Postdoctoral Cancer Research Training Award Fellow
National Cancer InstituteCare Coordination for Multimorbidity: A Mixed Methods Study to Address Health Disparities
The prevalence of multimorbidity (MM) is growing with 60% of adults having multiple chronic conditions. MM is an important public health and health equity issue given its significant impact on mortality and disproportionate burden on racial/ethnic minority population groups. For example, the largest increases in the prevalence of MM among cancer survivors were among Black and middle-aged adults. However, understanding of the care coordination challenges and mechanisms that contribute to these health disparities is limited.
Dr. Verhoeven and her team’s recent SEER-Medicare analysis found that individuals who identify as Black or with dual Medicaid coverage were less likely to have a care team that included oncology, primary care, and non-oncology subspecialities.
The aims of this mixed methods study are to: 1) understand clinical care team composition and care coordination challenges for cancer survivors with at least one additional chronic condition in the 12-months following cancer diagnosis, and 2) explore in-depth care coordination challenges and mechanisms that contribute to health disparities experienced by cancer survivors that self-identify as a racial/ethnic minority individual.
They will use a rapid two-phase explanatory sequential design where findings regarding clinical care team composition obtained from a quantitative survey of cancer survivors (n=379) in phase one will inform the sampling frame for qualitative semi-structured interviews (n=20) in phase two. Phase two activities will enable deeper exploration of the most common and impactful care coordination challenges and mechanisms. This project will identify care coordination mechanisms that lead to health disparities that can be used to inform the development of interventions to address health disparities.