Consultation Support for Diverse Rural Breast Patients
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Introduction: In past work, our team has helped patients prepare a list of questions (or Consultation Plan) before their meetings with breast care specialists. Now we understand that patients need help “drinking from the fire hose” when their doctors actually try to address all the issues raised. We discovered this when we conducted 6 focus groups and 5 interviews with 45 physicians, community health leaders, and survivors. These community representatives directed us to support patients during and after specialist consultations. They specifically identified audiorecording, note-taking, and debriefing as promising interventions to explore.
 
 
 
 
 
 
 
 Hypotheses: Our research question is “how can we help patients absorb, remember, and act upon the information and advice they get from breast specialists?” This question applies to patients at any stage of breast health, from prevention to metastatic follow-up. We are particularly focused on answering this question with regard to the significant Native American and Latina minorities in our counties, who may face cultural and language barriers in addition to the common rural challenges of poverty, geographic isolation, and health literacy. Our hypotheses are that we can successfully assess what key stakeholders would like to see by way of Consultation Support; design interventions that meet these requirements and that our health system can deliver; and test the acceptability of Consultation Support to doctors and patients.
 
 
 
 
 
 
 
 Methodology: First, we will interview 12 doctors, 12 patients, and 8 community health agency staff members. We will probe for very specific examples of what doctors, patients, or other people have said or done that helped or hindered patient understanding, recall, and decision-making. We expect that audiorecording, note-taking, and debriefing will emerge as critical success factors, but we hope to surface many others. We will circulate a summary Requirements Document for feedback and revision, and draft program specifications that address each requirement. Finally, we will test the resulting Consultation Support service with 18 diverse breast patients and their doctors to determine its acceptability.
 
 
 
 
 
 
 
 Innovative elements: Recently, breast patients are increasingly advised to “take a tape recorder” and “bring a friend along to take notes for you.” This common-sense advice has even been evaluated in urban teaching hospitals and cancer centers, and has proven effective in increasing patient satisfaction and knowledge. However, no one has evaluated and implemented such Consultation Support in rural areas with diverse populations. Our project also stands out in its focus on Native American and Latina minorities, and our ability to leverage our existing Consultation Planning study.
 
 
 
 
 
 
 
 Community involvement: 45 community members provided input to the development of this proposal, as well as 60 resource center board members, advisers, staff, and volunteers. We will also carry over from our existing grant the 24-member, bi-county Advisory Board that helps us with outreach and community relations. In general, our two resource centers serve as clearing-houses for information and support to breast patients and are fully integrated into the county health systems. We have established formal or informal relationships with primary care networks and specialty clinics, and with minority-focused agencies such as United Indian Health Services and Latino Net in Humboldt, and Consolidated Tribal Health Project and Nuestra Casa in Mendocino. We have secured 43 letters from community representatives pledging their collaboration.