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.