Division of Cancer Control and Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Womens Health (Larchmt). 2022 Nov;31(11):1519-1525. doi: 10.1089/jwh.2022.0372.
Treatment by a gynecologic oncologist is an important part of ovarian cancer care; however, implementation strategies are needed to increase care by these specialists. We partnered with National Comprehensive Cancer Control Programs in Iowa, Michigan, and Rhode Island in a demonstration project to deepen the evidence base for promising strategies that would facilitate care for ovarian cancer by gynecologic oncologists. Five main implementation strategies (increase knowledge/awareness; improve models of care; improve payment structures; increase insurance coverage; enhance workforce) were identified in the literature and used to develop initiatives. Specific activities were chosen by state programs according to feasibility and needs. Activities included: (1) qualitative interviews with patients to determine barriers to receipt of specialized care; (2) development of patient/provider educational materials; (3) creation of patient/provider checklists to facilitate appropriate referrals; (4) expansion of a toll-free patient navigation hotline for ovarian cancer patients; (5) training of the health care workforce. The programs developed resources (educational handouts, toolkits, 2 webinars, 2 podcasts); trained 167 medical and nursing students during 8 Survivors Teaching Students workshops; and conducted 3 provider education sessions reaching 362 providers in 45 states. Evaluations showed increases in providers' knowledge, awareness, abilities, and intentions to refer ovarian cancer patients to a gynecologic oncologist. The state program resources we discussed are available for other cancer control programs interested in initiating or expanding activities to improve access/referrals to gynecologic oncologists for ovarian cancer care. They serve as a valuable repository for public health professionals seeking to implement similar interventions.
妇科肿瘤学家的治疗是卵巢癌护理的重要组成部分;然而,需要实施策略来增加这些专家的护理。我们与爱荷华州、密歇根州和罗得岛州的国家综合癌症控制计划合作,开展了一个示范项目,旨在深化有前途的策略的证据基础,这些策略将促进妇科肿瘤学家对卵巢癌的护理。文献中确定了 5 种主要的实施策略(增加知识/意识;改善护理模式;改善支付结构;增加保险覆盖范围;增强劳动力),并用于制定计划。根据可行性和需求,州计划选择了具体的活动。活动包括:(1)对患者进行定性访谈,以确定接受专业护理的障碍;(2)开发患者/提供者教育材料;(3)创建患者/提供者检查表,以促进适当转诊;(4)扩大卵巢癌患者免费患者导航热线;(5)培训医疗保健劳动力。这些项目开发了资源(教育手册、工具包、2 个网络研讨会、2 个播客);在 8 个幸存者教学学生研讨会中培训了 167 名医学和护理学生;并举办了 3 个提供者教育会议,有 45 个州的 362 名提供者参加。评估表明,提供者的知识、意识、能力和将卵巢癌患者转介给妇科肿瘤学家的意愿有所提高。我们讨论的州计划资源可供其他有兴趣开展或扩大活动以改善妇科肿瘤学家对卵巢癌护理的获取/转诊的癌症控制计划使用。它们是公共卫生专业人员寻求实施类似干预措施的宝贵资源库。