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Principal Investigator: Jerod L Stapleton
Organization: UNIVERSITY OF COLORADO DENVER
Fiscal Year: 2024
Award: $571,997
Funding agency: National Cancer Institute
PROJECT SUMMARY
Among the devastating illnesses impacting rural America, few exact the physical, social, psychological, and
economic toll of lung cancer. Lung cancer is the leading cause of cancer death in rural America, and the levy is
particularly acute in Kentucky – a state that not only leads the nation in lung cancer incidence and mortality but
is a global epicenter of lung cancer. Despite the prevailing nihilism regarding lung cancer care, lung cancer
survivors are living longer. Innovations in prevention, early detection, and treatment, have created substantial
optimism and opportunities for long-term lung cancer survivorship. These dramatic changes in the lung cancer
care landscape have invigorated the need for quality lung cancer survivorship interventions. The overarching
goal of the Kentucky LEADS Collaborative Lung Cancer Survivorship Care program is to reduce the
burden of lung cancer by offering an innovative survivorship care approach that improves lung cancer
quality of life, overcomes lung cancer stigma, and helps survivors engage with care. Using a novel
precision survivorship approach and developed in collaboration with rural community stakeholders, the
program's foundation incorporates principles of patient-centered care, shared decision making, and
motivational interviewing to build survivor engagement. A large acceptability and feasibility trial conducted in
collaboration with nine lung cancer care facilities in Kentucky with lung cancer survivors (N=140) demonstrated
the acceptability of the intervention among survivors, caregivers, and lung cancer care clinicians. The study
also revealed the feasibility of conducting the proposed study methods in rural cancer care facilities. The
proposed project continues this program of research by conducting a two-group parallel randomized clinical
trial comparing the impact of the Kentucky LEADS Collaborative Lung Cancer Survivorship Care program
(KLCLCSC) among lung cancer survivors (N=300) against an enhanced usual care condition
(bibliotherapy+assessment) on quality of life outcomes. Rural-residing lung cancer survivors will be recruited
from ten oncology care facilities throughout Kentucky. The project's first aim compares the efficacy of the
interventions with regard to lung cancer quality of life among survivors as measured by the FACT-L and other
rigorous assessments of patient engagement, symptom burden, psychosocial well-being, and behavior
change. The project's second aim evaluates the moderating impact of including caregivers as intervention
partners on survivor quality of life outcomes. A third aim evaluates the cost-effectiveness of the KLCLCSC
intervention in comparison to the enhanced usual care condition. Based on highly encouraging pilot data
collected in collaboration with oncology care programs in Kentucky, this research holds credible potential to
establish a new paradigm for addressing the challenges associated with lung cancer and for delivering quality
survivorship care to rural-residing, economically distressed lung cancer survivors.
Terms: <Acute><Address><Advocate><Appalachia><Appalachian><Appalachian Region><Area><Bibliotherapy><Cancer Burden><Cancer Care Facilities><Cancer Cause><Cancer Etiology><Cancer Survivor><Cancer Survivorship><Care Givers><Caregivers><Caring><Cessation of life><Clinical><Collaborations><Communities><Data><Death><Development><Distress><Early Diagnosis><Early treatment><Economics><Educational Achievement><Educational Status><Fostering><Foundations><Goals><Guidelines><Health Facilities><Health behavior><Health behavior and outcomes><Health behavior change><Health care facility><Healthcare Facility><Illness impact><Impoverished><Incidence><Individual><Informal care giver><Infrastructure><Intervention><Intervention Strategies><Kentucky><Malignant Tumor of the Lung><Malignant neoplasm of lung><Measures><Methods><Modeling><NIH><National Cancer Burden><National Institutes of Health><Oncology><Oncology Cancer><Outcome><Patient-Centered Care><Play><Population><Poverty><Prevention><Pulmonary Cancer><Pulmonary malignant Neoplasm><QOC><QOL><Quality of Care><Quality of life><Randomized, Controlled Trials><Research><Role><Rural><Rural Community><Salaries><Socioeconomically disadvantaged><Survivors><Symptom Burden><Symptoms><Thoracic Oncology><Tobacco><Treatment Efficacy><Treatment Side Effects><Treatment-related side effects><United States National Institutes of Health><Wages><acceptability and feasibility><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><behavior change><burden of disease><burden of illness><cancer care><cancer survivor care><cancer survivorship care><care as usual><care delivery><care facilities><collaboration with communities><community advisory board><community advisory committee><community advisory panel><community collaboration><community-based collaboration><comparable efficacy><comparative efficacy><compare efficacy><cost effective><cost effectiveness><cost-effectiveness evaluation><developmental><disease burden><early detection><early therapy><economic><educational level><evaluate cost-effectiveness><experience><feasibility trial><health care access><health care availability><health care service access><health care service availability><health related behavior><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><implementation design><implementation research design><improved><improved outcome><informal caregiver><innovate><innovation><innovative><intervention efficacy><intervention program><interventional strategy><lung cancer><lung cancer prevention><manage symptom><mortality><motivational enhancement therapy><motivational interview><novel><optimism><participant engagement><patient engagement><pilot trial><positive attitude><preference><programs><psychologic><psychological><psychological distress><psychosocial well-being><psychosocial wellbeing><psychosocial wellness><quality of life and care for cancer survivors><quality of life for cancer survivors><randomized control trial><randomized, clinical trials><recruit><rural America><rural area><rural cancer care><rural location><rural region><screening><screenings><shared decision making><social><social role><social stigma><socio-economic><socio-economic disadvantage><socio-economically><socio-economically disadvantaged><socio-economically underprivileged><socioeconomic disadvantage><socioeconomically><socioeconomically underprivileged><socioeconomics><stigma><survivorship><symptom management><therapeutic efficacy><therapy efficacy><training achievement><training level><training status><treatment as usual><trial comparing><under served community><underserved community><usual care>