A multi-stakeholder health policy study using implementation science to advance access to cancer care and clinical trials for medically vulnerable populations: A focus on our Catchment Community

项目总结 此申请将作为PA-20-272调查员提出的请求重新提交，以回应 确定为NOT-CA-23-044的特殊兴趣(NOSI)，并响应我们的P30-CA033572-40战略 优先通过增加代表不足的人口和少数群体来减少癌症负担和差距 获得癌症护理和临床试验的机会。增加少数群体获得专门的癌症护理和临床治疗的机会 介入治疗试验是包括NIH、NCI和Our等医学研究机构的首要任务 希望之城癌症中心。家长P30拨款的战略计划，特别是我们的目标3 社区外联和参与(COE)，优先考虑增加少数族裔入学和解决 癌症差异。为了推进我们的P30战略优先事项和COE目标，我们提议进行一项卫生政策研究 建立在多个利益相关者参与的基础上，以增加获得专业癌症护理和临床试验的机会 医疗弱势群体，特别是针对我们的集水区社区。令人无法接受的低水平 少数群体在癌症控制政策研究和临床试验中的代表性继续阻碍公众利益 医学进步和立法。为了解决这一差距，我们建议评估以下项目的实施情况 2023年1月生效的加州癌症护理公平法案(CCEA-SB987)，该法案扩大了覆盖范围 专门的癌症护理和临床试验。通过确保CCEA-SB987中的社区响应能力 实施后，我们的长期目标是迅速增加少数群体获得癌症护理和临床试验的机会 NCI癌症中心。我们的创新方法将使患者和家属、医疗保健提供者、健康 系统、付款人和社区成员更好地了解指导方针和资格，并根据 信息。在传播和实施概念框架的指导下，我们的目标是：(1)评估 患者角度的通知策略付款人用来通知患者有关CCEA-SB987指南和 资格，使用有患者顾问的焦点小组。我们将探讨患者对付款人通知的看法 战略(类型和交付方式)、付款人通知质量(内容、清晰度以及文化和语言 响应性)和资格指南；以及(2)评估组织利益相关者对CCEA的看法- 实施SB987，使用对组织/诊所领导人和提供商的半结构化访谈。我们会 进行深入的定性访谈，以了解参与政策执行的观点， 实施的障碍和促进者，以及资格准则。我们将使用这项政策的调查结果 发现科学研究以共同创建(倡导者、临床医生和研究人员)沟通战略 最佳提供者和患者激活，以增加获得最高质量的癌症护理和临床服务的机会 CCEA-SB987提供的治疗研究。这一结果与我们的母公司赠款直接相关，目标是 代表不足的少数民族更多地获得专门的癌症护理，包括临床治疗 在NCI癌症中心的研究。

PROJECT SUMMARY This application is being re-submitted as a PA-20-272 investigator-initiated request responsive to the Notice of Special Interest (NOSI) identified as NOT-CA-23-044, and in response to our P30-CA033572-40 strategic priority to reduce cancer burden and disparities by increasing underrepresented and minority population access to cancer care and clinical trials. Increasing minority access to specialized cancer care and clinical interventional treatment trials are top priorities for medical research organizations including NIH, NCI, and our City of Hope Cancer Center. The strategic plan of the parent P30 grant, and in particular aim 3 of our Community Outreach and Engagement (COE), prioritizes increasing minority enrollment and addressing cancer disparities. To advance our P30 strategic priorities and our COE aim, we propose a health policy study built on multi-stakeholder engagement to increase access to specialty cancer care and clinical trials for medically vulnerable populations, especially targeting our Catchment Communities. The unacceptably low representation of minorities in cancer control policy studies and clinical trials continue to hamper public benefit of medical advancement and legislation. To address this gap, we propose evaluating the implementation of The California Cancer Care Equity Act (CCEA-SB987) that took effect in January 2023, which expands access to specialized cancer care and clinical trials. By ensuring community responsiveness in CCEA-SB987 implementation, our long-term goal is to rapidly increase minority access to cancer care and clinical trials at NCI Cancer Centers. Our innovative approach will enable patients and families, health care providers, health systems, payors, and community members to better understand guidelines and eligibility, and act upon the information. Guided by dissemination and implementation conceptual frameworks, we aim to: (1) Evaluate patient perspectives of notification strategies payors use to inform patients about CCEA-SB987 guidelines and eligibility, using focus groups with patient advisors. We will explore patient perspectives on payor notification strategies (type and delivery modality), payor notification quality (content, clarity, and cultural and linguistic responsiveness), and eligibility guidelines; and (2) Evaluate organization stakeholder perspectives on CCEA- SB987 implementation, using semi-structured interviews with organization/clinic leaders and providers. We will conduct in-depth qualitative interviews to learn about perspectives on engagement in policy implementation, barriers and facilitators to implementation, and eligibility guidelines. We will use the findings from this policy discovery science research to co-create (advocate, clinician, and researcher) communication strategies for optimal provider and patient activation to increase access to the highest quality cancer care and clinical treatment studies afforded by CCEA-SB987. This outcome has direct relevance to our parent grant that targets underrepresented ethnic minorities for increased access to specialty cancer care, including clinical treatment studies at NCI Cancer Centers.