PO.CL04.02 · 临床研究

一种整合本土知识体系(IKS)的统一生物社会与数字健康模型，用于减少印度农村地区的癌症差异

A unified Indigenous Knowledge System (IKS)-integrated biosocial and digital health model to reduce cancer disparity in rural India

编号 2473 展板 3 时间 4/20 09:00–12:00 区域 Section 42 主讲 Rupam Das, MA

分会场 Community-Engaged Approaches to Equity Across the Cancer Journey: From Prevention to Trial Design

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作者与单位 Authors & Affiliations

Rupam Das¹, Lekhika Pathak², Shirsajit Mitra², Tulika Sarma³, Chayanika Das³, Upasha Sarmah², Riya Kanodia², Partha Saikia², Sonali Das⁴, Manisha Canteenwala⁴, Mallika Maral³, Nayan Bhattacharjee⁵, Hem Bhai⁵, Uday Shanker Dixit¹, Bikul Das²

¹Center of Indian Knowledge System, Indian Institute of Technology, Guwahati, India,²Department of Medical Humanity, KaviKrishna Laboratory, Guwahati, India,³KaviKrishna Telemedicine Care, Sualkuchi, India,⁴Department of Medical Humanity, Thoreau Lab for Global Health, Lowell, MA,⁵Center of Indian Knowledge System, KaviKrishna Laboratory, Sualkuchi, India

摘要 Abstract

中文摘要

背景：通过长达三十年的社区参与式行动研究(CBPAR)(参考文献1)，我们正在研究癌症差异。自2010年以来，"KaviKrishna Satra"项目通过基于本土知识体系(IKS)的社会网络框架(参考文献2)、运用民族志+现象学(参考文献3)以及pancha-padika教育(1-2)，构建了一个长期的癌症差异研究平台。我们正在开发一种基于IKS的数字化干预措施(KaviKrishna HealArt应用程序+Nigudah瑜伽+营养+焦点小组讨论/FGDs)，以及一套植根于吠陀Jiva Upakara Cikitsha Tantra(一种基于Avatar-Kosha的生物社会疗愈体系)的生物社会韧性量表(Sahasa-Ojash)(参考文献1和4)。我们假设印度农村地区的癌症差异是一种生物社会现象，可以通过结合基于IKS的沟通体系、数字健康连接以及社会心理关怀来减少。方法：我们通过家访、访谈、FGDs以及临床医生互动分析，绘制了200名农村癌症患者的社会支持网络，以检测通过CBPAR形成的基于IKS的沟通体系的出现。我们在前35名患者中测量了Sahasa-Ojash，并将通过Heal-Art应用程序对全部200名患者进行纵向测量，以进行持续的生物社会分析。我们还评估了照护的连续性(按计划随访的依从性、治疗完成情况以及12个月内远程医疗联系的持续性)。结果：整合的数字-IKS干预产生了可测量的生物社会和临床影响：1)干预后Sahasa-Ojash增加了2-3倍(平均增幅，p = 0.065；因样本量原因趋向显著)。2)疲劳和失眠减少了35-45%(p = 0.046)，而食欲增加了50-60%(p = 0.032)。3)通过KaviKrishna HealArt应用程序，治疗依从性和随访连续性提高了3倍。4)初步IKS网络分析显示，类似于历史上IKIN结构的本土社会沟通途径得到重新激活，改善了患者导航和信任。5)患者报告心理韧性增强、自我照护改善以及与肿瘤科医生的沟通得到改善。6)临床合并症减少(贫血、血压波动和胃肠道紊乱)。这些生物社会方面的获益与照护连续性提高3倍、化疗完成率提高以及治疗脱落率显著降低相关。结论：我们开发了一种统一、可扩展且经济高效的整合IKS的癌症差异模型，该模型运用民族志和现象学绘制生物社会决定因素。 (1). https://doi.org/10.1158/1538-7445.AM2024-1005 (2). https://doi.org/10.1158/1538-7445.AM2019-3342 (3). https://doi.org/10.1158/1538-7445.AM2024-807 (4). https://zenodo.org/records/8062404

查看英文原文 English abstract

Background: Through a three decades of community based participatory action research (CBPAR) (Ref.1), we are studying cancer disparity. Since 2010, the "KaviKrishna Satra" program has developed a long-term cancer disparity research platform through an Indigenous Knowledge System (IKS)-based social-network framework (Ref.2) and using ethnography + phenomenology (Ref. 3), plus pancha-padika education (1-2). We are developing a digital IKS-based intervention (KaviKrishna HealArt App + Nigudah Yoga + nutrition + Focussed group discussions/FGDs) and a biosocial resilience scale (Sahasa-Ojash) rooted in Vedic Jiva Upakara Cikitsha Tantra, an Avatar-Kosha-based biosocial healing system (Ref. 1 & 4). We hypothesize that cancer disparity in rural India is a biosocial phenomenon that can be reduced by combining IKS-based communication systems, digital health connectivity, and psychosocial care. Methods: We mapped the social-support networks of 200 rural cancer patients through home visits, interviews, FGDs, and clinician-interaction analysis to detect the emergence of an IKS-based communication system through CBPAR. We measured Sahasa-Ojash in the first 35 patients, and will longitudinally measure all 200 patients through the Heal-Art app for continuous biosocial analytics. We also evaluated the continuity of care (adherence to scheduled follow-ups, completion of treatment, and persistence in telemedicine contact over 12 months). Results: The integrated digital-IKS intervention produced measurable biosocial and clinical impact: 1) Sahasa-Ojash increased 2-3-fold after the intervention (mean increase, p = 0.065; trend toward significance due to sample size). 2) Fatigue and insomnia reduced by 35-45% (p = 0.046), whereas appetite increased by 50-60% (p = 0.032) . 3 ) Treatment adherence and follow-up continuity increased 3-fold through the KaviKrishna HealArt App. 4) Preliminary IKS-network analysis showed reactivation of indigenous social-communication pathways resembling historical IKIN structures, improving patient navigation and trust. 5) Patients reported greater psychological resilience, enhanced self-care, and improved communication with oncologists. 6) Clinical co-morbidities decreased (anemia, hypertension fluctuations, and GI disturbances). These biosocial gains correlated with a 3-fold improvement in continuity of care, greater chemotherapy completion, and markedly reduced treatment dropout. Conclusion: We have developed a unified, scalable, and cost-effective IKS-integrated cancer disparity model that Maps biosocial determinants using ethnography and phenomenology. (1). https://doi.org/10.1158/1538-7445.AM2024-1005 (2). https://doi.org/10.1158/1538-7445.AM2019-3342 (3). https://doi.org/10.1158/1538-7445.AM2024-807 (4). https://zenodo.org/records/8062404

利益披露 Disclosure

R. Das, None.. L. Pathak, None.. S. Mitra, None.. T. Sarma, None.. C. Das, None.. U. Sarmah, None.. R. Kanodia, None.. P. Saikia, None.. S. Das, None.. M. Canteenwala, None.. M. Maral, None.. N. Bhattacharjee, None.. H. Bhai, None.. U. Dixit, None.. B. Das, None.

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