Grant Number:	3R01CA282149-02S1 Interpret this number
Primary Investigator:	Van Cleave, Janet
Organization:	University Of Texas Hlth Sci Ctr Houston
Project Title:	Assessing and Enhancing Survivorship Care in Rural and Urban Patients with Head and Neck Cancer
Fiscal Year:	2024

ABSTRACT Thisapplication is being submitted in response to the Notice of Special Interest (NOSI) identified as "NOT-CA- 24-041." This proposed descriptive research aims to evaluate the processes, policies, and evaluation/assessment metrics of the head and neck cancer (HNC) survivorship care program at Memorial Hermann Health System and how these processes, policies, and evaluation/assessment metrics align with the recently developed National Standards for Cancer Survivorship Care. Memorial Hermann Health System provides cancer care for a diverse head and neck cancer (HNC) population residing in 13 counties (7 urban, 6 rural), offering a unique opportunity to evaluate differences across urban and rural populations. Cancer survivorship care programs are a core component of quality care for patients with HNC, who are treated aggressively with multi-modal therapies, increasing the HNC 5-year survival rate from 60% in 1995 to 69% in 2020, expanding the HNC survivor population to 522,846. This improved survival rate comes with a human cost of a profound symptom burden, leading to a lower quality of life and adverse events, such as hospitalizations, which significantly alter the trajectory of patients' lives. Evidence-based, multidisciplinary cancer survivorship care programs can markedly improve cancer survivors' quality of life and prevent premature death. Yet, many patients with HNC do not receive survivorship care. For patients living in rural areas, access to HNC cancer survivorship services may be even more limited and fragmented, creating disparities in HNC outcomes between urban and rural areas, with worse survival for the black rural population. Research to identify the gaps in policy, processes, and evaluation strategies of survivorship programs in healthcare systems serving rural populations is limited and critically needed to enhance HNC survivorship care. This proposed research addresses these gaps by obtaining a holistic view of the alignment of Memorial Hermann's HNC survivorship program with the National Standards for Cancer Survivorship Care using quantitative and qualitative research approaches. The study hypothesis is that patients with HNC residing in urban areas receive greater survivorship services than those residing in rural areas. The specific aims are: 1) Assess the alignment of head and neck cancer (HNC) survivorship care program at Memorial Hermann Health System with the National Standards for Cancer Survivorship Care using surveys; 2) Compare and contrast the extent to which the HNC cancer survivorship care program serves patients with HNC at Memorial Hermann Health System across urban and rural settings (n=250); and 3) Identify facilitators and barriers to accessing survivorship care by patients with HNC in urban and rural settings through interviews with patients (urban 3, rural 3), HNC Clinicians (urban 2, rural 2), and health system administrators (urban 2, rural 2). Ultimately, this proposed research will identify future strategies to enhance HNC survivorship programs serving patients in urban and rural settings.





None. See parent grant details.