Document text
Principal Investigator: Rebecca DeBoer
Organization: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Fiscal Year: 2024
Award: $269,653
Funding agency: National Cancer Institute
PROJECT SUMMARY/ABSTRACT
The burden of cancer is rising in Africa and mortality rates are high. A majority (70-80%) of patients present at
advanced stages, and cancer care incurs substantial financial costs for families and healthcare systems. Even
for potentially curable patients, effective treatment delivery is hampered by low adherence and retention in
care. In this context, patient-centered communication (PCC) offers an immediate opportunity to improve
treatment outcomes, optimize resource utilization, and alleviate suffering. PCC means responding to individual
patients’ perspectives and needs, involving patients in decision making, and providing emotional support.
Patients and clinicians in many African settings, including in Rwanda, have identified critical deficits in PCC
and have called for a cultural shift toward patient-centered care. Empowering patients through patient-reported
measures, and clinicians through communication skills training, has the potential for broadly impactful
improvements in PCC. A key barrier to progress in PCC research in African cancer care is the absence of
context-appropriate measures of communication quality. Currently, no measures of clinical communication
have been validated in an African cancer care context. This proposal addresses this gap by adapting,
validating, and piloting a patient survey of communication quality in Rwanda. Specifically, Dr. DeBoer aims to
(1) adapt an existing patient survey, the Patient-Centered Communication in Cancer Care (PCC-Ca), based on
input from Rwandan stakeholders; (2) establish psychometric properties of the adapted PCC patient survey in
Rwanda; and (3) conduct a feasibility pilot trial of the adapted PCC patient survey to evaluate a communication
training intervention for clinicians in Rwanda. To achieve these aims, Dr. DeBoer will leverage her existing
research partnership at Butaro Hospital in Rwanda and her prior work adapting a PCC clinician training
intervention for the Rwandan context. The proposed research will result in context-appropriate measures that
can be used to evaluate a PCC clinician training intervention in a future R01 cluster randomized trial in
Rwanda. This K08 award will support advanced training in implementation science and career development in
global oncology, organized around four training goals: (1) stakeholder-engaged research; (2) program
evaluation; (3) interventional trial design; and (4) career development in global oncology. For each goal, Dr.
DeBoer will complete coursework, fulfilling the UCSF Certificate in Implementation Science, as well as
mentored tutorials and experiential learning from research aims. An exceptional multidisciplinary team of
mentors with an optimal balance of complementary expertise will guide Dr. DeBoer in achieving her goals. This
training will position Dr. DeBoer for a successful independent research career as an implementation scientist
and leader in the emerging academic field of global oncology, advancing Dr. DeBoer’s ultimate objective of
promoting global cancer equity by improving the quality of care for patients in East Africa and beyond.
1
Terms: <Active Learning><Address><Adherence><Advocate><Africa><African><Award><Belief><Bioethics><Biomedical Ethics><Budgets><Cancer Burden><Cancer Center><Cancer Treatment><Cancers><Caring><Clinical><Cluster randomization trial><Cluster randomized trial><Communication><Communication Research><Cooperative Learning><Country><Death Rate><Decision Making><Dedications><Distress><Education for Intervention><Educational Intervention><Emotional><Equilibrium><Equity><Experiential Learning><Family><Financial cost><Future><Goals><Health Care Systems><Healthcare><Healthcare Systems><Hospitals><Instruction Intervention><Intervention><Intervention Strategies><Intervention Trial><Interventional trial><Interview><Investigators><Malignant Neoplasm Therapy><Malignant Neoplasm Treatment><Malignant Neoplasms><Malignant Tumor><Measures><Mentors><Modification><Morale><National Cancer Burden><Oncology><Oncology Cancer><Outcome><Patient Care><Patient Care Delivery><Patient Outcomes Assessments><Patient Reported Measures><Patient Reported Outcomes><Patient-Centered Care><Patients><Personal Satisfaction><Position><Positioning Attribute><Process><Program Evaluation><Property><Psychometrics><QOC><QOL><Quality of Care><Quality of life><Randomization trial><Research><Research Personnel><Research Resources><Researchers><Resources><Ruanda><Rwanda><Scientist><Structure><Survey Instrument><Surveys><Testing><Training><Training Intervention><Treatment outcome><Validation><Validity and Reliability><Work><anti-cancer therapy><balance><balance function><cancer care><cancer therapy><cancer-directed therapy><care for patients><care of patients><career><career development><caring for patients><clinician communication><cognitive interview><communicate to clinicians><communicate to providers><communicate with clinicians><communicate with doctors><communicate with providers><cost><design><designing><doctor communication><effective therapy><effective treatment><empowerment><field based data><field learning><field study><field test><health care><implementation process><implementation research><implementation science><implementation strategy><improved><individual patient><instructional intervention><interventional strategy><malignancy><monetary cost><mortality rate><mortality ratio><multidisciplinary><neoplasm/cancer><oncology program><patient centered><patient oriented><pilot trial><programs><provider communication><randomized trial><response><skills training><strategies for implementation><therapy optimization><treatment adherence><treatment compliance><treatment optimization><trial design><validations><well-being><wellbeing>