的预后信息，但我们的 初步数据显示，儿科肿瘤学家经常推迟或审查不良预后信息的披露。 这份K08申请表描述了一份职业发展计划，它将使我成为一名成功的 独立的临床调查员，专注于改善儿科癌症护理中的沟通。 该项目的短期目标是开发一种基于证据、利益相关者驱动的预测 通信指南和文档模板，以支持在以下情况下及时披露预测 儿童癌症晚期。首先，我们将采访患者、父母和肿瘤学家，以确定利益相关者 对预后信息的时机、内容和传递的偏好和建议(研究目标1)。 第二，我们将协助利益相关者小组制定概念框架，并设计患者/父母- 以预测为中心的沟通指南和文档模板，将通过可用性和 与肿瘤学家Beta测试者进行认知测试。如果在利益相关者的建议下，我们将开发和测试患者/父母- 也以工具为中心(研究目标2)。第三，我们将评估干预的可行性和可接受性- 与儿科肿瘤学家和晚期癌症患者-父母二人组进行的ARM试点研究(研究目标3)。 这个职业发展奖将为我实现作为一名独立调查员的长期目标做好准备。 在儿童癌症、姑息治疗和传播研究的交叉点上。通过结构化 导师的指导，正式的课程作业，以及实践的临床研究经验，我将在 衡量和修正沟通行为的科学(培训目标1-3)，学习和应用参与式 使儿童癌症利益攸关者，特别是儿童参与数据合成的设计方法(培训目标 2)，获得正规培训和设计传播干预措施的实际经验(培训目标 2-3)，并获得临床试验设计和实施方面的知识和技能(培训目标3)。 在完成这个奖项后，我将有数据和技能来研究这种干预在多个地点随机 对照试验，作为未来R01提交的基础。该奖项提供的严格培训将为 我的职业生涯致力于改善癌症晚期儿童及其家人的沟通。

PROJECT SUMMARY/ABSTRACT My career goal is to develop an independent research program focused on improving communication for children with advancing cancer and their families. When parents understand prognosis, children with advancing cancer are more likely to receive palliative care and interventions to alleviate suffering. Most patients and parents want clear prognostic information, yet our preliminary data show that pediatric oncologists often delay or censor poor prognostic disclosure. This K08 Application describes a career development plan that will enable me to evolve into a successful independent clinical investigator with a career focused on improving communication in pediatric cancer care. The short-term goal of this project is to develop an evidence-based, stakeholder-driven prognostic communication guide and documentation template to support timely prognostic disclosure in the setting of advancing childhood cancer. First, we will interview patients, parents, and oncologists to define stakeholder preferences and recommendations for timing, content, and delivery of prognostic information (Research Aim 1). Second, we will facilitate a Stakeholder Panel to develop a conceptual framework and design a patient/parent- centered prognostic communication guide and documentation template, which will undergo usability and cognitive testing with oncologist beta testers. If advised by stakeholders, we will develop and test patient/parent- centered tools as well (Research Aim 2). Third, we will assess intervention feasibility and acceptability in a single- arm pilot study with pediatric oncologists and advancing cancer patient-parent dyads (Research Aim 3). This career development award will prepare me to achieve my long-term goals as an independent investigator at the intersection of pediatric cancer, palliative care, and communication research. Through structured mentorship, formal coursework, and hands-on clinical research experience, I will expand my training in the science of measuring and modifying communication behaviors (Training Aims 1-3), learn and apply participatory design methods to engage pediatric cancer stakeholders, particularly children, in data synthesis (Training Aim 2), acquire formal training and practical experience with designing interventions for dissemination (Training Aims 2-3), and gain knowledge and skills in clinical trial design and conduct (Training Aim 3). Upon completion of this Award, I will have the data and skills to study this intervention in a multi-site randomized control trial, as the basis for a future R01 submission. The rigorous training provided by this Award will prepare me for a career dedicated to improving communication for children with advancing cancer and their families.