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					University of Colorado at Denver
  CANCER PREVENTION AND CONTROL RESEARCH NETWORK

             COLORADO SITE ACTIVITIES
                    FALL 2010

                         ADVISORS:
                      GINGER BORGES
                         TIM BYERS
                        LORI CRANE
                       JEAN KUTNER
                        AL MARCUS
                      JACK WESTFALL

                     INVESTIGATORS:
                     BETSY RISENDAL
                    KRISTIN KILBOURN
                    KATHY JANKOWSKI
                     BILL THORLAND

             PROJECT DIRECTOR:   ANDREA DWYER
                 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 Colorado
 Dr. 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 implement
 Disseminate 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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