Cancer survivors with ostomies, most commonly rectal and bladder cancers, face complex adjustment issues. Typically, post-operative care does not adequately prepare cancer survivors for ostomy self-management, behavior change, psychological support or healthy living, which is requisite to assure optimal Health-Related Quality of Life (HRQOL). We developed an ostomy nurse and peer ostomate-led post-treatment chronic care- based Ostomy Self-Management Telehealth program (OSMT). This program is an education and support curriculum delivered in the group setting for both cancer survivors and their caregiver/support person. We received positive pilot feasibility results, but encountered major access barriers in patients getting to a centralized location to participate in the program. Therefore, we are utilizing telehealth as a delivery method to improve cancer survivor ability to participate. For this study, we will target patients living in rural and other nonmetro areas. The proposal is a randomized controlled study of our self-management program delivered by telehealth intervention compared to an Attention Control Condition (ACC) group. We expect OSMT subjects will improve patient activation, self-efficacy, HRQOL and knowledge via: 1) techniques for self-management to handle frustration, fatigue, pain, isolation, equipment, social situations; 2) overcoming barriers to appropriate exercise; 3) communication skills; 4) nutrition, menu planning, meal timing. In addition, we hope to show a cost benefit to the program, and evidence of reimbursement in the community.
Aim 1 : Using our enhanced telehealth techniques, determine if patient activation (PA), self-efficacy, ostomy- related knowledge, and HRQOL are improved and sustained over time, comparing OSMT and attention control condition (ACC) groups in rural populations.
Aim 2 : Determine whether third-party reimbursement for telehealth care encounters are comparable to those for in-person visits and adequate for supporting our OSMT intervention in rural areas.

Public Health Relevance

Typical post-operative care does not adequately prepare cancer survivors for ostomy self-management, behavior change, psychological support or healthy living, which is necessary to assure optimal Health-Related Quality of Life. This chronic care-based Ostomy Self-Management Telehealth program, led by ostomy nurses and peer ostomates, is a patient/caregiver education and support program delivered via telehealth. Telehealth improves ability to participate, especially for cancer survivors with ostomies living in rural and other nonmetro areas.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA204193-02
Application #
9904567
Study Section
Clinical Management of Patients in Community-based Settings Study Section (CMPC)
Program Officer
Mitchell, Sandra A
Project Start
2019-04-01
Project End
2024-03-31
Budget Start
2020-04-01
Budget End
2021-03-31
Support Year
2
Fiscal Year
2020
Total Cost
Indirect Cost
Name
University of Pennsylvania
Department
Surgery
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104