Advancing the Quality of Cancer Care through Behavioral Economics and Implementation Science

宾夕法尼亚州立大学癌症控制实施科学中心(宾夕法尼亚州立大学ISC3)解决的重大挑战是 应用行为经济学的见解，加快癌症循证实践的步伐 部署护理以改善癌症患者的预后。宾夕法尼亚大学提供了一个独特的环境， 为了进行这一范式转变的工作，鉴于我们在实施科学、行为经济学、 和创新的癌症护理服务。三个MPI的互补和多学科专业知识(BEI- Das，Bekelman，Schnoll)，再加上宾夕法尼亚大学现有的资源，包括宾夕法尼亚大学癌症护理中心 创新[PC3I]，健康激励和行为经济学中心[CHIBE]，以及宾夕法尼亚大学- 伦纳德·戴维斯研究所的心理科学中心[PISCE@LDI]，代表着一个独特的机会-- 万斯对癌症护理的质量提出了质疑。由贝达斯、贝克尔曼和施诺尔博士领导的行政核心将确保 宾夕法尼亚州立大学ISC3的活动与时间表是协调、协同和一致的。实施 由Bekelman博士和Shulman博士领导的实验室代表了一个多样化的生态系统，其中包括五家医院和 相互关联的临床站点，拥有200多名肿瘤学家，每年为15,000多名独特的新患者提供服务。我们的研究 该计划由Beidas博士和Buttenheim博士领导，将监督实施战略的开发和测试。 在我们的实施实验室中以患者和临床医生为目标的EGES，其核心思想是“轻推” 以实现最佳实施和实效成果。研究计划包括调查人员与前- 精通实施科学、行为经济学、癌症护理服务研究、医疗创新、 测量方法和混合方法。在头两年，我们提出了三个标志性的试点项目和两个 方法项目，致力于快速学习，使宾夕法尼亚大学ISC3能够最大限度地灵活。签名 试点项目1(Jenssen/Leone)测试以患者和临床医生为导向的实施策略，以增加转诊次数 在癌症患者中实施戒烟计划。标志性试点项目2(Bekelman/Patel)测试患者- 以及临床医生指导的实施策略，以增加患者更高价值的骨改良剂 乳腺癌、肺癌和前列腺癌。链接了常见的方法和措施，以允许数据和 以实现我们在不同背景下测试多级别实施战略和机制的目标。 我们的探索性和高回报签名试点项目3(Bekelman/Rendle)将测试一个以患者为导向的实施方案- 利用人工智能和机器学习来推广口服化疗广告的心理策略- 病因学和症状管理。支持这些项目的两个方法项目将推动科学的发展。 实施方法的一部分。方法项目1将开发一个工具包，用于应用快速循环方法 (Asch/Buttenheim)；方法项目2将使用定性比较分析来表征多层次的 文本变体(Barg/Rendle)。宾夕法尼亚州立大学ISC3具有识别新奇、可传播和可扩展的潜力 如何提高癌症护理的质量，改善癌症患者的健康状况。 PHS 398/2590(06/09版)页面续格式页面

The grand challenge addressed by the Penn Implementation Science Center in Cancer Control (Penn ISC3) is to apply insights from behavioral economics to accelerate the pace at which evidence-based practices for cancer care are deployed to improve outcomes for individuals with cancer. Penn offers a unique environment in which to conduct this paradigm-shifting work, given our expertise in implementation science, behavioral economics, and innovative cancer care delivery. The complementary and multi-disciplinary expertise of the three MPIs (Bei- das, Bekelman, Schnoll), coupled with existing Penn resources, including the Penn Center for Cancer Care Innovation [PC3I], the Center for Health Incentives and Behavioral Economics [CHIBE], and the Penn Imple- mentation Science Center at the Leonard Davis Institute [PISCE@LDI], represent a unique opportunity to ad- vance the quality of cancer care. The Administrative Core, led by Drs. Beidas, Bekelman, and Schnoll, will ensure that the activities of Penn ISC3 are coordinated, synergistic, and congruent with timelines. The Implementation Laboratory, led by Drs. Bekelman and Shulman, represents a diverse ecosystem that includes five hospitals and linked clinical sites, with over 200 oncologists that serve over 15,000 unique new patients annually. Our Research Program, led by Drs. Beidas and Buttenheim, will oversee the development and testing of implementation strat- egies that target patients and clinicians within our Implementation Lab and are centered on the idea of ‘nudging’ for optimal implementation and effectiveness outcomes. The Research Program includes investigators with ex- pertise in implementation science, behavioral economics, cancer care delivery research, healthcare innovation, measurement, and mixed methods. In the first two years, we propose three Signature Pilot Projects and two Methods Projects with a commitment to rapid learning that will allow Penn ISC3 to be optimally nimble. Signature Pilot Project 1 (Jenssen/Leone) tests patient- and clinician-directed implementation strategies to increase referral to tobacco cessation programs among cancer patients. Signature Pilot Project 2 (Bekelman/Patel) tests patient- and clinician-directed implementation strategies to increase higher-value bone modifying agents in patients with breast, lung, and prostate cancer. Common methods and measures are linked to allow for pooling of data and to accomplish our objectives of testing multilevel implementation strategies and mechanisms across contexts. Our exploratory and high-reward Signature Pilot Project 3 (Bekelman/Rendle) will test a patient-directed imple- mentation strategy that leverages artificial intelligence and machine learning to promote oral chemotherapy ad- herence and symptom management. Two methods projects, in support of the Projects, will advance the science of implementation methods. Methods Project 1 will develop a toolkit for the application of rapid cycle approaches (Asch/Buttenheim); Methods Project 2 will use qualitative comparative analysis to characterize multilevel con- textual variation (Barg/Rendle). The Penn ISC3 has the potential to identify novel, disseminable, and scalable ways to advance the quality of cancer care and improve the health outcomes for individuals with cancer. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page