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

Patel, Manali I.; Andrea, Nevedal; Bhattacharya, Jay; Coker, Tumaini R.

doi:10.1007/s10900-019-00632-x

Cited by 16 publications

(14 citation statements)

References 40 publications

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“…We did not identify any published studies of effective interventions at the patient, provider, employer, health system, policy, or regulatory levels that help patients maintain continuous health insurance coverage throughout the cancer control continuum. Several studies testing interventions to improve coverage continuity are in progress (60,61), however. For example, within federally qualified health centers in multiple states, the introduction of electronic health record tools for identifying patients in advance of their Medicaid recertification to ensure continuity of coverage is being evaluated for potential improvements in receipt of cancer prevention and screening (60).…”

Section: Discussionmentioning

confidence: 99%

“…Another ongoing intervention study involves a multi-employer Taft-Hartley Trust Fund that provides health benefits to hourly, low-wage employees who would otherwise not have health insurance coverage. This ongoing study is testing provision of continuous health benefits coverage for low-wage employees after a cancer diagnosis and incentives for the use of high-quality cancer care providers through travel benefits and narrow networks (61). Further development and testing of interventions to improve coverage continuity in public and private settings using experimental designs, especially for patients at risk of coverage disruptions, will be important.…”

Section: Discussionmentioning

confidence: 99%

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Health Insurance Coverage Disruptions and Cancer Care and Outcomes: Systematic Review of Published Research

Yabroff

Reeder‐Hayes

Zhao

et al. 2020

JNCI: Journal of the National Cancer Institute

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Abstract Background Lack of health insurance coverage is associated with poor access and receipt of cancer care and survival in the United States. Disruptions in coverage are common among low-income populations, but little is known about associations of disruptions with cancer care, including prevention, screening, and treatment, as well as outcomes of stage at diagnosis and survival. Methods We conducted a systematic review of studies of health insurance coverage disruptions and cancer care and outcomes published between 1980 and 2019. We used the PubMed, EMBASE, Scopus, and CINAHL databases and identified 29 observational studies. Study characteristics and key findings were abstracted and synthesized qualitatively. Results Studies evaluated associations between coverage disruptions and prevention or screening (31.0%), treatment (13.8%), end-of-life care (10.3%), stage at diagnosis (44.8%), and survival (20.7%). Coverage disruptions ranged from 4.3% to 32.8% of patients age-eligible for breast, cervical, or colorectal cancer screening. Between 22.1% and 59.5% of patients with Medicaid gained coverage only at or after cancer diagnosis. Coverage disruptions were consistently statistically significantly associated with lower receipt of prevention, screening, and treatment. Among patients with cancer, those with Medicaid disruptions were statistically significantly more likely to have advanced stage (odds ratios = 1.2-3.8) and worse survival (hazard ratios = 1.28-2.43) than patients without disruptions. Conclusions Health insurance coverage disruptions are common and adversely associated with receipt of cancer care and survival. Improved data infrastructure and quasi-experimental study designs will be important for evaluating the associations of federal and state policies on coverage disruptions and care and outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Health Insurance Coverage Disruptions and Cancer Care and Outcomes: Systematic Review of Published Research

Yabroff

Reeder‐Hayes

Zhao

et al. 2020

JNCI: Journal of the National Cancer Institute

Self Cite

View full text Add to dashboard Cite

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“…This co-produced intervention included mutiple elements and providers and was tailored to the target population. This represents a challenge in terms of replication of the delivery model across different patient populations and medical infrastructures although comparable community partnerships models to deliver complex health interventions have similarly met the needs and preferences of service users [16]. Ultimately, the wider adoption of asset-based collaborative community services is dependent on local policymakers [38].…”

Section: Discussionmentioning

confidence: 99%

Assessing the Acceptability of a Co-produced Long COVID Intervention in an Underserved Community in the UK

