Andrea M' Denicoff, RN, MS, CANP

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NCI Initiatives in Palliative Care for Cancer
Andrea M. Denicoff, RN, MS, CANP Coordinator for
Palliative Care Initiatives
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NCI Initiatives in Palliative Care

• IOM Report was a catalyst for action
• Developed an internal working group
• Conducted a grant portfolio analysis
• Held Partners in Palliative Care Meeting

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NCI Formed Working Group to Cut Across Extramural
Divisions
DCCPS
DCP
OD Offices
DCTD
NCI Palliative Care Working Group
Quality of Cancer Care Committee
ODDES
NIH EOL SIG
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NCI Initiatives to Improve Palliative Care for
Cancer

Increase Capacity of the Field
Patient and Caregiver Education

Continuing Education Programs
Integration of Palliative Care Research

Dissemination of Research
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Current NCI Education Initiatives

• Improve and integrate patient and family/
  caregiver education
• Integrate palliative care into professional
  education
• Increase awareness of funding opportunities for
  training

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Improve Palliative Care Content

• Reviewed education and information content
  utilizing the broad definition of palliative
  care.
• Conducted a palliative care content analysis of
  NCI materials to strategically plan improvements.

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Palliative Care Content Analysis

• 107 NCI publications were reviewed including
• Patient education publications (12)
• What You Need to Know About (25)
• Cancer.gov web pages (26)
• Physician Data Query (PDQ) patient and health
  professional summaries (44)

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Content Review Methods

• Publications were rated on the scale used in the
  review of medical textbook content by Carron,
  Lynn, Keaney, 1999
• Content absent or no mention (0)
• Content is present, but minimal ()
• Content is helpful, commendable ()

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Framework for Evaluating Content

• Utilized Ferrell et al, 1999 nine content
  domains
• Palliative care defined
• Quality of Life
• Pain
• Other symptom management
• Communication with dying patients and families
• Role/needs of family caregivers
• Death
• Issues of policy, ethics, and law
• Bereavement

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Content Analysis Results

• Minimal palliative care coverage was found in the
  publications reviewed

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Palliative Care Content Across the Cancer
Continuum
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Initiative to Improve NCIs Palliative Care
Content

• Goal Improve and integrate palliative care
  content with partner organizations. Promote and
  disseminate materials to our various audiences
  using the spectrum of communication and education
  vehicles.

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Short-term Strategies

• Completed new training for NCIs Cancer
  Information Service (CIS).
• Developed new end of life fact sheet for patients
  and caregivers.
• Evaluating current Pain products as they need
  to address pain across the continuum.
• Revising 2 publications Advanced Cancer and
  When Cancer Recurs

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Long-term Strategies

• Develop new palliative care materials along with
  partner organizations- NCIs Patient and Family
  Education Branch.
• Integrate palliative care training and content
  into NCIs Cancer Information Service.
• Integrate and improve the packaging and search
  capability of palliative care content on NCIs
  web site, cancer.gov.

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Health Professional Education Initiatives

• NCIs Professional Continuing Education Branch is
  beginning to partner with organizations to
  improve palliative care content in oncology.
• Increase reporting of clinical research results
  in symptom management across the continuum on
  clinical trials area of the cancer.gov web site.
• Integrate palliative care content within
  disease-specific content among PDQ summary
  statements.

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Increase Capacity of the Field

• Increase awareness of training and education
  funding that can be used to support expanding the
  palliative care field.
• Generate feedback about the understanding and
  barriers of NCIs training and education grant
  mechanisms.
• Survey of awareness of NCIs Cancer Education
  Grants, R25 mechanism.

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R25 Survey

• E-mailed 88 participants to complete a five-
  item, online survey 34 responded (39)
• Participants
• NCI-designated cancer centers
• Oncology and palliative care professional
  organizations
• Graduate nursing programs

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Results of R25 Survey (n34)

• 70 (n23) of respondents were aware of R25
  mechanism
• 43 of those (n10) were aware of the web site,
  http//cancertraining.nci.nih.gov
• 67 (n12) of respondents learned about this
  mechanism through a colleague
• 61 (n11) said they would serve as mentors to
  others
• 80 (n27) reported being interested in
  participating in a multi-disciplinary workshop

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R25 Survey Results Next Steps

• NCIs Cancer Training Branch considering a
  focused workshop in this area.
• Increase awareness and understanding of NCIs
  funding mechanisms for palliative care and
  symptom management training.
• Coordinate efforts with partner organizations on
  various funding mechanisms.

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Career Development Awards Comprehensive
Minority Biomedical Branch

• K08 Mentored Clinical Scientist Award for
  Underrepresented Minorities PAR 03-002
• K23 Mentored Patient-Oriented Research for
  Underrepresented Minorities PAR 03-006

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Mentored Patient-Oriented Research for
Underrepresented Minorities

• PAR-03-006 (K23)
• Provides an opportunity for research-oriented
  clinicians to obtain research skills required to
  become independent investigators.
• Must have health professional degree or
  equivalent, doctorally trained nurse, Ph.D. in a
  clinical discipline.
• Provides salary (fringe benefits), research
  development support and indirect costs.

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Career Development Awards

• Common Features
• US Citizen or non-citizen national
• Supports up to 5 years research training
• Minimum of 75 research effort
• Allowable costs include salary up to 75,000
  benefits RD costs up to 30,000
• PHS form 398/Research Career Award

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Overview of Award Process

• Select K-08 or K-23
• Contact Program Director Belinda Locke
• Lockeb_at_mail.nih.gov or 301-496-7344
• Submission Feb. 1, June 1, Oct. 1
• IRB June/July, Oct/Nov, Feb/March
• NCAB Sept/Oct, Jan/Feb, May/June
• Project Start Date Dec, April, July

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Continuing Education Programs
Patient and Caregiver Education

Increase Capacity of the Field

Increase, Improve, and Integrate Palliative Care
Education and Training in Oncology
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NCI must be a champion and promote the value of
palliative care education and research in oncology