Cancer Communications Initiative Expands into the Real World
After showcasing the culmination of their 5-year effort last spring in Atlanta, the NCI-funded Centers of Excellence in Cancer Communication Research (CECCR) initiative grantees are prepared for the next step of the initiative, CECCR II.
"We're taking the knowledge that we've gained and applying it in large-scale studies to existing health care systems in real world settings," said Dr. Matthew Kreuter, principal investigator of the Washington University CECCR in St. Louis.
During CECCR I, his team piloted a clinical tool using a touch screen computer tablet that allowed African American women to navigate a library of stories by their peers "to see whether, through the power of narrative, we can increase the quality of life-related outcomes and social support and adherence to follow-up treatment," he said.
Now they plan to have National Public Radio's Story Corps project come to the NCI-designated Siteman Cancer Center in St. Louis, MO, to record conversations between African American adult cancer survivors and their children. "We hope to use excerpts from those stories to build an educational tool using touch-screen computers for parents who are newly diagnosed that can help them think about how to talk with their kids about what their diagnosis means," he explained.
Another change in CECCR II - and a tremendous boost for the research infrastructure - is the addition of the Kaiser Permanente Colorado (KPC) health care system as a grantee, which will provide access to the Cancer Research Network (CRN) of 14 large health care delivery systems (HMOs) covering nearly 11 million individuals.
"The key perspective and experience that folks in this CRN will bring to CECCR is really an emphasis in organizational studies and organizational communications," explained Dr. James Dearing, principal investigator of the KPC CECCR, noting, "We focus on those instances where people are communicating about cancer within these complex organizations. This is both the bane and promise of managed care." The goal is to lessen "the missed hand-offs, the errors, and the frequent lack of coordination that occur" within large health systems, he said.
The addition of KPC and CRN to the CECCR II network is important for several reasons, said Dr. Bradford Hesse, who oversees the initiative and is chief of the Health Communication and Informatics Research Branch in NCI's Division of Cancer Control and Population Sciences.
"The science in cancer communications has matured across the entire cancer care continuum, and it's ready to start moving into serious effectiveness trials," he explained. "Health communications is going to get a lot of emphasis, especially in the new White House administration, which is focused on how to use electronic medical records and information technologies to improve patient-centered communications." Kaiser currently holds the largest private electronic medical records system in the world, with more than 8.6 million patient records in its collection.
Another real world application during CECCR II is a collaboration between Dr. Kreuter's center and the United Way's "211" national social services referral hotline. "We're taking very poor adults who call 211 needing help paying their electric or utility bills, or because they're being evicted or lost a job," he explained, "and we're proactively screening them for cancer risks. We then refer them to clinical preventive services in the community, where they can get a free mammogram, Pap smear, colonoscopy, smoking cessation counseling, or an HPV vaccine."
"Evidence-based communication approaches are essential for moving what we currently know about the prevention and treatment of cancer into practice," said Dr. Hesse. "This next round of CECCRs should help us take advantage of dramatic changes in biomedical communication to accelerate successes against cancer now."