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A Community-Partnered, Evidence-Based Approach to Improving Cancer Care Delivery for Low-Income and Minority Patients with Cancer

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Abstract

Community-engaged adaptations of evidence-based interventions are needed to improve cancer care delivery for low-income and minority populations with cancer. The objective of this study was to adapt an intervention to improve end-of-life cancer care delivery using a community–partnered approach. We used a two-step formative research process to adapt the evidence-based lay health workers educate engage and encourage patients to share (LEAPS) cancer care intervention. The first step involved obtaining a series of adaptations through focus groups with 15 patients, 12 caregivers, and 6 leaders and staff of the Unite Here Health (UHH) payer organization, and 12 primary care and oncology care providers. Focus group discussions were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis. The second step involved finalization of adaptations from a community advisory board comprised of 4 patients, 2 caregivers, 4 oncology providers, 2 lay health workers and 4 UHH healthcare payer staff and executive leaders. Using this community-engaged approach, stakeholders identified critical barriers and solutions to intervention delivery which included: (1) expanding the intervention to ensure patient recruitment; (2) including caregivers; (3) regular communication between UHH staff, primary care and oncology providers; and (4) selecting outcomes that reflect patient-reported quality of life. This systematic and community-partnered approach to adapt an end-of-life cancer care intervention strengthened this existing intervention to promote the needs and preferences of patients, caregivers, providers, and healthcare payer leaders. This approach can be used to address cancer care delivery for low-income and minority patients with cancer.

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Acknowledgements

Research reported in this publication was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number K23MD013474. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Division of Oncology, Stanford University School of Medicine, 1070 Arastradero, Palo Alto, CA, 94305, USA

    Manali Patel

  2. Medical Services, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA

    Manali Patel & Nevedal Andrea

  3. Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, USA

    Manali Patel & Bhattacharya Jay

  4. Seattle Children’s Research Institute, Seattle, WA, USA

    Tumaini R. Coker

  5. Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA

    Tumaini R. Coker

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  1. Manali Patel
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Correspondence to Manali Patel.

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Authors Manali Patel, Jay Bhattacharya, and Tumaini Coker have received research funding from the National Institutes of Health. Author Andrea Nevedal has no conflict of interest to declare.

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Patel, M., Andrea, N., Jay, B. et al. A Community-Partnered, Evidence-Based Approach to Improving Cancer Care Delivery for Low-Income and Minority Patients with Cancer. J Community Health 44, 912–920 (2019). https://doi.org/10.1007/s10900-019-00632-x

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