An initiative aimed at improving health outcomes for underserved cancer survivors is set to launch with a $4.8 million grant from the National Cancer Institute. Researchers at UTHealth Houston will lead the project, partnering with eight primary care community health centers in Texas that cater to underinsured and uninsured patients.
"Project CASCADE focuses on how primary health care teams provide whole-person and coordinated care to underserved patients who have a history of cancer," said Bijal Balasubramanian, MBBS, PhD. She serves as professor of epidemiology and Rockwell Distinguished Chair in Society and Health at UTHealth Houston School of Public Health and is a principal investigator for the study. "Primary care is uniquely suited to deliver whole-person and coordinated care for cancer survivors because, at its core, it prioritizes, personalizes, and integrates health care for all conditions, not just the cancer." Project CASCADE stands for Community and Academic Synergy for Cancer Survivorship Care Delivery Enhancement.
Balasubramanian emphasized that 70% of cancer survivors face other chronic conditions requiring attention from multiple clinical teams, which can result in uncoordinated care. With an increasing number of cancer survivors and an expected shortage of oncology specialists, this research gains importance.
This project is one of four National Cancer Institute-funded U01 grants addressing primary care needs for cancer survivors. The research was developed by Balasubramanian alongside Simon Lee, PhD, MPH from the University of Kansas.
The intervention will focus on improving identification and tracking of cancer survivors by modifying clinic workflows and employing a designated care coordinator champion. Additionally, it will implement Project ECHO—a telementoring strategy—to enhance clinicians' knowledge about survivorship care.
Researchers anticipate improved rates in screenings for secondary cancers and enhanced patient-reported experiences in care coordination. They will also assess adherence to surveillance guidelines for prevalent cancers like breast, colorectal, prostate, and lung.
"Community health centers are the primary care homes for patients who are underinsured or uninsured," stated Balasubramanian. "In collaboration with community health center clinics, this study will develop a model of cancer survivorship care that can be disseminated and scaled up to be used across other health systems in Texas."
Roxana Cruz, MD from the Texas Association of Community Health Centers will advise on this study. Other partners include institutions within The University of Texas System such as UT Southwestern Medical Center (Rebecca Eary) and The University of Texas MD Anderson Cancer Center (Hilary Ma).
Co-investigators from UTHealth Houston include Samiran Ghosh; Melissa Valerio-Shewmaker; L. Aubree Shay; Suja Rajan; Derek Craig.
