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CANCER PREVENTION AND CONTROL RESEARCH NETWORK
COLORADO SITE ACTIVITIESFALL 2010
ADVISORS:GINGER BORGES
TIM BYERSLORI CRANE
JEAN KUTNERAL MARCUS
JACK WESTFALL
INVESTIGATORS:BETSY RISENDAL
KRISTIN KILBOURNKATHY JANKOWSKI
BILL THORLAND
PROJECT DIRECTOR: ANDREA DWYER
University of Colorado at Denver
Overall Goal
“Promote the long-term health and well-being of cancer survivors by facilitating
the delivery and uptake of evidence-based, sustainable strategies at the
patient, provider, system, and community level.”
Cancer Survivorship
Cancer survivors are at increased risk for co-morbidities and new cancers
Late and long-term side effects require ongoing surveillance
Psychosocial morbidities are common in this population
Specialty care needs such as fertility, genetic counseling, and physical therapy are also common
Emerging evidence suggests that physical activity and weight management are important in reducing risk of recurrence and managing side effects
A time of opportunity….
Communication and coordination between the patient, provider, and community to properly address these issues are therefore of keen interest in cancer survivorship.
Primary care well-situated to coordinate these health issues in this population, with input from Oncology
Patient-centered medical home provide incentives and infrastructure for coordination of quality cancer survivorship care
Self-management is a key component of both Patient-Centered Medical Home and Chronic Care Models (“How do I talk to my family doctor about my cancer diagnosis?” What do I need to know as a cancer survivor about my health and healthcare?”)
Chronic Disease Self-Management Program (CDSMP)
Facilitating the translation, implementation, and dissemination of this
evidence-based strategy to cancer survivors in Colorado.
Key components: Six week educational intervention Peer-led Produces measurable changes in self-efficacy, physical activity, and
trend toward reduction in hospitalizations and cost effectiveness
Evidence-based, recommended by Surgeon General Promotes physical activity through CDC recommended strategies
such as goal setting and social support Community-based and embedded in several healthcare systems
(0ver 300 trainers in Colorado) High fidelity (Master Trainer and Lay Leader, must be certified to
deliver, manual)
Partnerships
Cancer survivors throughout ColoradoDr. Kate Lorig (Professor, Stanford, creator of
CDSMP)Consortium for Aging and Wellness (holds
state-wide license, multiple collaborators throughout state including 320 certified trainers)
Initial discussions with CDPHE, Texas A&M about dissemination
Plans and Activities Underway
First training of cancer survivor leaders in U.S. to take place in Colorado (Jan 2011) with Dr. Lorig and Dr. Rick Seidel (UVa, currently piloting the program)
CPCRN mini grant to COAW to recruit trainers and facilities
Randomized controlled trial of curriculum to demonstrate effectiveness in cancer survivor (new target population)
Project WIN (What is Next) – Cancer “Transition” Healthcare Delivery
Partnership with healthcare providers and public health to facilitate transition care and health promotion strategies to cancer survivors
Key components Series of billable group medical visits led by primary care in
partnership with oncology, with cancer survivor themes Group medical visits as a model of care delivery has been
successfully used in geriatrics, diabetes in primary care setting, with cancer patients such as with prostate cancer seed implementation
Deploys evidence-based strategies of goal setting, social support, and tailored one-on-one counseling for increasing physical activity
Emphasis on preventive/primary care including cancer prevention and control screenings
Patients will complete a Survivorship Care Plan Multi-disciplinary, coordinated care delivery (PT, Psychology,
Primary Care, Oncology, Nutrition providers) billable under high level provider
Uses social marketing theory and is “problem-focused” rather than “information driven”
Partnerships
Clinical “Champions” at the University of Colorado Cancer Center and Hospital as well as Providers throughout Colorado
Coordination with LAF Center of Excellence/THRIVE Clinical Team (Survivorship Clinic at UCH)
Area Health Education Centers and Practice Based Research Networks in Colorado (eventual)
Cancer survivors throughout Colorado
Plans and Activities Underway
Clinical leadership team sets goals and content for visits
Developing Facilitator Guide for high fidelity dissemination
Coordinate with Oncology to implementDisseminate through Practice Based
Research Networks in Colorado (High Plains Research Network – also leader in CRC dissemination)
Additional Efforts
R25 submitted 9/2010 to provide cancer survivorship education to primary care practice-based research networks in Colorado
Survivorship Survey and Scoping Study -Colorado site specific activity but based on interest in effort has grown to a workgroup activity.
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