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Principal Investigator: VIRGINIA Chih-Yi SUN
Organization: BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
Fiscal Year: 2024
Award: $746,773
Funding agency: National Cancer Institute
PROJECT SUMMARY
The overarching goal of this five-year grant proposal, submitted on behalf of the Beckman Research Institute of
City of Hope and the University of California, Riverside, in response to RFA-CA-19-035, is to test the efficacy
of an advance-practice nurse (APRN)-driven telehealth Survivor Self-Management (SSM) Intervention in 414
lung and colorectal cancer survivors. This research is critical because lung and colorectal cancer survivors
have high post-treatment needs, are older, and suffers from greater co-morbidities and poor quality of life
(QOL). Lung and colorectal cancer survivors remain underrepresented in research, leading to significant
disparities in post-treatment outcomes. Based on the Chronic Care Self-Management Model (CCM), the SSM
Intervention includes the following components: 1) care coordination and communication between oncology
and primary care on surveillance/follow-up, health promotion, disease prevention, and comorbidity
management; 2) provision of clinician care plan to PCPs; 3) comprehensive patient/geriatric assessment for
survivors of all ages; 4) personalized care plan for survivors; and 5) survivor self-management skills building
for surveillance/follow-up, late and long-term effects of treatments, comorbidities, and healthy living. It is
administered in five telehealth sessions (Zoom videoconferencing) and three subsequent maintenance
telehealth sessions for survivors who are four months post-treatment. We will test the efficacy of the SSM
Intervention using a randomized design of attention control arm versus an intervention arm to pursue the
following specific aims: Specific Aim 1 (Primary): Determine the efficacy of the intervention on care
coordination, communication, and provider knowledge at 4 months post-accrual; Specific Aim 2 (Primary):
Determine the efficacy of the intervention on survivor outcomes at 4 months post-accrual; and Specific Aim 3
(Exploratory): Assess the reach, efficacy, adoption, implementation, and maintenance (RE-AIM) of the
intervention. The RE-AIM Framework informs intervention delivery process, which will set the stage for future
large scale implementation for sustainability in real-world care settings. This proposal is innovative because it
addresses a critical need to improve care delivery and outcomes for high needs, understudied survivorship
populations (lung, colorectal, older survivors), and the telehealth approach promotes scalability. The
interdisciplinary team, which includes expertise in nursing science (Sun, Reb, Ferrell), oncology (Fakih), and
primary care (Kim) is uniquely suited to conduct this research. The proposal is significant, with high scientific
rigor and outcomes that are of critical importance to survivors, clinicians, healthcare systems, the National
Cancer Institute, and the Beau Biden Cancer MoonshotSM. The research will address a critical gap in
knowledge of how self-management interventions improve care delivery and outcomes during post-treatment
transitions to follow-up care.
Terms: <21+ years old><65 and older><65 or older><65 years of age and older><65 years of age or more><65 years of age or older><65+ years><65+ years old><> 65 years><APN><Active Follow-up><Address><Adult><Adult Human><Advanced Practice Nurse><After Care><After-Treatment><Aftercare><Age><Aged 65 and Over><American><Anxiety><Applications Grants><Appointment><Breathlessness><California><Cancer Survivor><Cancers><Caring><Chronic Care><Cities><Collaborations><Colon or Rectum><Colorectal><Colorectal Cancer><Communication><Complex><Data><Deterioration><Discipline of Nursing><Disparities><Disparity><Distress><Dysfunction><Dyspnea><Early Diagnosis><Early treatment><Elderly Assessment><Family><Fatigue><Friends><Functional disorder><Future><Geriatric Assessment><Goals><Grant Proposals><Health Care Systems><Health Promotion><Healthcare Systems><History><Intervention><Intervention Strategies><Intestinal><Intestines><Knowledge><Lack of Energy><Long-Term Effects><Longterm Effects><Lung><Lung Respiratory System><Maintenance><Malignant Neoplasms><Malignant Tumor><Malignant Tumor of the Lung><Malignant neoplasm of lung><Manuals><Mental Depression><Modeling><NCI Organization><National Cancer Institute><Neuropathy><Nursing><Nursing Field><Nursing Profession><Oncologist><Oncology><Oncology Cancer><Ostomy><Outcome><Pain><Painful><Patients><Personal awareness><Physiopathology><Population><Precision care><Price><Primary Care><Process><Provider><Pulmonary Cancer><Pulmonary malignant Neoplasm><QOL><Quality of life><RE-AIM><Randomized><Reach, Effectiveness, Adoption, Implementation, and Maintenance><Recording of previous events><Reporting><Research><Research Institute><Research Priority><Research Resources><Resources><Salutogenesis><Science><Self Efficacy><Self Management><Self Perception><Self image><Self view><Specific qualifier value><Specified><Survival Rate><Survivors><Symptoms><Testing><Treatment Efficacy><Treatment outcome><Universities><Videoconferencing><above age 65><acceptability and feasibility><active followup><adoption by clinician><adoption by healthcare providers><adoption by physician><adoption by provider><adulthood><after age 65><age 65 and greater><age 65 and older><age 65 or older><age > 65><age of 65 years onward><aged 65 and greater><aged 65+><aged ≥65><ages><anti-cancer research><arm><attentional control><bowel><cancer research><care coordination><care delivery><care outcomes><chronic symptom><clinician adoption><co-morbid><co-morbidity><colorectum><comorbidity><compare intervention><comparison intervention><coordinating care><depression><design><designing><determine efficacy><disease prevention><disorder prevention><early detection><early therapy><efficacy analysis><efficacy assessment><efficacy determination><efficacy evaluation><efficacy examination><efficacy testing><evaluate efficacy><examine efficacy><experience><facilitators to implementation><follow up><follow-up><followed up><followup><geriatric screening><health care outcomes><healthcare outcomes><histories><human old age (65+)><implementation facilitators><improve symptom><improved><improved outcome><individualized care><individualized patient care><innovate><innovation><innovative><intervention arm><intervention delivery><intervention efficacy><interventional strategy><lung cancer><malignancy><manage symptom><neoplasm/cancer><neuropathic><old age><over 65 years><pathophysiology><patient centered><patient oriented><persistent symptom><personalized care><personalized patient care><physician adoption><post treatment><pricing><primary care provider><promoting health><provider adoption><provider-level adoption><providers from primary care><providers of primary care><pulmonary><randomisation><randomization><randomly assigned><reach, efficacy, adoption, implementation, and maintenance><response><self awareness><self knowledge><skills><skills training><surgical construction of a stoma><survivorship><symptom improvement><symptom management><symptomatic improvement><telehealth><therapeutic efficacy><therapy efficacy><treatment arm><treatment effect><video conferencing><≥65 years>