$8.6 Million Grant Will Test New Strategies to Eliminate Cancer Disparities


Diane Duke Williams



Oct. 20, 2008 – Disadvantaged and minority populations are more likely to be diagnosed with and die from cancer than other groups in the United States. A five-year, $8.6 million grant to Washington University and the Siteman Cancer Center will explore how improved information and referral systems can help eliminate these disparities.

The grant, from the National Cancer Institute, was awarded to the Health Communications Research Laboratory (HCRL) at Washington University's Brown School of Social Work, and establishes the HCRL as one of only five Centers of Excellence in Cancer Communication Research nationwide.

The grant will enable the HCRL to test communication strategies to enhance prevention, early detection and treatment of cancer in low-income populations. The research will take place in real-world settings with local partners, including the United Way of Greater St. LouisMissouri Department of Health and Senior Services and Missouri Foundation for Health. The grant also supports research with the American Cancer Society to evaluate effects of a national cancer news service for minority-serving media.

"We know a lot about how to prevent cancer or detect it early, and many of these services are available for free to those with low income or no insurance," says Matthew Kreuter, PhD, principal investigator of the grant and director of the HCRL. "But we need to do a much better job connecting people to these services."

Kreuter also is a professor at the Brown School and a member of the Siteman Cancer Center. Additionally, he is a scholar at Washington University's Institute for Public Health.

The grant will fund three studies. In the first study, 3,564 participants statewide will receive referrals to free cancer prevention and screening services available close to home. Some also will receive help from a personal assistant or individualized health information to act on the referral.

The second study will evaluate a news service that distributes localized cancer information to minority-serving newspapers. The American Cancer Society will select these newspapers through its divisions in 14 states that are home to 55 percent of the U.S. African-American population. In a previous HCRL study involving newspapers primarily serving African Americans in 24 U.S. cities, the news service, called Ozioma, significantly increased the amount and quality of cancer coverage and increased the rate readers talked about cancer, sought information about cancer and adopted cancer-prevention behaviors.

African-American women who are diagnosed with breast cancer tend to be diagnosed with more advanced-stage disease, and deaths from breast cancer are higher among African-American women compared with Caucasian women, according to the National Cancer Institute. These disparities are due in part to differences in adherence to follow-up care, patterns of patient/provider communication and availability of emotional support.

The third study, involving 220 African-American women being treated for breast cancer at Siteman, seeks to improve treatment adherence by providing them with a touch-screen computer system, Living Proof, that contains hundreds of videotaped stories from local African-American women who are survivors of the disease. The stories share survivors' strategies for coping with a cancer diagnosis and treatment, dealing with personal and professional relationships, having a positive experience in the health-care system and assuring follow-up care.

Kreuter says these studies are unique because of their scale and their integration into existing state and national systems that serve disadvantaged populations. "We want to assure that the great progress science has made in finding and fighting cancer benefits all people," Kreuter says. "If these strategies are effective, they can be applied all over the United States."