Reaching Populations to Address Disparities in Cancer Care Delivery: Results From a Six-Site Initiative

Background: Large segments of the US population do not receive quality cancer care due to pervasive and systemic inequities, which can increase morbidity and mortality. Multicomponent, multilevel in-terventions can address inequities and improve care, but only if they reach communities with suboptimal access. Intervention studies often underenroll individuals from historically excluded groups. Methods: The Alliance to Advance Patient-Centered Cancer Care includes 6 grantees across the United States who implemented unique multi -component, multilevel intervention programs with common goals of reducing disparities, increasing engagement, and improving the quality of care for targeted populations. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework in-formed the evaluation efforts across sites. Each Alliance site identi-fied their intended populations, which included underrepresented minorities (eg, Black and Latinx persons), individuals who prefer a language other than English, and rural residents. We evaluated the demographic characteristics of participants to determine program reach. Results: Between 2018 and 2020, a total of 2,390 of 5,309 po-tentially eligible participants were enrolled across the 6 sites. The pro-portion of enrolled individuals with selected characteristics included 38% (n=908) Black adults, 24% (n=574) Latinx adults, 19% (n=454) preferring a language other than English, and 30% (n=717) rural resi-dents. The proportion of those enrolled who were the intended population was commensurate to the proportion with desired char-acteristics in those identified as potentially eligible. Conclusions: The grantees met or exceeded enrollments from their intended populations who have been underserved by quality cancer care into patient-centered intervention programs. Intentional application of recruitment/engagement strategies is needed to reach individuals from historically underserved communities.J Natl Compr Canc Netw 2023;21(5):481-486 doi: 10.6004/jnccn.2023.7006