||5R01CA249501-03 Interpret this number
||Beckman Research Institute/City Of Hope
||Self-Management to Optimize Survivorship Care and Outcomes in Lung and Colorectal Cancer
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.
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