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
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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 statewide 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 practicebased 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.