Minority-Based Community Clinical Oncology Program

描述(由申请人提供)：少数群体在适当的医疗保健方面有多种障碍，这种差距在癌症预防和治疗方面最有意义。非洲裔美国人的总体癌症死亡率高于所有其他种族，从1979年到1998年，男性和女性的差异--以黑人与白人癌症相关死亡率的比率衡量--甚至恶化了。考虑到这些事实，显然需要为少数群体作出更大的努力。这一努力必须包括癌症治疗(CT)和癌症预防和控制(CPC)试验的应计费用，在这些试验中，少数族裔人口的代表性严重不足，甚至校正了与高加索人口的相对频率。该提案旨在建立一种机制，让更多的少数族裔患者参加CT和CPC试验，让少数族裔社区的初级保健保健中心参与进来，并评估整个过程的障碍。这项提案的具体目标是通过将大量少数族裔患者纳入NCI批准的CT和CPC研究，扩大少数族裔人群获得癌症治疗研究的机会；增加社区执业医生对NCI批准的研究的参与；向照顾少数族裔和服务不足的人群的卫生保健提供者转让新技术。此外，该提案将研究少数群体中的CPC障碍，并检查MBCCOP试验绩效中的问题，包括招募、应计和方案绩效。梅哈里医学院(MMC)基于少数族裔的社区临床肿瘤学项目(MBCCOP)基于MMC的双重使命：1)教育少数族裔医生；2)治疗少数族裔和未得到充分服务的人群。MMC将作为基于其在大都会戴维森县(MDC)集水区活跃的和不断增加的癌症治疗试验计划的MBCCOP的中心，那里的少数民族人口约占总人口的33%。MBCCOP的CT部分将是最大的多医生肿瘤学实践(TN肿瘤学)的集水区，已经非常活跃于临床试验研究。MBCCOP内科医生将占集水区所有内科肿瘤学家的56%。这两个群体在MDC中照顾大量的少数族裔患者，都有将患者安排在NCI批准的方案中的可靠记录。MMC在研究少数民族社区的卫生保健差距和改善卫生保健方面有着悠久而辉煌的历史。MMC和范德比尔特大学拥有广泛的正在进行的CT和CPC研究，这些研究将作为基础，将收益扩大到NCI批准的研究基地的其他试验(S)。方案和方案部分将是一个已经建立的初级保健保健诊所联盟，重点关注少数群体和服务不足的人。这个“安全网”联盟由MBCCOP的一名成员领导，鼓励研究和医疗保健的提供。这组卫生保健诊所，加上一种新的和有效的方法来增加社区对卫生保健的参与，将被用来吸引患者参加CPC研究。MBCCOP的设计，连同组成部分和既定的患者护理方法，将允许大量患者进入NCI的CT和CPC研究。

DESCRIPTION (provided by applicant): Minority populations have multiple impediments to proper health care and this disparity is nowhere more meaningful than in cancer prevention and treatment. The overall cancer death rate for African-Americans is greater than for all other ethnic groups and the disparity, measured as the ratio of black:white cancer related mortality, has even worsened from 1979 to 1998 for both males and females. Considering these facts, it is clear that greater efforts are required for minority populations. This effort must include accrual to cancer therapy (CT) and cancer prevention and control (CPC) trials where minority populations are substantially underrepresented, even correcting for relative frequency to Caucasian populations. This proposal aims to establish a mechanism to accrue greater numbers of minority patients onto CT and CPC trials, to involve primary care health care centers in the minority community and to evaluate impediments for the overall process. The specific goals of this proposal are to broaden access to cancer treatment studies for minority populations by entering substantial numbers of minority patients onto NCI approved CT and CPC studies; to increase community practicing physician participation on NCI approved studies; and to transfer new technology to health care providers caring for minority and underserved populations. Additionally, the proposal will study barriers to CPC in minority populations and examine issues in MBCCOP performance for trials including recruitment, accrual and protocol performance. The Meharry Medical College (MMC) Minority-Based Community Clinical Oncology Program (MBCCOP) is based on the dual mission of MMC to 1) educate minority physicians and 2) to treat minority and the underserved populations. MMC will serve as the centerpiece of the MBCCOP based on its active and increasing cancer treatment trials program in the catchment region of Metropolitan Davidson County (MDC) where minority populations make up approximately 33% of the entire population. The CT component of the MBCCOP will be the catchment areas largest multi-physician oncology practice (TN Oncology) already very active in clinical trials research. MBCCOP physicians will constitute 56% of all medical oncologists in the catchment area. These two groups care for large numbers of minority patients in MDC and both have a proven track record for placing patients on NCI approved protocols. MMC has a long and illustrious history in studying health care disparity and improving health care in the minority community. MMC and Vanderbilt University have extensive ongoing CT and CPC research that will serve as a foundation to expand accrual to other NCI approved trials of the research base(s). The CPC component will be an already established consortium of primary care health clinics that focus on minority and the underserved. This "Safety-Net" consortium is directed by a member of the MBCCOP and encourages research and health care delivery. This group of health care clinics, together with a novel and validated method to increase community participation in health care will be used to accrue patients onto CPC studies. The design of the MBCCOP, together with the components and established patient care methods, will allow for substantial numbers of patients to be entered onto CT and CPC studies of the NCI.