A Role of Multilevel Healthcare Access Dimensions in Ovarian Cancer Disparities
多层次医疗保健获取维度在卵巢癌差异中的作用
基本信息
- 批准号:10394858
- 负责人:
- 金额:$ 49.46万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-02-01 至 2024-04-30
- 项目状态:已结题
- 来源:
- 关键词:AddressAdjuvantAftercareAmericanAreaAttitudeBlack raceCancer PatientCancer SurvivorCaringCommunity SurveysComplexCost SharingDataData SetDatabasesDevelopmentDimensionsEquationFatigueFinancial HardshipGuidelinesHealth PersonnelHealth Services AccessibilityHealthcareHospitalsKnowledgeLinkLocationMalignant NeoplasmsMalignant neoplasm of ovaryMediatingMedicareMental DepressionModelingNational Cancer InstituteNatureNeighborhoodsOperative Surgical ProceduresOutcomePainPatient Outcomes AssessmentsPatientsPatterns of CarePerceptionPharmaceutical PreparationsPlatinumPopulationPovertyProviderQuality of CareQuality of lifeRaceReportingResearch PersonnelResourcesRoleRuralSEER ProgramSamplingSocial supportSourceSpecialistSubgroupSupportive careSurveysSurvival RateSurvivorsSymptomsTimeTravelTrustTumor DebulkingWomanbarrier to carebaseblack patientblack womencancer carecancer health disparitycancer survivalcancer therapychemotherapycohortdifferences in accessdisparity reductionhealth care availabilityhealth care servicehealth care service organizationhealth literacyhealthcare acceptabilityimprovedinsightneoplasm registrynovelpatient-clinician communicationpopulation basedpreferenceracial differenceracial disparityrecruitsocioeconomicssurveillance datasymptom managementtheoriestreatment strategytrend
项目摘要
Less than 40% of ovarian cancer (OC) patients in the US receive stage-appropriate guideline- adherent
surgery and chemotherapy; Black OC patients are even less likely to receive such treatment. While 5-year
relative survival for White OC patients improved by 47% between 1975 and 2009, it declined by 27% for
Black patients during this same period. Among cancer survivors, Black patients are also observed to have
significantly higher depression, pain, and fatigue than White survivors. These racial disparities are likely due
largely to differences in healthcare access – specifically, access to high quality initial treatment and post-
treatment supportive care. Healthcare access is a complex subject; however, the Penchansky healthcare
access framework proposed that it comprises of five specific dimensions: availability, affordability,
accessibility, accommodation and acceptability of health care services. Our study will comprehensively
evaluate all five dimensions of healthcare access (HCA) among Black and White patients to identify and
quantify the specific factors contributing to the striking racial differences in OC care and survival. More
specifically, we will utilize data from SEER-Medicare (8,060 OC patients) along with primary survey data
from a population-based sample of 1,010 OC patients, linked with several existing datasets (e.g., American
Community Survey, Area Healthcare Resource File), to characterize racial differences in associations
between each HCA dimension and three outcomes: quality of initial treatment and supportive care, quality of
life based on patient-reported outcomes in prevalent yet manageable symptoms, and survival. We will
evaluate HCA dimensions across patient, neighborhood, provider and hospital levels, and utilize hierarchical
regression models with random effects to account for clustering, and multilevel structural equation models to
estimate the total, direct and indirect effect of race on treatment mediated through HCA dimensions. Our
preliminary studies suggest that certain under-studied dimensions (e.g., acceptability) may outweigh other
dimensions (e.g., availability) in determining quality of care. Moreover, the impact of the various HCA
dimensions may vary by race. By analyzing high-quality multilevel datasets with Black and White patients,
we can fully characterize the nature of racial disparities, assess the relative importance of race-specific
barriers to care, and identify race-specific modifiable factors. Our study will provide novel, empirical, and
generalizable insights regarding the distinct and collective influence of HCA dimensions on OC outcomes.
These insights will help identify and prioritize specific modifiable factors that can then be targeted to reduce
disparities and improve care for all patients.
在美国,不到40%的卵巢癌(OC)患者接受了适合分期的指南依从性治疗
项目成果
期刊论文数量(0)
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Tomi F Akinyemiju其他文献
Adapting Enhanced Recovery After Surgery (ERAS) Protocols to Promote Equity in Cancer Care and Outcomes
调整加速康复外科 (ERAS) 方案以促进癌症护理和结果的公平
- DOI:
- 发表时间:
2024 - 期刊:
- 影响因子:0
- 作者:
Clare Meernik;Michaela Z. Kolarova;Melina Ksor;Samantha Kaplan;Julie K. Marosky Thacker;Rebecca A. Previs;Tomi F Akinyemiju - 通讯作者:
Tomi F Akinyemiju
Neighborhood-level socioeconomic disparities in Radon testing in North Carolina from 2010 to 2020.
2010 年至 2020 年北卡罗来纳州氡气测试中社区层面的社会经济差异。
- DOI:
- 发表时间:
2024 - 期刊:
- 影响因子:2.3
- 作者:
Zhenchun Yang;Lauren Prox;Clare Meernik;Yadurshini Raveendran;Phillip Gibson;Amie Koch;Jeffrey Clarke;Ruoxue Chen;J. Zhang;Tomi F Akinyemiju - 通讯作者:
Tomi F Akinyemiju
Tomi F Akinyemiju的其他文献
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{{ truncateString('Tomi F Akinyemiju', 18)}}的其他基金
Systemic Racism and Biological Embodiment of Risk in Breast Cancer Mortality
系统性种族主义和乳腺癌死亡率风险的生物学体现
- 批准号:
10453878 - 财政年份:2022
- 资助金额:
$ 49.46万 - 项目类别:
Systemic Racism and Biological Embodiment of Risk in Breast Cancer Mortality
系统性种族主义和乳腺癌死亡率风险的生物学体现
- 批准号:
10709512 - 财政年份:2022
- 资助金额:
$ 49.46万 - 项目类别:
Stress-related inflammation and racial disparities in ovarian cancer
卵巢癌中与压力相关的炎症和种族差异
- 批准号:
10064445 - 财政年份:2020
- 资助金额:
$ 49.46万 - 项目类别:
A Role of Multilevel Healthcare Access Dimensions in Ovarian Cancer Disparities
多层次医疗保健获取维度在卵巢癌差异中的作用
- 批准号:
9904903 - 财政年份:2019
- 资助金额:
$ 49.46万 - 项目类别:
Racial/ethnic differences in functional metabolites among ovarian cancer patients
卵巢癌患者功能代谢物的种族/民族差异
- 批准号:
10531800 - 财政年份:2019
- 资助金额:
$ 49.46万 - 项目类别:
A Role of Multilevel Healthcare Access Dimensions in Ovarian Cancer Disparities
多层次医疗保健获取维度在卵巢癌差异中的作用
- 批准号:
10614420 - 财政年份:2019
- 资助金额:
$ 49.46万 - 项目类别:
Metabolic Syndrome and Epigenetic Markers of Breast Cancer in Nigerian Women
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9555400 - 财政年份:2016
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