NCI-funded study aims to decrease care inequities for African-Americans with cancer

A five-year national study now underway in Greensboro, N.C., and Pittsburgh attempts to determine whether technology and other tools can ensure that African-Americans being treated for breast and lung cancer receive the same level of care as their white counterparts.Earlier work by this research team has shown that more white Americans than African-Americans are diagnosed with breast and lung cancers, but African-Americans disproportionately die from these diseases.

Eugenia Eng, DrPH, professor of health behavior at UNC Gillings School of Global Public Health, is co-principal investigator of the study, called Accountability for Cancer Care through Undoing Racism and Equity (ACCURE). Funded by the National Cancer Institute, ACCURE is a collaboration of The University of North Carolina at Chapel Hill (UNC), The Partnership Project Inc., Cone Health and the University of Pittsburgh Medical Center (UPMC). The study will be based at the UNC Center for Health Promotion and Disease Prevention, where Eng is a research fellow.

Eng says the study team will employ community-based participatory research (CBPR), a methodology that engages academic ‘experts’ in collaboration with community members to address a community’s health challenges.

“It is critical that we lead this study equitably and in partnership, using the CBPR approach, if our findings are to be relevant for the communities in which we hope to have positive impact,” Eng says.

ACCURE aims to optimize transparency and accountability to achieve racial equity in the completion of cancer treatment among patients with early-stage breast and lung cancer. Patients are encouraged to be more proactive in analyzing power and authority within the health-care system and to work with a patient navigator, who has comprehensive training in cancer issues, health literacy and communication techniques.

Health care providers will receive information about patients’ progress and will flag any treatment disparities. A real-time electronic registry will alert caregivers when a patient has dropped out of care so that contact can be established and care can be resumed.

“Our previous pilot research data indicates that African-American women would appreciate additional time with providers to understand more about their cancer diagnosis, which is why our ACCURE Navigator position will be so powerfully helpful,” said Nora Jones, MS, community-based principal investigator and executive director of The Partnership Project Inc.

In addition to decreasing racial disparities among cancer patients, ACCURE also has potential to define technologies that could help resolve disparities in cancer and other chronic illnesses – as envisioned by the American Association for Clinical Oncology in its Rapid Quality Reporting System– and to create sustainable change within cancer care systems.

“We are hopeful that our approach to using interventions that include race-specific data feedback and [quality improvement] techniques for provider groups will improve outcomes for all patients and close the gap experienced by African-American patients and other underserved ethnic groups,” said Sam Cykert, MD, co-principal investigator. “Our systems-level approach has potential to reduce racial disparities in 1,500 cancer centers affecting 1.4 million patients annually.”

 

Cykert is professor of medicine in the UNC medical school, associate director of medical education for the N.C. Area Health Education Centers (AHEC) Program and clinical director of the N.C. Regional Extension Center for Health Information Technology.This study is a continuation of exploratory research conducted by the Greensboro Health Disparities Collaborative between 2006 and 2009. The earlier project sought to understand more about the reasons for disparities between African-Americans and whites who were diagnosed with breast cancer. The Collaborative’s mission is to establish structures and processes that respond to, empower and facilitate communities in defining and resolving issues related to disparities in health.

“One of our core values at Cone Health is caring for our community, says Skip Hislop, site principal investigator and vice president of oncology services for Cone Health Systems. “This study strengthens and deepens our commitment to providing exceptional care to all.”

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UNC Gillings School of Global Public Health contact: Linda Kastleman, communications editor, (919) 966-8317 or linda_kastleman@unc.edu.