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评估志愿者导航肿瘤支持项目的实施情况及影响:一项实用的真实世界混合型2期研究的研究方案

Evaluating the implementation and impact of a volunteer navigation oncology support programme: study protocol for a pragmatic, real-world hybrid type 2 study.

作者信息

Rocque Gabrielle B, Dent D'Ambra N, Waugh Charlotte, Hill Emily K, Federman Noah, Bostock Rosenzweig Ian, Morris Bonny, Kamal Arif

机构信息

Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA

Medicine Division of Geriatrics, Gerontology, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA.

出版信息

BMJ Open. 2025 Jan 20;15(1):e088047. doi: 10.1136/bmjopen-2024-088047.


DOI:10.1136/bmjopen-2024-088047
PMID:39832972
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11748934/
Abstract

INTRODUCTION: Patient navigation is recommended by accrediting bodies such as the Commission on Cancer and is a key element in payment reform demonstration projects, due to the established benefits in reducing barriers to healthcare, improving care coordination and reducing healthcare utilisation. However, oncology practices are often resource constrained and lack the capacity to extend navigation services at the desired intensity for their patient population. The American Cancer Society (ACS) developed the ACS Community Access to Resources, Education, and Support (CARES) programme to expand navigation capacity through the training of students from local universities as volunteers to serve as non-clinical navigators to support cancer patients. Although this approach has great potential for scalability, the best approach to early implementation and impact of volunteer navigation remains unclear. METHODS AND ANALYSIS: This pragmatic single-arm pre-post study evaluates the implementation and effectiveness of volunteer navigation for patients participating in the 2023-2024 pilot. This study will use data collected during routine care for quantitative implementation and patient outcomes. The Updated Consolidated Framework for Implementation Research will guide evaluation of early programme implementation with three initial pilot sites. This pragmatic evaluation of real-world implementation of volunteer navigation in the oncology setting will support future efforts to scale-up this intervention across US health systems. ETHICS AND DISSEMINATION: This study was approved by University of Morehouse School of Medicine Social and Behavioral (IRB), which served as the IRB for record for this project (IRB-2025819-2). No consent required for this study protocol. ACS CARES plans to disseminate this model and include additional sites as participants in future years.

摘要

引言:诸如癌症委员会等认证机构推荐患者导航服务,并且它是支付改革示范项目的关键要素,因为其在减少医疗保健障碍、改善护理协调和降低医疗保健利用率方面已证实具有益处。然而,肿瘤学实践往往资源有限,缺乏能力以期望的强度为其患者群体扩展导航服务。美国癌症协会(ACS)制定了ACS社区资源、教育与支持获取(CARES)计划,通过培训当地大学的学生作为志愿者担任非临床导航员来支持癌症患者,以扩大导航能力。尽管这种方法具有很大的扩展潜力,但志愿者导航早期实施的最佳方法及其影响仍不明确。 方法与分析:这项务实的单臂前后对照研究评估了2023 - 2024年试点项目中患者志愿者导航服务的实施情况和有效性。本研究将使用常规护理期间收集的数据进行定量实施和患者结局分析。更新后的实施研究综合框架将指导对三个初始试点地点早期项目实施情况的评估。这项对肿瘤学环境中志愿者导航实际实施情况的务实评估将支持未来在美国卫生系统中扩大这一干预措施的努力。 伦理与传播:本研究已获得莫尔豪斯医学院社会与行为学(IRB)批准,该机构作为本项目的记录IRB(IRB - 2025819 - 2)。本研究方案无需患者同意。ACS CARES计划传播此模式,并在未来几年纳入更多地点作为参与者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e780/11748934/3dd8249e9351/bmjopen-15-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e780/11748934/3dd8249e9351/bmjopen-15-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e780/11748934/3dd8249e9351/bmjopen-15-1-g001.jpg

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本文引用的文献

[1]
Adjunctive interventions: change methods directed at recipients that support uptake and use of health innovations.

Implement Sci. 2024-2-8

[2]
Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature.

CA Cancer J Clin. 2023

[3]
Patient-Centered Communication (PCC) scale: Psychometric analysis and validation of a health survey measure.

PLoS One. 2022

[4]
The updated Consolidated Framework for Implementation Research based on user feedback.

Implement Sci. 2022-10-29

[5]
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Implement Sci. 2022-1-22

[6]
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JCO Oncol Pract. 2021-11

[7]
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JAMA Netw Open. 2020-3-2

[8]
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JCO Oncol Pract. 2020-1

[9]
Patient Navigation in Cancer: The Business Case to Support Clinical Needs.

J Oncol Pract. 2019-9-11

[10]
Distribution of global health measures from routinely collected PROMIS surveys in patients with breast cancer or prostate cancer.

Cancer. 2018-12-4

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