https://openworks.mdanderson.org/sumexp23/1126/thumbnail.jp

Batalini, Felipe

Brandão, Gabriela

Carvalho, Bruno

Comini, Ana

George, Milan S

Hicklen, Rachel

Jorge, Carlos

Kann, Benjamin

Lin, John

Lowenstein, Lisa

Marinho, Alice

McNeill, Lorna

Miyawaki, Isabele

Moreira, Matheus

Nazer, Lama

Pessôa, Beatriz

Reis, Pedro

Silva, Caroliny

Xavier, Débora

English

OpenWorks @ MD Anderson

Background• Racial/ethnically minoritized populations have higher cancer mortality across nearly all cancer types.• Disparities in mortality occur due to persistent differential uptake of evidence-based practices (EBPs) across the cancer care continuum, from prevention to end-of-life.• Reducing disparities will require widespread adoption of effective and sustainable interventions to increase EBPs.• Numerous research studies have evaluated interventions to reduce disparities in EBPs, but to our knowledge, no review has systematically collated and characterized these studies.• Our findings will:• Serve as a comprehensive source on successful strategies to reduce disparities in cancer EBPs.• Highlight gaps in research. • Suggest future research directions and potential policy changes.Methods• Inclusion Criteria: USA-based intervention studies that aimed to improve the uptake, and reduce racial/ethnic disparities, of an EBP along the continuum: prevention (HPV vaccine), secondary prevention (i.e. screening/diagnosis), treatment, survivorship, and EOL care, published between January 1st, 2010 to June 30th, 2022.• We focused on HPV vaccines in the prevention continuum due to prior reviews on tobacco cessation, diet, and physical activity interventions.• Title/abstract and full-text reviews performed by two reviewers, with a third reviewer resolving discrepancies.• Included articles were tagged by cancer type and continuum area during full-text review. • Relevant data were collected by one reviewer via RedCap, with a second reviewer preforming random validations on collected data to ensure accuracy of data. • Our protocol used the PRISMA-ScR checklist and scoping review framework and is registered in OpenScienceFramework.ResultsConclusion• There exists a robust research concerning prevention and screening, but a scarcity of studies addressing treatment, survivorship, and end-of-life (EOL) care.• We observed limited research on hard outcomes and implementation outcomes, particularly concerning costs and sustainability, based on the available interim evidence.• Implementation outcomes play a vital role in ensuring the effectiveness and long-term sustainability of interventions outside the research setting.• Future research should utilize implementation outcomes to identify barriers and facilitators to the use of EBPs and interventions.Interventions Reducing Racial/Ethnic Disparities Across the Cancer Care Continuum: A Scoping ReviewMilan George1; Matheus Moreira; Gabriela Brandão; Bruno Carvalho; Ana Comini; Carlos Jorge; Beatriz Pessôa; Alice Marinho; Isabele Miyawaki; Pedro Reis; Caroliny Silva; Débora Xavier; Rachel Hicklen, MLS2; Lama Nazer, PharmD, BCPS; Felipe Batalini, MD; Benjamin Kann, MD; Lisa Lowenstein, PhD, MPH, RD2; Lorna McNeill, PhD, MPH2; John Lin, MD, MSHP21Rice University, 2The University of Texas MD Anderson Cancer CenterAcknowledgementsFig. 1: PRISMA Flowchart of Inclusion/Exclusion ProcessFig. 2: Articles by Cancer Care ContinuumFig. 3: Articles by Cancer TypeMG was supported by a NIH/NCI R25CA056452 educational grant award (Shine Chang, Ph.D., Principal Investigator).To conduct a scoping review of interventions to reduce racial/ethnic disparities in uptake of EBPs across the cancer care continuum from prevention to end-of-life, using an implementation science framework.Objective*Includes secondary prevention (i.e. screening/early diagnosis)*Some articles had more than one cancer type characterizedFig. 4: Progress on Data Extraction on InclusionsResults (cont.)Table 3. Implementation Science Characteristics: Interim ResultsDevelopment of Implementation Strategy# of Articles (n=28)Involvement of Stakeholders in Intervention Development/Evaluation 13Adaption of Intervention for the Target Population 17Tailored Intervention to Recipients/Deliverers11Evaluation of Implementation OutcomesAcceptability 7Adoption 3Appropriateness 3Costs 3Feasibility 3Fidelity 2Penetration 1Sustainability 0Outcomes and Interventions Utilized By Studies: Interim Results (n=28)Patient Educational ToolPatient NavigatorReminder ToolWarning EMR SystemWorkplace Training ProgramDecision Aid Tool Mailed ScreeningFinancial ReimbursementOther Patient-targetingOther Provider-targetingPrevention/ScreeningScreening Knowledge 2 0 1 0 0 0 1 0 0 0Screening Intention 3 0 1 0 0 0 1 0 0 0Screening Rate 1 0 1 0 0 0 1 0 0 0Adherence To Recommendation 1 0 1 0 0 0 0 0 0 0TreatmentKnowledge of Treatment 2 0 0 0 0 1 0 0 0 0Appointment Attendence 0 1 0 1 0 0 0 0 0 0Concordant Decision-making 2 0 0 0 0 2 0 0 0 0Time to Treatment 1 2 0 0 0 0 0 0 0 0Treatment Adherence 2 2 2 3 2 0 0 1 0 1Guideline-concordant Treatment 1 1 0 1 1 0 0 1 0 1SurvivorshipQuality of LIfe 2 0 0 0 0 0 0 0 1 0Physical Activity Level 1 0 0 0 0 0 0 0 0 0Supportive Care 1 0 0 0 0 0 0 0 1 0End-of-LifePPC Consult 0 0 0 0 1 0 0 0 0 0Other (Not listed above) 4 1 1 0 0 0 0 0 0 0

Interventions Reducing Racial/Ethnic Disparities Across the Cancer Care Continuum: A Scoping Review

https://openworks.mdanderson.org/cgi/viewcontent.cgi?article=1126&context=sumexp23

Interventions Reducing Racial/Ethnic Disparities Across the Cancer Care Continuum: A Scoping Review

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