Grant Details
Grant Number: |
5R01CA094827-04 Interpret this number |
Primary Investigator: |
Ell, Kathleen |
Organization: |
University Of Southern California |
Project Title: |
Improving Patient Adherence to Cancer Treatment |
Fiscal Year: |
2004 |
Abstract
DESCRIPTION (provided by investigator): Studies of adherence to cancer
treatment find that low-income and minority population experience important
barriers (including access barriers) to optimal treatment adherence behavior
(helping to explain less favorable morbidity and mortality cancer outcomes
among women living in poverty). A randomized clinical trial is proposed to test
the efficacy of a multifaceted intervention on patient adherence to breast and
gynecological adjuvant cancer treatment and post-treatment follow-up among
low-income minority women. The proposed study will test the efficacy of a
culturally tailored intervention model that combines interactive health
education (decisional support), counseling (emotional support), and systems
navigation (resource access) interventions that have been shown to be effective
in enhancing adherence to abnormal screening diagnostic follow-up among
low-income minority women. The efficacy of IMPAACT will be tested by comparing
adherence outcomes between intervention and modestly enhanced usual care group
patients. The nature of relationships between assessed barriers, adherence
outcomes, and quality of life outcomes and patient satisfaction with the
intervention and with their cancer care will be identified. In addition, the
study will test models specifying direct, indirect, and intervening
relationships between assessed barriers and adherence behaviors within
intervention and control groups. In addition, estimates of direct costs of the
intervention and usual care arms will be compared.
Study Hypotheses:
1.IMPAACT will result in significantly higher rates of: 1) patient acceptance
of adjuvant cancer treatment; 2) adjuvant cancer treatment adherence; and 3)
follow-up appointment keeping compared to usual care (UC).
2.IMPAACT will result in better functional status, quality of life, and
satisfaction with cancer care vs. UC.
3.IMPAACT will result in greater reduction of depressive symptoms (by
increasing identification and receipt of treatment) and practical and health
system barriers vs. UC.
4.Depression and practical/system barriers will serve as mediators between all
other barriers and adherence outcomes.
5 IMPAACT intervention effects will be mediated by changes in targets of the
components of the intervention, viz., strengthened intentions, reduced
emotional barriers particularly depression, and reduced practical and system
barriers.
Publications
Cancer treatment adherence among low-income women with breast or gynecologic cancer: a randomized controlled trial of patient navigation.
Authors: Ell K.
, Vourlekis B.
, Xie B.
, Nedjat-Haiem F.R.
, Lee P.J.
, Muderspach L.
, Russell C.
, Palinkas L.A.
.
Source: Cancer, 2009-10-01 00:00:00.0; 115(19), p. 4606-15.
PMID: 19551881
Related Citations
Economic stress among low-income women with cancer: effects on quality of life.
Authors: Ell K.
, Xie B.
, Wells A.
, Nedjat-Haiem F.
, Lee P.J.
, Vourlekis B.
.
Source: Cancer, 2008-02-01 00:00:00.0; 112(3), p. 616-25.
PMID: 18085642
Related Citations
Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer.
Authors: Ell K.
, Sanchez K.
, Vourlekis B.
, Lee P.J.
, Dwight-Johnson M.
, Lagomasino I.
, Muderspach L.
, Russell C.
.
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2005-05-01 00:00:00.0; 23(13), p. 3052-60.
PMID: 15860863
Related Citations