Validation of Quality Measures for Patient-Centered Cancer Communication in Rwanda

PROJECT SUMMARY/ABSTRACT The burden of cancer is rising in Africa and mortality rates are high. A majority (70-80%) of patients present at advanced stages, and cancer care incurs substantial financial costs for families and healthcare systems. Even for potentially curable patients, effective treatment delivery is hampered by low adherence and retention in

care. In this context, patient-centered communication (PCC) offers an immediate opportunity to improve treatment outcomes, optimize resource utilization, and alleviate suffering. PCC means responding to individual patients’ perspectives and needs, involving patients in decision making, and providing emotional support.

Patients and clinicians in many African settings, including in Rwanda, have identified critical deficits in PCC and have called for a cultural shift toward patient-centered care. Empowering patients through patient-reported measures, and clinicians through communication skills training, has the potential for broadly impactful

improvements in PCC. A key barrier to progress in PCC research in African cancer care is the absence of context-appropriate measures of communication quality. Currently, no measures of clinical communication have been validated in an African cancer care context. This proposal addresses this gap by adapting,

validating, and piloting a patient survey of communication quality in Rwanda. Specifically, Dr. DeBoer aims to (1) adapt an existing patient survey, the Patient-Centered Communication in Cancer Care (PCC-Ca), based on input from Rwandan stakeholders; (2) establish psychometric properties of the adapted PCC patient survey in

Rwanda; and (3) conduct a feasibility pilot trial of the adapted PCC patient survey to evaluate a communication training intervention for clinicians in Rwanda. To achieve these aims, Dr. DeBoer will leverage her existing research partnership at Butaro Hospital in Rwanda and her prior work adapting a PCC clinician training

intervention for the Rwandan context. The proposed research will result in context-appropriate measures that can be used to evaluate a PCC clinician training intervention in a future R01 cluster randomized trial in Rwanda. This K08 award will support advanced training in implementation science and career development in

global oncology, organized around four training goals: (1) stakeholder-engaged research; (2) program evaluation; (3) interventional trial design; and (4) career development in global oncology. For each goal, Dr. DeBoer will complete coursework, fulfilling the UCSF Certificate in Implementation Science, as well as

mentored tutorials and experiential learning from research aims. An exceptional multidisciplinary team of mentors with an optimal balance of complementary expertise will guide Dr. DeBoer in achieving her goals. This training will position Dr. DeBoer for a successful independent research career as an implementation scientist

and leader in the emerging academic field of global oncology, advancing Dr. DeBoer’s ultimate objective of promoting global cancer equity by improving the quality of care for patients in East Africa and beyond. 1