A program aimed at improving access to high-quality cancer care has significantly increased adherence to cancer treatment among minority and low-income communities, according to data presented at the 2023 ASCO Quality Care Symposium.1
The introduction of the ALCANCE-PLUS program in Monterey County, California, improved the rates of cancer treatment completion from an average of 62% at baseline to 100% of program participants. The program was also associated with a nearly 50% reduction in the number of days from diagnosis to treatment in the intervention group.
“Community-academic partnerships to codesign and implement approaches for marginalized populations are essential to achieve cancer health equity.”— Emily Hayes Wood, MPH
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“We’ve had some wonderful early returns on this work, boosting access to supportive cancer care services, clinical trials for diverse participants, and also managing to reduce missed visits and time delays to diagnosis,” said study coauthor Emily Hayes Wood, MPH, Senior Manager of Research Operations for Partnerships to Advance Cancer Care at the Stanford University School of Medicine.
Study Background
As Ms. Wood explained, Monterey County is approximately 60% Hispanic or Latino, with 55% of individuals speaking a language other than English at home. In addition, one in five households depends on source income related to agriculture, and the median household income is often less than $70,000 per year.
TheALCANCE-PLUS Program for Long-Term United Skills Building is an ongoing community-academic partnership between the Stanford University School of Medicine Partnerships to Advance Care and Pacific Cancer Care. The partnership began in 2019 and comprises several community-identified multilevel interventions to improve cancer health equity.
This intervention, which was delivered by trained community health workers to low-income and racially and ethnically minoritized patients receiving active cancer treatment, aimed to:
- Provide advance care planning and proactive symptom screening support
- Develop culturally tailored and language-concordant precision medicine education
- Provide free supplemental nutrition resources for patients who were identified as having food insecurity during treatment
- Train community health workers across the county.
Key Findings
As Ms. Wood reported, a total of 143 patients have participated in the program since its initiation in June 2022. At baseline, 62% of low-income and racially/ethnically minoritized patients in the county completed treatment, 35% had no-shows to clinic or infusion appointments, with an average of 82.7 days from diagnosis to treatment, and 15% received clinical trial education.
As of June 2023, however, there were statistically significant improvements in treatment completion (P < .001), with all 143 patients completing treatment. There were also reductions in no-shows, said Ms. Wood, with only three participants (2%) missing a clinical or infusion appointment without canceling or rescheduling.
KEY POINTS
- The ALCANCE-PLUS program substantially improved cancer treatment adherence in minority and low-income populations in Monterey County, California.
- The program promoted advance care planning and clinical trial education and addressed food insecurity in the participating patients.
In addition, the average time from diagnosis to treatment was reduced by nearly half—from 82.7 days to 42.5 days (P < .001)—and all participants received clinical trial education (P < .001), with 48 (34%) actively participating in a clinical trial.
Ms. Wood and colleagues hope to boost the impact of the program by training approximately 150 community health workers throughout the county.
“We’re going to be working closely with the Monterey County Department of Health and our community partners in order to make this available,” Ms. Wood concluded. “Community-academic partnerships to codesign and implement approaches for marginalized populations are essential to achieve cancer health equity.”
DISCLOSURE: The ALCANCE-PLUS program was funded by a grant from the American Cancer Society. Ms. Wood reported no conflicts of interest.
REFERENCE
1. Kamran R, Wood EH, Perez C, et al: Advancing equity in cancer care through community-academic partnerships: Results from the Addressing Latinx Cancer Care Equity–Program for Long-Term United Skills Building (ALCANCE-PLUS). 2023 ASCO Quality Care Symposium. Abstract 77. Presented October 28, 2023.