Fowler-Davis¹,

Young²,

Maden‐Wilkinson³

et al. 2021

Preprint

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Background: The COVID-19 pandemic has disproportionately affected people from more deprived communities. The experience of Long Covid is similarly distributed but very few investigations have concentrated on the needs of this population. The aim of this project was to co-produce an acceptable intervention for people with Long Covid, living in communities recognised as more deprived. Methods: The intervention was based on a multi-disciplinary team using approaches from sport and exercise medicine and functional rehabilitation. The co-production process was undertaken with a stakeholder advisory group and patient public involvement representation. This study identified participants by postcode and the indices of multiple deprivation (IMD); recruitment and engagement were supported by an existing health and wellbeing service. A virtual ‘clinic’ was offered with a team of professional practitioners who met participants three times each; to directly consider their needs and offer structured advice. The acceptability of the intervention was based on the individual’s participation and their completion of the intervention. Results: Ten participants were recruited with eight completing the intervention. The partnership with an existing community health and wellbeing service was deemed to be an important way of reaching participants. Two men and six women ages ranging from 38 to 73 were involved and their needs were commonly associated with fatigue, anxiety and depression with overall de-conditioning. None reported serious hardship associated with the pandemic although most were in self-employment/part-time employment or were not working due to retirement or ill-health. Two older participants lived alone, and others were single parents and had considerable challenges associated with managing a household alongside their Long Covid difficulties. Conclusions: This paper presents the needs and perspectives of eight individuals involved in the process and discusses the needs and preferences of the group in relation to their support for self- managed recovery from Long Covid.

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“…Some people of diverse ethnicity demonstrate greater levels of pre-existing chronic health conditions and higher levels of chronic illness and this may be a product of socioeconomic disadvantage and racial discrimination [ 15 ] and so there is a likelihood that the incidence of Long COVID is higher in ethnically diverse communities. However, there are limited examples of co-production of health interventions with deprived communities [ 16 ] that might achieve improvements in service uptake and subsequent better health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Acceptability of a Co-Produced Long COVID Intervention in an Underserved Community in the UK

Fowler-Davis

Young

Maden‐Wilkinson

et al. 2021

IJERPH

View full text Add to dashboard Cite

Background: The COVID-19 pandemic has disproportionately affected people from more deprived communities. The experience of Long COVID is similarly distributed but very few investigations have concentrated on the needs of this population. The aim of this project was to co-produce an acceptable intervention for people with Long COVID living in communities recognised as more deprived. Methods: The intervention was based on a multi-disciplinary team using approaches from sport and exercise medicine and functional rehabilitation. The co-production process was undertaken with a stakeholder advisory group and patient public involvement representation. This study identified participants by postcode and the indices of multiple deprivation (IMD); recruitment and engagement were supported by an existing health and wellbeing service. A virtual ‘clinic’ was offered with a team of professional practitioners who met participants three times each; to directly consider their needs and offer structured advice. The acceptability of the intervention was based on the individual’s participation and their completion of the intervention. Results: Ten participants were recruited with eight completing the intervention. The partnership with an existing community health and wellbeing service was deemed to be an important way of reaching participants. Two men and six women ages ranging from 38 to 73 were involved and their needs were commonly associated with fatigue, anxiety and depression with overall de-conditioning. None reported serious hardship associated with the pandemic although most were in self-employment/part-time employment or were not working due to retirement or ill-health. Two older participants lived alone, and others were single parents and had considerable challenges associated with managing a household alongside their Long COVID difficulties. Conclusions: This paper presents the needs and perspectives of eight individuals involved in the process and discusses the needs and preferences of the group in relation to their support for self- managed recovery from Long COVID.

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

Cited by 16 publications

References 40 publications

Health Insurance Coverage Disruptions and Cancer Care and Outcomes: Systematic Review of Published Research

Health Insurance Coverage Disruptions and Cancer Care and Outcomes: Systematic Review of Published Research

Assessing the Acceptability of a Co-produced Long COVID Intervention in an Underserved Community in the UK

Assessing the Acceptability of a Co-Produced Long COVID Intervention in an Underserved Community in the UK

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