R01CA296021

CONVERSATIONAL AGENT TO IMPROVE GUIDELINE CONCORDANT CARE FOR PEOPLE WITH CERVICAL CANCER SCREENING ABNORMALITIES - PROJECT SUMMARY / ABSTRACT CERVICAL CANCER IS ALMOST ENTIRELY PREVENTABLE WITH APPROPRIATE SCREENING AND MANAGEMENT OF ABNORMAL RESULTS, YET IN THE US, OVER 14,000 INDIVIDUALS WERE DIAGNOSED WITH CERVICAL CANCER IN 2023, AND OVER 4,000 DIED. BLACK, HISPANIC, AND LOW-INCOME INDIVIDUALS HAVE HIGHER CERVICAL CANCER INCIDENCE AND MORTALITY. OVER 20% OF THOSE DIAGNOSED WITH CERVICAL CANCER DID NOT RECEIVE APPROPRIATE DIAGNOSIS AND TREATMENT AFTER AN ABNORMAL RESULT. THE FDA APPROVED HPV SELF-COLLECTION, A NEW FORM OF SCREENING, IN MAY 2024. SELF-COLLECTION WILL EXPAND ACCESS TO SCREENING, BUT INCREASES BY NEARLY TWOFOLD THE NUMBER OF PATIENTS REQUIRING IMMEDIATE FOLLOW-UP AFTER AN ABNORMAL RESULT. FEAR OF CANCER, POOR COMMUNICATION, AND DIFFICULTY SCHEDULING FOLLOW-UP APPOINTMENTS WERE KEY BARRIERS. EMBODIED CONVERSATIONAL AGENTS (ECAS) ARE ANIMATED COMPUTER CHARACTERS THAT SIMULATE FACE-TO-FACE CONVERSATION BETWEEN A PATIENT AND A CAREGIVER, USING BOTH VERBAL AND NONVERBAL CONVERSATIONAL BEHAVIOR, TO PROVIDE A NATURAL AND INTUITIVE COMPUTER INTERFACE THAT IS ACCESSIBLE TO PATIENTS OF ALL LEVELS OF HEALTH AND COMPUTER LITERACY. WE HAVE SUCCESSFULLY DEVELOPED AND EVALUATED THIS INTERFACE IN SEVERAL CLINICAL TRIALS TO MOTIVATE HEALTH BEHAVIOR CHANGE FOR A WIDE RANGE OF POPULATIONS, INCLUDING A PILOT EVALUATION OF AN ECA THAT PROMOTES HPV VACCINATION FOR THE FAMILIES OF PATIENTS WITH CERVICAL PRE-CANCER AND CANCER. IN THIS PROJECT WE WILL ADAPT THIS TECHNOLOGY TO PRODUCE ENGLISH AND SPANISH SMARTPHONE ECAS FOR FOLLOW-UP OF ABNORMAL CERVICAL CANCER SCREENING RESULTS (ECA-CCSA). THE ECA WILL PROVIDE FOLLOW-UP RECOMMENDATIONS AND MOTIVATIONAL INTERVIEWING TO PATIENTS WITH ABNORMAL SCREENING TEST RESULTS AND WILL FACILITATE COMMUNICATION WITH CLINIC STAFF. FOLLOW-UP PROMOTION OVER TIME CAN LEAD TO COMPLETION OF NEEDED TESTING AMONG THOSE WITH BARRIERS, AND THE ECA CAN CONDUCT REPEATED CONVERSATIONS WITH PATIENTS BOTH PRIOR TO AND FOLLOWING CLINIC VISITS. WE WILL EVALUATE ECA-CCSA IN A RANDOMIZED CONTROLLED TRIAL FOR PATIENTS AGED 21 AND OLDER WITH ABNORMAL SCREENING TEST RESULTS TO EVALUATE ECA-CCSA, COMPARING USUAL CARE (UC) VERSUS USUAL CARE PLUS THE ECA (UC + ECA-CCSA). THE RESEARCH TEAM IS NATIONALLY RECOGNIZED AS LEADERS IN CERVICAL CANCER PREVENTION, HEALTH LITERACY, AND INNOVATIVE TECHNOLOGIES TO IMPROVE HEALTH. THIS STUDY WILL ADVANCE OUR RESEARCH ON THE DEVELOPMENT OF EASY-TO-USE TECHNOLOGIES TO EMPOWER PATIENTS. THIS SCALABLE APPROACH HAS SIGNIFICANT POTENTIAL TO INCREASE FOLLOW-UP AFTER AN ABNORMAL SCREENING TEST RESULT, WHICH IS TIMELY AS CLINICAL SETTINGS ARE CURRENTLY ADOPTING HPV SELF-COLLECTION TECHNOLOGIES. IF SUCCESSFUL, OUR TEAM WILL PROMOTE THE ECA-CCSA THROUGH NATIONAL NETWORKS FOR BROAD IMPLEMENTATION AND WORK TO ADAPT ECA-CCSA TO OTHER LANGUAGES AND SETTINGS.

Tufts Medical Center Parent

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS, (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION, (3) EPIDEMIOLOGY, (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS, (5) IMMUNOLOGY AND VACCINES, (6) FIELD STUDIES AND STATISTICS, (7) CANCER CHEMOPREVENTION AND INTERCEPTION, (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT, (9) ORGAN SITE STUDIES AND CLINICAL TRIALS, (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES, AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO STIMULATE TECHNICAL INNOVATION, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

Massachusetts United States

State-Wide

Innovative Approaches to Studying Cancer Communication in the New Information Ecosystem (R01 Clinical Trial Optional) (PAR-22-164)