Grant Details
Grant Number: |
3R01CA240092-03S1 Interpret this number |
Primary Investigator: |
Wheeler, Stephanie |
Organization: |
Univ Of North Carolina Chapel Hill |
Project Title: |
Examining the Relationship Between Spatial Accessibility to Care, Ft, and Hrqol Among Rural Cancer Survivors |
Fiscal Year: |
2021 |
Abstract
ABSTRACT
The proposed supplemental project leverages the existing survey design for Lessening the Impact of Financial
Toxicity (LIFT) Study (5R01CA240092-02) to examine the effects of financial toxicity on healthcare help-
seeking and care utilization among rural cancer patients. The parent grant funds a prospective study designed
to evaluate the implementation and effectiveness of a Financial Navigation (FN) intervention within rural
oncology settings in North Carolina, (1) leveraging key informant stakeholder interviews to produce process
maps to characterize the context of rural oncology practices; (2) offering training, technical support, and
coaching for financial navigators in rural oncology settings to improve FN implementation; and 3) evaluating
the effect of FN on FT, health-related quality of life (HRQoL), harmful care-altering behavior, program
acceptability, and responsiveness to patients’ concerns. Whereas the objective of the parent grant is to
evaluate the implementation and effectiveness of FN within rural oncology settings, the proposed supplemental
project leverages the research infrastructure developed by the team to further map out the effects of FT on
healthcare help-seeking among rural cancer survivors across five (5) intervention sites in rural North Carolina.
The proposed supplemental project seeks to adapt existing models of healthcare help-seeking to explain
healthcare access and utilization to understand how rural cancer survivors enrolled in a FN intervention in
North Carolina access care. The overall objective of the proposed supplemental study is to examine how FT)
and care access are experienced differentially by rural cancer populations. This supplemental project will link
the survey data with spatially-referenced data, including area-level characteristics, such as socio-economic
status, income, and racial/ethnic composition, as well as patient-level data, such as travel distances/times to
cancer care and routine (primary) care. The central hypothesis is that both FT and the spatial (in)accessibility
of healthcare modify rural cancer survivors’ healthcare use patterns. The central hypothesis will be tested
through three (3) aims: (1) To explore the relationship between FT and the spatial barriers to care prior to and
after receipt of cancer diagnosis and financial toxicity among rural cancer survivors (2) To analyze the
associations between spatial access to cancer care and level of FT among rural cancer survivors. (3) To
examine the relationships between FT, and care continuity among rural cancer survivors, controlling for spatial
access to care. The research proposed in this application is innovative, with a focus on adapting models of
access to health care to better address the experiences of rural cancer patients.
Publications
None. See parent grant details.