. Surgical resection is the standard-of-care for patients with early stage lung cancer, and multiple published studies have shown that improvements in resection rates translate into improvements in overall survival. African Americans (AAs) with early stage, non-small cell lung cancer (NSCLC) are significantly less likely than European Americans (EAs) to undergo resection, even when controlling for age, comorbidity, tumor stage, socioeconomic status, insurance status, and surgical consultation. This racial disparity is particularly pronounced in South Carolina (SC). Investigators at the National Cancer Institute-designated Medical University of South Carolina Hollings Cancer Center (MUSC HCC) hypothesize that a dynamic, [statewide], patient navigation intervention will reduce potential barriers to surgical cancer care and improve resection rates among AAs with early stage NSCLC. The patient navigation intervention will be tested in a two-arm, cluster- randomized trial comparing the intervention versus [usual care] in a sample of 200 AAs in SC with Stage I or II NSCLC. Study participants will be recruited from six geographically diverse study sites within a [statewide] cancer Clinical Trials Network (CTN) coordinated by MUSC, and participants will be cluster-randomized by CTN site. The investigators will further evaluate the modifying effects of income and urban-rural residence on the relationships between the intervention and the main study outcome (receipt of surgery), as well as [receipt of surgical consultation], time to resection, [time to death (survival)], health-related quality of life, state anxiety, perceived self-efficacy in patient-physician interaction, trust in physicians, and satisfaction with the treatment decision made. The proposed research is highly significant for many reasons. First, lung cancer is the leading cause of cancer death in the United States (US) and SC. Second, less than half of AAs in SC with early stage NSCLC undergo surgical resection, and the median survival of AAs with early stage NSCLC is consistently lower than that of EAs. Third, SC has a large AA population (approximately 30%), has urban as well as large rural geographic areas, and has wide income distributions. A [statewide] patient navigation intervention to enhance access to surgical therapy for AAs with NSCLC could lead to significant improvements in care and reductions in racial disparities in lung cancer outcomes [across wide geographic and socioeconomic strata] in SC, as well as in other communities across the US.
. Lung cancer is the leading cause of cancer deaths in the US;however, while surgical resection is the optimal treatment for localized, early stage lung cancer, less than half of the African Americans (AAs) diagnosed with this disease undergo surgical resection. This study will test whether a [statewide] patient navigation intervention improves receipt of surgical resection, [receipt of surgical consultation], reduces time to surgery and [improves survival] in AAs with early stage disease, and it may uncover modifiable root causes underlying underuse of lung cancer surgery among AAs. The patient navigation intervention may prove to be a practical but powerful strategy for use by other health care providers, institutions, and communities seeking to reduce persistent racial disparities in lung cancer surgery and outcomes.
|Ford, Marvella E; Abraham, Latecia M; Harrison, Anita L et al. (2016) Mentoring Strategies and Outcomes of Two Federally Funded Cancer Research Training Programs for Underrepresented Students in the Biomedical Sciences. J Cancer Educ 31:228-35|
|Menon, Shailaja; McCullough, Laurence B; Beyth, Rebecca J et al. (2015) Use of a values inventory as a discussion aid about end-of-life care: A pilot randomized controlled trial. Palliat Support Care :1-11|
|Ford, Marvella E; Wei, Wei; Moore, Leslie A et al. (2015) Evaluating the reliability of the Attitudes to Randomized Trial Questionnaire (ARTQ) in a predominantly African American sample. Springerplus 4:411|
|Michaels, Margo; Blakeney, Natasha; Langford, Aisha T et al. (2015) Five principles for effective cancer clinical trial education within the community setting. J Cancer Educ 30:197-203|
|Halbert, Chanita Hughes; Briggs, Vanessa; Bowman, Marjorie et al. (2014) Acceptance of a community-based navigator program for cancer control among urban African Americans. Health Educ Res 29:97-108|
|Foster, Dion; Spruill, Laura; Walter, Katherine R et al. (2014) AGE metabolites: a biomarker linked to cancer disparity? Cancer Epidemiol Biomarkers Prev 23:2186-91|
|Spruill, Ida J; Leite, Renata Serricchio; Fernandes, Jyotika K et al. (2013) Successes, Challenges and Lessons Learned: Community-engaged research with South Carolina's Gullah population. Gateways 6:|
|Ford, Marvella E; Siminoff, Laura A; Pickelsimer, Elisabeth et al. (2013) Unequal burden of disease, unequal participation in clinical trials: solutions from African American and Latino community members. Health Soc Work 38:29-38|
|Andrews, Jeannette O; Cox, Melissa J; Newman, Susan D et al. (2013) Training partnership dyads for community-based participatory research: strategies and lessons learned from the Community Engaged Scholars Program. Health Promot Pract 14:524-33|
|Esnaola, Nestor F; Ford, Marvella E (2012) Racial differences and disparities in cancer care and outcomes: where's the rub? Surg Oncol Clin N Am 21:417-37, viii|
Showing the most recent 10 out of 11 publications