Grant Details
Grant Number: |
6R21CA258105-02 Interpret this number |
Primary Investigator: |
Chow, Eric |
Organization: |
Fred Hutchinson Cancer Center |
Project Title: |
Improving Cancer Survivorship Care Delivery in Latino Survivors: Telehealth & Lay Health Educators |
Fiscal Year: |
2021 |
Abstract
PROJECT SUMMARY
In this R21 application, we address NCI’s Provocative Question #8 by proposing a pilot randomized clinical trial
to test an innovative strategy of using telehealth and bilingual lay health educators to provide linguistically and
culturally appropriate cancer survivorship care for Latinos. Latinos are now the largest minority population in the
US. However, compared with non-Latino Whites, they continue to experience significant disparities in cancer
care, including survivorship care. These disparities are attributable to a multitude of systemic and cultural factors
and contribute to a greater burden of cancer-related comorbidities and a lower quality of life. Factors that may
be amenable to interventions include disparities in patient-provider communication, due in part to language
barriers and limited culture competence among healthcare providers. Survivorship care plans (SCPs) may
improve patient knowledge of survivorship issues and improve coordination between oncology specialists and
primary care providers. They have been recommended by the National Academy of Medicine along with multiple
national and professional organizations. However, the delivery of SCPs in a comprehensive fashion has been
difficult, especially in under-resourced settings. Overall, research into the Latino cancer survivorship experience
has been limited, with few studies examining the impact of SCPs among Latino survivors. Most studies have
focused only on breast cancer survivors, and often feature resource-intensive oncology nursing or physician-led
interventions. To address these gaps in knowledge, we propose to recruit a mixture of urban and rural Latino
cancer survivors of the 5 most common cancer histologies (breast, colorectal, lung, lymphoma, and prostate)
from academic- and community-based oncology clinics in Washington State. Our specific goals are to determine,
in randomized fashion, the feasibility and preliminary efficacy of SCPs delivered using remote-based lay health
educators vs SCPs alone, with a focus on whether proximal outcomes (survivors’ knowledge of their cancer
history and their self-efficacy towards their follow-up care needs) can be improved. The proposal leverages NCI’s
Cancer Information Service, with its pool of survivorship-trained, bilingual, lay health educators. We also
propose, using a mixed-method approach, to obtain feedback from study participants (Latino cancer survivors)
via qualitative semi-structured interviews, and to assess their primary care providers’ knowledge and self-efficacy
regarding survivorship care. Finally, we will apply the Promoting Action on Research Implementation in Health
Services (PARIHS) implementation science framework to inform future implementation strategies to integrate
SCP delivery and more comprehensive survivorship care for Latino cancer survivors into routine care. The results
of this multi-level proposal will provide key preliminary data to inform the development and application of a larger,
robustly powered randomized clinical trial, as well as complementary strategies to facilitate the development of
effective and sustainable survivorship care for Latino cancer patients.
Publications
Feasibility of delivering survivorship care via lay health educators: A pilot randomized controlled trial among rural cancer survivors.
Authors: Duggan C.
, Cushing-Haugen K.L.
, Cole A.M.
, Allen J.
, Gilles R.
, Hornecker J.R.
, Gutierrez A.I.
, Warner J.
, Baker K.S.
, Ceballos R.M.
, et al.
.
Source: The Journal Of Rural Health : Official Journal Of The American Rural Health Association And The National Rural Health Care Association, 2023-01-02 00:00:00.0; , .
EPub date: 2023-01-02 00:00:00.0.
PMID: 36593127
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