Project Description
Cultural Adaptation of a Serious Illness Communication Intervention for Latinx Patients with Advanced Cancer at a Public Safety Net Hospital
Disparities in the quality of serious illness communication contribute to inequitable care of Latinx patients with advanced cancer. Most serious illness communication interventions have been developed and validated among English-speaking white patients within an Anglo-centric cultural context. In order to achieve high quality care for Latinx patients with advanced cancer, research is needed to culturally adapt serious illness communication interventions to respond to the needs and preferences of Latinx patients. A leading intervention, Ariadne Labs’ Serious Illness Care Program (SICP), is being implemented at San Francisco’s public safety net hospital, Zuckerberg San Francisco General Hospital (ZSFG), through an existing initiative. I will collaborate with Ariadne Labs, the SICP implementation initiative at ZSFG, key community partners, and an expert mentorship team to: (1) Culturally adapt SICP components through community-based participatory research with stakeholders involved in serious illness conversations with Latinx cancer patients (e.g., patients, caregivers, interpreters, patient navigators, and oncology providers); (2) Identify the communication and decision-making research outcomes that are most relevant and important to stakeholders; (3) Evaluate the feasibility and acceptability of implementing the adapted SICP intervention at ZSFG and assessing the intervention using stakeholder identified outcomes. The proposed research will result in a communication intervention and outcome measurement approach that will promote high quality and equitable care of Latinx patients with advanced cancer. It will also lay the groundwork for a career development (K) award focused on developing and validating instruments to optimally evaluate the adapted intervention in the Latinx context. This will be followed by a multisite randomized trial of the adapted SICP in an R01 award. To prepare for this work, I will pursue structured training with the objectives of learning how to use community-based participatory research methods and deepening my knowledge of outcome measurement in serious illness communication research.
Bio
Rebecca
DeBoer, MD, MA is an Assistant Clinical Professor in the Division of
Hematology/Oncology at UCSF and a medical oncologist on faculty at
Zuckerberg San Francisco General Hospital. She received her BA in Human
Biology from Stanford University and her joint MD and MA in Medical Humanities
and Bioethics from Northwestern University, and wrote her master’s thesis on
The Ethics of Global Cancer Care and Control. She completed internal medicine
residency at the University of Chicago and a fellowship at the MacLean Center
for Clinical Medical Ethics. During her training, she conducted qualitative
research on cancer treatment decision-making in India and pursued clinical
oncology rotations in Uganda and Nigeria. After residency she worked as an
oncology clinician at a cancer center in Rwanda with the organization Partners
In Health. As a medical oncology fellow at UCSF, she led collaborative research
in Rwanda and Tanzania focused on serious illness communication, resource
allocation, and clinical guideline implementation. Her current
research focuses on improving the delivery of equitable cancer care to patients
with advanced cancer in the U.S. safety net setting.
Email: Rebecca.Deboer@ucsf.edu