Abstract PO-076: Strategies to improve the reach of interventions to address inequities in cancer care: Results from a six-site initiative

• Published in: Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2020-12, Vol.29 (12_Supplement), p.PO-076-PO-076
• Main Authors: Barton, Debra L., Ghosh, Bidisha, Hamann, Heidi A., Percac-Lima, Sanja, Dobs, Adrian S., Naughton, Michelle J., Matthews, Roland P., Gabram-Mendola, Sheryl, Simon, Melissa A., Bueno, Yvonne, Moy, Beverly, Paskett, Electra D., Danner, Sankirtana M., Chen, Bingxin, Snyder, Robert J. Ploutz, Friese, Christopher R.
• Format: Article
• Language: English
• ISSN: 1055-9965; 1538-7755
• DOI: 10.1158/1538-7755.DISP20-PO-076

Introduction: Large segments of the United States population do not receive quality cancer care due to pervasive and systemic inequities. Disparate cancer care is associated with increased morbidity and mortality. Multi-component, multi-level interventions can address inequities and improve care, but only if they reach populations of interest. Intervention studies often under-enroll populations of interest, despite having an adequate eligible pool. Procedures: The Alliance to Advance Patient-Centered Cancer Care supports six grantees across the US to implement diverse multi-component (e.g., access, symptom monitoring, wellness, survivorship), multi-level (e.g., patients, clinicians, caregivers) intervention programs with the shared goals of reducing disparities, increasing patient engagement, and improving the quality of cancer care. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework informs the evaluation efforts across the six sites. An important first step is to reach and enroll individuals who are most in need of cancer screening or access to cancer treatment. Target populations across sites include underrepresented minorities (e.g., Black and Latinx persons), those who speak English as a second language, and rural residents. Each participating site defined the target population(s) for their program. The sites used four key strategies to reach their target populations, which included: lay and clinical navigators, community advisory boards, data algorithms to conduct eligibility screening from the electronic health record, and dynamic community-based participatory research approaches. For years 2018-2019, we evaluated the demographic characteristics of participants recruited to program interventions compared to the overall demographic characteristics of each site’s pool of potentially eligible participants. Summary data: Of 4,692 potentially eligible participants, the six sites have enrolled 1,880 participants to date. Below we report the proportion of individuals with selected characteristics from the total enrolled: Black adults: 39% enrolled, (n=733), Latinx adults: 23% enrolled, (n=432), English as second language speakers: 19% enrolled, (n=357), and rural residents: 25% enrolled, (n=470). These proportions were similar or exceeded the proportions observed across the entire pool of eligible persons. Specifically, of 4,692 eligible persons across all sites, 35% were Black adults, 19% were Latinx adults, 15% spoke E