Rural Cancer Workgroup
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1 Rural Cancer Workgroup Jan Eberth, PhD University of South Carolina Arnold School of Public Health Robin Vanderpool, DrPH, CHES University of Kentucky College of Public Health CPCRN Annual Meeting May 22, 2018
2 Rural vs. Urban
3 Impetus for new CPCRN Workgroup Although cancer rates have slowed nationwide, that decline is slower in rural areas. Rates of lung, colorectal, and cervical cancer are particularly high in rural (vs. urban) areas. Unique financial and structural barriers to quality cancer prevention and treatment services in rural areas Transportation challenges High level of uninsured adults Few medical specialists available More lenient policies towards tobacco use/exposure Henley et al. Invasive Cancer Incidence, , and Deaths, , in Nonmetropolitan and Metropolitan Counties United States. MMWR Surv Summ. 2017;66(14):1-13.
4 Investment by Federal Agencies
5 Investment by Federal Agencies
6 Investment by Federal Agencies Rural Cancer Control: Challenges and Opportunities meeting in Memphis (May 2017) Rural Definition Workshop at NCI (October 2017) National Academies hosted a workshop on Improving Health Research on Small Populations (January 2018) Dr. Croyle and other NCI staff attended Rural Health Policy Institute hosted by the National Rural Health Association (February 2018) NCI staff recently visited South Carolina for a 2-day trip to visit rural health providers (e.g., FQHC, CAH, RHC) NCI solicited supplement applications for P30 CCSGs to develop rural cancer control capacity (May 2018)
7 Investment by Federal Agencies
8 RFA-CA due in September
9 Proposed Workgroup Aims & Structure Workgroup Co-Leaders: Jan Eberth (University of South Carolina) Robin Vanderpool (University of Kentucky) Workgroup members will attend the ARCC Research Meeting, May 30-31, 2018; working dinner the evening of May 30 Prioritize conference call schedule for summer 2018
10 Possible Project Idea Utilize Medicare Expenditure Panel Survey (MEPS): Your Experiences with Cancer Survivorship Supplement to explore urban-rural differences in self-reported financial burden post-cancer diagnosis Conduct qualitative interviews with rural-dwelling cancer patients regarding financial toxicity experiences associated with cost of cancer treatment Remaining questions for workgroup: Sampling design and recruitment strategies for qualitative component Suggestions for questions, topics, domains of interest Centers IRB requirements/timing, study logistics, budgets, etc. Proposed pilot studies or RCTs to improve financial planning and associated stress reduction among cancer patients and their healthcare provider team
11 Financial Hardship Associated with Cancer
12 MEPS Section 6: The Effects of Cancer and Its Treatment on Finances 1. Have you or has anyone in your family had to borrow money or go into debt because of your cancer, its treatment, or the lasting effects of that treatment? 2. How much did you or your family borrow, or how much debt did you incur because of your cancer, its treatment, or the lasting effects of that treatment? 3. Did you or your family ever file for bankruptcy because of your cancer, its treatment, or the lasting effects of that treatment? 4. Have you or your family had to make any other kinds of financial sacrifices because of your cancer, its treatment, or the lasting effects of that treatment? 5. Have you ever worried about having to pay large medical bills related to your cancer? 6. Please think about medical care visits for cancer, its treatment, or the lasting effects of that treatment. Have you ever been unable to cover your share of the cost of those visits?
13 Preliminary Timetable Activity April May June July August September Regular Conference Calls X X X X Recruitment scholars w/ rural cancer expertise CPCRN and NCI ARCC meetings Finalize workgroup project X X X Conduct selected project X X X Write project manuscript X X Generate progress report to CPCRN Steering Committee X X Consider future of workgroup and/or additional grant applications X
14 Questions?
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