Specific Aims of Current CCRC Research Projects:

Testing an Optimal Model of Patient-Centered Cancer Care (Ed Wagner, PI, Group Health Research Institute, R01)
The primary goal is to assess the impact on quality of life, quality of care, and other outcomes of an Oncology Nurse Care Management program for newly diagnosed breast, colorectal, and lung cancer patients.
Specific Aims:
1. To develop a robust early cancer notification system based on automated data to facilitate intervention shortly after cancer diagnosis
2. To implement an Oncology Nurse Care Management program that addresses patient questions, symptoms, psychosocial needs, and facilitates timely, coordinated care.
3. To compare the impact of the Oncology Nurse Care Manager Program with enhanced usual care in Group Health cancer patients using a randomized clinical trial design. Our two primary outcomes are quality of life and patients’ perspectives of quality of care.  As secondary outcomes, we will evaluate the impact of the intervention on psychosocial distress and depression. 
4. To compare the impact of the nurse intervention on primary care physicians in different Group Health (GH) delivery models – capitated GH primary care and cancer specialty services; and capitated GH primary care and contracted external specialty services.

For More Information, Please Contact:

Kathryn Horner, horner.k@ghc.org

Effective Communication for Preventing and Responding to Oncology Adverse Events (Kathy Mazor, Co-PI, Meyers Primary Care Institute and Tom Gallagher, Co-PI, University of Washington, R01)
The goal of the study is to improve patient-centered communication around adverse events and errors in cancer care. 
Specific Aims:
1. To describe patients’ experiences with communication around adverse events and errors in cancer care,
2. To describe providers' experiences and practices with communication around adverse events and errors in cancer care,
3. To develop practical recommendations, provider training materials and patient educational materials for improving communication around adverse events and errors in cancer care,
4. To disseminate the recommendations and materials through three health plans, and 5. To conduct a preliminary evaluation of the perceived usefulness and impact of the materials.

For more information, please contact:

Kathy Mazor, Kathy.Mazor@meyersprimary.org Thomas Gallagher, thomasg@u.washington.edu

Discovery Core:

James W. Dearing, PhD, Chair, CCRC, IHR, KPCO

The purpose of the Discovery Core is to identify, document and assess organizational efforts, big and small, for improving communication related to cancer care. We will:

• Identify and classify innovations from within the 14 CRN institutions related to cancer communication for the sharingg of lession with healthcare systems generally.
• Assess patient and provider perceptions of cancer communication innocations in terms of compatibility, effectiveness, cost, trailability, and obersvability.
• Measure unit-level climate and organizational-level culture for determining readiness for change, capacity for changes, and barriers to change;
• Measure informal influence structures via social network ananlysis as a means to create sociometic baseline data-sets so that network position can be used as a formative indicator of where to find and recruit opinion leaders for affecting the rate and reach of cancer communication innocations..
• Help with the Design of demonstrations as a means of sharing the processes and results of innovations in cancer communication.

Proposals Submitted with Decision Pending:

1. Feasibility Study of the Cancer Survival Query System (CSQS).  Competitive Revision proposal to NCI (2 yrs).  James Dearing, PI, Kaiser Colorado.

-not funded

2. A Multi-State Smokers' Quitline for Asian Language Speakers.  R21 proposal to the CDC.  Shu-Hong Zhu, PI, University of California, San Diego.  James Dearing, site PI, Kaiser Colorado.

- funded

3. Comparative Effectiveness of Cancer Care Delivery Organizations: A Natural Experiment. R01 proposal to NCI (5 yrs).  James Dearing, PI, Kaiser Colorado.

- to be reviewed Oct. 8-9

4. Disseminating the CHESS EHealth Breast Cancer Support Intervention in Population-Based Care (CHESS CR). Competitive Revision sub to Wisconsin CECCR (2 years) to NCI.  Suzanne Pingree, PI, University of Wisconsin.  Alex Menter, site PI, Kaiser Colorado.

5. Disseminating the CHESS EHealth Breast Cancer Support Intervention in Population-Based Care (CHESS R01).  R01 sub to Wisconsin CECCR (3 years), to NCI.  Suzanne Pingree, PI, University of Wisconsin.  Alex Menter, site PI, Kaiser Colorado.

6. Development of an Online Dissemination Planning Tool (D-RIG).  Administrative Supplement proposal to NCI (2 yrs).  Borsika Rabin, PI, Kaiser Colorado.

- funded: start date 8/1/2009

7. Designing for Dissemination of BIG-HEALTH Innovations (BIG-Health).  Contract proposal to NCI (2 yrs).  James Dearing, PI, Kaiser Colorado.

8. Validation of HINTS Patient-Centered Communication Measures with Cancer Patients in a Managed Care Setting (HINTS).  Contract proposal to NCI (2 yrs). Russ Glasgow, PI, Kaiser Colorado.

9. Understanding Serious Adverse Communication Events in Oncology.  (Affiliated R01 proposal to NCI.)  Kathy Mazor, PI, MPCI and Tom Gallagher, PI, UWashington.

Developmental Projects:

Colorectal Cancer Screening Health Communication, Health Literacy, and Acculturation for Latinos in a Managed Care Organization

Bridget Gaglio, MPH, PhD, PI, Kaiser Colorado

This study will expand a current study testing health literacy and orally transmitted health messages (HL-O, Mazor, PI) to a Latino population. Additional goals are to conduct a preliminary analysis of Latinos’ knowledge, attitudes and beliefs towards colorectal cancer screening to inform future interventions testing prevention and screening messages tailored to this population, and to contribute to the CCRC focus on optimizing communication processes with Latino patients.

• Publications Related to this Project

Improving Physician-Parent Communication to Reduce Home Medication Errors and Improve Adherence in Children

Kathleen Walsh, MSC, PI, Fallon Clinic

The goal of this study is to inform and activate parents, and support self management of complex medication regimens in outpatient pediatric cancer care.  Specifically we will assess parent understanding of instructions about home medication regimens for children with cancer; assess how the level of understanding of those regimens affects home medication errors and nonadherence; develop an intervention to improve parents’ understanding of instructions; and assess the feasibility of disseminating this communication tool using the RE-AIM framework.

• Publications Related to this Project

Dissemination Core:

Borsika Rabin, MPH, PharmD, PhD, Chair CCRC, IHR, KPCO

The purpose of the Dissemination Core is to maximize the relelvance of the Cancer Communication Research Center activities to clinical practice. to accomplish this overall goal, the Disemination Core will:

• Serve as a resource to research projects concerning partnership relationships with medical practices, design and evaluation, and dissemination;
• Participate in measurement and data harmonization activities that emphasize issues central to patients and practitioners and disseminate findings/lessons learned;
• Identify, develop, apply and disseminate tools and materials to facilitate translation of research finding into practice;
• Consult on the development of additional proposals with a dissemination and implementation research focus, and provide training in dissemination research and
• Apply dissemination and implementation science to inform future intervention research and measurement methods in managed care organizations and medical practices of all sizes.

Proposals In Development:

1. Using StoryCorps to Increase Minority Recruitment into Clinical Trials.  R01 proposal for NCI.  Matthew Kreuter, PI, Washington University; Diane King, Site PI.  To be submitted Oct 5, 2009.

2. Developing New Cancer Control and Population Sciences Researchers.  Administrative supplement to NCI.  Larissa Nekhlyudov , PI, Harvard Pilgrim, David Price, Site PI, Kaiser Colorado.

3. Developmental Research Projects.  Administrative supplement.  Sarah Madrid, PI, Kaiser Colorado.