American Indians and Alaska Natives (AI/AN) have the highest cancer mortality rates of any racial group in the United States. Cancer is the second leading cause of death for the AI/AN population and one of the leading causes of premature death in this population. The overall objective of this Phase I SBIR project is to study the feasibility and acceptability of a mobile- and web-based system to support cancer coordination in Native American communities. Following a user-centered design approach, we will develop a novel tool expressly designed for community health representatives (CHRs) who are primarily tasked with delivering educational information and guidance to members of the Navajo Nation who have or are at high risk of cancer. While CHRs have been found to be critical to raising cancer health awareness and promoting health literacy, a gap remains in care coordination. Culturally appropriate care coordination support will be designed and built on existing mobile tools currently used by this workforce to connect the care team directly with patients and to allow for streamlined, safe and secure communication. Work in this Phase I will be used to determine how to develop the interfacing between the care team and patients. In Aim 1, we will conduct 20 formative interviews with key informants, stakeholders and potential end users, such as oncologists, primary care providers (PCPs), and Navajo Nation patients to understand how the proposed technology can be designed to directly support existing cancer care coordination processes. We will develop user stories and personas to capture the process. In Aim 2, we will build off of Aim 1 and design a prototype of the system that will be reviewed by a panel of Navajo cancer survivors and families using a walkthrough method. In Aim 3, we will conduct usability testing with another cohort of target end users (5 CHRs, 5 breast cancer patients, 5 colorectal patients) to assess feasibility and usability of the prototype. The system will be built on a community-based health framework focusing on follow-up care for breast and colorectal cancer survivors after the point of diagnosis. Results from this project will go towards the future development of novel, culturally-appropriate technologies designed to promote collaboration and coordination between cancer patients and at-risk cancer patients, CHRs, oncologists, PCPs, and other cancer care team members in Navajo Nation. This innovation has high public health significance with the potential to serve other Native American communities across the US.
Public Health Relevance Statement: PROJECT NARRATIVE Native American communities suffer from cancer mortality at a disproportionate rate compared to other racial groups in the United States. In this Phase I SBIR, we will employ a user-centered design approach to develop and demonstrate the acceptability and feasibility of an innovative mobile- and web-based system, COPECare, for Navajo Nation patients who have been recently diagnosed with breast and/or colorectal cancer. COPECare will be designed to comprehensively support cancer care coordination between cancer patients, community health representatives (CHRs), primary care clinics, and cancer centers.
NIH Spending Category: American Indian or Alaska Native; Behavioral and Social Science; Bioengineering; Breast Cancer; Cancer; Clinical Research; Colo-Rectal Cancer; Digestive Diseases; Health Disparities; Health Services; Minority Health; Prevention; Rural Health; Women's Health
Project Terms: Address; Alaska Native; American Indians; Awareness; base; Breast Cancer Patient; cancer care; Cancer Center; Cancer Family; Cancer Patient; cancer prevention; cancer risk; Cancer Survivor; cancer therapy; care coordination; care providers; Caregivers; Caring; Cause of Death; Cessation of life; Clinic; Clinical; cohort; colon cancer patients; Colorectal; Colorectal Cancer; commercialization; Communication; Communities; community based care; Community Health; Continuity of Patient Care; Coordination and Collaboration; Data Collection; data sharing; design; Development; Diagnosis; early screening; Educational Curriculum; Ensure; expectation; Family member; Feasibility Studies; Feedback; follow-up; Future; Goals; Guidelines; Health; health care availability; health care delivery; health literacy; Health Personnel; Health Promotion; Health system; High-Risk Cancer; Hospitals; Incidence; informant; innovation; Interview; Life; Linguistics; Link; Logistics; malignant breast neoplasm; Malignant Neoplasms; member; men; Methods; mobile application; Modeling; mortality; Native Americans; Navajo; novel; Oncologist; Online Systems; Participant; Patient Care; Patients; Perception; Performance; Pharmacists; Phase; Population; premature; Primary Health Care; Process; prototype; Public Health; Public Health Nursing; Race; Recommendation; recruit; screening; Secure; Series; Small Business Innovation Research Grant; Specialist; Structure; Survivors; survivorship; System; Systems Integration; Technology; technology development; Testing; Time; tool; United States; United States Dept. of Health and Human Services; usability; user centered design; web app; Woman; Work
