SMART Cancer Care Teams: Enhancing EHR Communication to Improve Interprofessional Teamwork - Diversity Supplement

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ABSTRACT While access to cancer treatment and care has increased since the implementation of the Affordable Care Act (ACA) in 2010, the benefits are not experienced proportionately across all groups in the United States. One of the major factors contributing to persistent disparities is the complexity and expansiveness of social determinants of health (SDOH), of which access to care is only one component. A recent emphasis in SDOH research has been on the role that neighborhood characteristics or community health play in health disparities and inequities in cancer care. We propose to examine the relationship between SDOH, specifically community health, and cancer health outcomes and access to care. As it relates to the parent award, leveraging SDOH data and incorporating their potential impact on cancer care team communication networks will elicit a more comprehensive and in-depth examination of a key SDOH domain with team structures and patient outcomes. This Diversity Supplement proposal centers on patient-level factors that impact cancer care, with these aims: Aim 1. Determine the geospatial distribution of cancer patients and the association of their SDOH, specifically community health, with unplanned hospitalizations and potentially preventable emergency department (ED) visits. Aim 2. Elicit cancer patient perceptions of access to and burden of cancer care treatment through an expansion of the qualitative interviews in the parent grant. We will map community health indicators and analyze their association with cancer health outcomes for patients from UC Davis with stage II or II breast, colorectal, and non-small cell lung cancer. As an expansion of the interviews and focus groups in the parent award, we will conduct in-depth interviews with patients to ascertain their perceived barriers to care. This supplement addresses a key priority of the NIH specifically aimed at measuring health disparities. The research proposed here addresses Goal 2 of the NIH Minority Health and Health Disparities Strategic Plan, which is to advance scientific understanding of the causes of health disparities. The mentoring and training that Dr. Garcia would receive as part of this supplement would enable her to develop skills in geospatial mapping and qualitative methodologies, with results from this study serving as preliminary results for an early-stage investigator proposal.