Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients
Background: Black individuals with cancer have a higher prevalence of comorbidities and a worse cancer prognosis than other racial groups in the US. As part of a quality improvement project, we aimed to demonstrate feasibility of self-monitoring and community health worker (CHW) support among managi...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Contemporary Clinical Trials Communications |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451865424001340 |
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| author | Laura C. Schubel Ana Barac Michelle Magee Mihriye Mete Malinda Peeples Mansur Shomali Kristen E. Miller Lauren R. Bangerter Allan Fong Christopher Gallagher Jeanne Mandelblatt Hannah Arem |
| author_facet | Laura C. Schubel Ana Barac Michelle Magee Mihriye Mete Malinda Peeples Mansur Shomali Kristen E. Miller Lauren R. Bangerter Allan Fong Christopher Gallagher Jeanne Mandelblatt Hannah Arem |
| author_sort | Laura C. Schubel |
| collection | DOAJ |
| description | Background: Black individuals with cancer have a higher prevalence of comorbidities and a worse cancer prognosis than other racial groups in the US. As part of a quality improvement project, we aimed to demonstrate feasibility of self-monitoring and community health worker (CHW) support among managing comorbidities for Black individuals with breast or prostate cancer. Methods: In a single arm, pre-post study, we enrolled patients with diabetes and/or hypertension who identified as Black and were diagnosed with 1) stage 0-IV breast cancer, or 2) prostate cancer and on long-term androgen-deprivation therapy. Participants received a home-monitoring device linked to a mobile app and worked with a CHW over six months to track their blood pressure (BP) and/or blood glucose (BG). PROMIS surveys assessed support and self-efficacy. Results: Between May 2021–December 2022, 61 patients with breast or prostate cancer comorbid with hypertension (79 %) or hypertension and diabetes (21 %) enrolled. Once weekly self-recording of BP and BG was achieved in 92 % of individuals (with hypertension) and 77 % of individuals (with diabetes and hypertension). Participants (n = 47) who reported ≥4 readings in Months 1 and 6 demonstrated improved BP control (mean reduction = 4.07 mmHg); too few BG readings were collected to assess change. We observed a slight decrease in PROMIS scores for informational (mean 3.2, sd 8.0) and instrumental support (mean 3.6, sd 8.3). Conclusions: A self-monitoring and CHW intervention is a feasible approach to monitor hypertension among Black cancer patients. Modifications are needed to improve BG monitoring and patient reported outcomes. |
| format | Article |
| id | doaj-art-bf0a704a208e495da220ba528655553a |
| institution | Kabale University |
| issn | 2451-8654 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Contemporary Clinical Trials Communications |
| spelling | doaj-art-bf0a704a208e495da220ba528655553a2025-01-12T05:25:28ZengElsevierContemporary Clinical Trials Communications2451-86542025-02-0143101387Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patientsLaura C. Schubel0Ana Barac1Michelle Magee2Mihriye Mete3Malinda Peeples4Mansur Shomali5Kristen E. Miller6Lauren R. Bangerter7Allan Fong8Christopher Gallagher9Jeanne Mandelblatt10Hannah Arem11Healthcare Delivery Research, MedStar Health Research Institute, Washington, DC, USAHeart and Vascular Institute Inova Health System, Falls Church, VA, USASchool of Medicine, Georgetown University, Washington, DC, USA; Diabetes Institute, MedStar Washington Hospital Center, Washington, DC, USAHealthcare Delivery Research, MedStar Health Research Institute, Washington, DC, USA; Center for Biostatistics, Informatics, and Data Science School of Medicine, Georgetown University, Washington, DC, USAWellDoc, Inc, Columbia, MD, USAWellDoc, Inc, Columbia, MD, USAHealthcare Delivery Research, MedStar Health Research Institute, Washington, DC, USAHealthcare Delivery Research, MedStar Health Research Institute, Washington, DC, USA; Health Economics and Aging Research Institute, MedStar Health, Washington, DC, USACenter for Biostatistics, Informatics, and Data Science School of Medicine, Georgetown University, Washington, DC, USAMedStar Washington Hospital Center, Washington, DC, USALombardi Comprehensive Cancer Center, Institute for Cancer and Aging REsearch (I-CARE), School of Medicine, Georgetown University, Washington, DC, USAHealthcare Delivery Research, MedStar Health Research Institute, Washington, DC, USA; Department of Oncology, Georgetown University, Washington, DC, USA; Corresponding author. Healthcare Delivery Research, MedStar Health Research Institute, Washington, DC, USA.Background: Black individuals with cancer have a higher prevalence of comorbidities and a worse cancer prognosis than other racial groups in the US. As part of a quality improvement project, we aimed to demonstrate feasibility of self-monitoring and community health worker (CHW) support among managing comorbidities for Black individuals with breast or prostate cancer. Methods: In a single arm, pre-post study, we enrolled patients with diabetes and/or hypertension who identified as Black and were diagnosed with 1) stage 0-IV breast cancer, or 2) prostate cancer and on long-term androgen-deprivation therapy. Participants received a home-monitoring device linked to a mobile app and worked with a CHW over six months to track their blood pressure (BP) and/or blood glucose (BG). PROMIS surveys assessed support and self-efficacy. Results: Between May 2021–December 2022, 61 patients with breast or prostate cancer comorbid with hypertension (79 %) or hypertension and diabetes (21 %) enrolled. Once weekly self-recording of BP and BG was achieved in 92 % of individuals (with hypertension) and 77 % of individuals (with diabetes and hypertension). Participants (n = 47) who reported ≥4 readings in Months 1 and 6 demonstrated improved BP control (mean reduction = 4.07 mmHg); too few BG readings were collected to assess change. We observed a slight decrease in PROMIS scores for informational (mean 3.2, sd 8.0) and instrumental support (mean 3.6, sd 8.3). Conclusions: A self-monitoring and CHW intervention is a feasible approach to monitor hypertension among Black cancer patients. Modifications are needed to improve BG monitoring and patient reported outcomes.http://www.sciencedirect.com/science/article/pii/S2451865424001340Community health workersBreast cancerProstate cancerHypertensionDiabetesmHealth |
| spellingShingle | Laura C. Schubel Ana Barac Michelle Magee Mihriye Mete Malinda Peeples Mansur Shomali Kristen E. Miller Lauren R. Bangerter Allan Fong Christopher Gallagher Jeanne Mandelblatt Hannah Arem Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients Contemporary Clinical Trials Communications Community health workers Breast cancer Prostate cancer Hypertension Diabetes mHealth |
| title | Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients |
| title_full | Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients |
| title_fullStr | Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients |
| title_full_unstemmed | Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients |
| title_short | Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients |
| title_sort | comorbidities and reducing inequities cares feasibility of self monitoring and community health worker support in management of comorbidities among black breast and prostate cancer patients |
| topic | Community health workers Breast cancer Prostate cancer Hypertension Diabetes mHealth |
| url | http://www.sciencedirect.com/science/article/pii/S2451865424001340 |
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