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The Alliance for Equity in Cancer Care Convenes Inaugural Meeting
April 7, 2023
NPO leaders Robert A. Winn, M.D., (far left), Leslie M. Hardy, MHS of the Merck Foundation (second from left), Marcie S. Wright, Ph.D., MPH (second from right) and Emmanuel A. Taylor, MSc, DrPH (far right) are pictured at the Annual Meeting in Richmond.
The Alliance for Equity in Cancer Care held its inaugural in-person meeting on March 22-23 in Richmond, Va. The Alliance is a national multi-site initiative funded by a $20 million commitment from the Merck Foundation to advance health equity by improving access to high-quality culturally responsible cancer care for patients from underserved communities. The Alliance is led by the VCU Massey Comprehensive Cancer Center, which in partnership with the VCU Center on Health Disparities serves as the National Program Office (NPO).
In addition to the NPO, the Alliance consists of eight program sites from across the country: Boston Medical Center; Case Comprehensive Cancer Center, Case Western Reserve University; Conquer Cancer®, the ASCO Foundation; Mary Bird Perkins Cancer Center; Memorial Sloan Kettering Cancer Center; RWJBarnabas Health; University of Kentucky Markey Cancer Center and the National Comprehensive Cancer Network.
Grantees have been selected to develop and deploy evidence-informed strategies aimed at improving equitable, patient-centered cancer care and address access barriers related to social determinants of health (SDOH) – or social drivers of health. Many are partnering with community-based and health care organizations to implement multilevel interventions for patients from underserved communities. Alliance grantees are also working together on ways to better assess and inform the equity of care delivery strategies.
Attendees were welcomed by Robert A. Winn, M.D., director and Lipman Chair in Oncology at VCU Massey Comprehensive Cancer Center, senior associate dean for cancer innovation at the VCU School of Medicine, and co-director of the Alliance (NPO). Winn set the stage for the two-day event and provided the nearly 50 in-person attendees with words of encouragement highlighting the important work being done through the initiative. “There will be missteps, in the process of doing what we are trying to do – but when we get it right, we become what others want to follow.”
The gathering provided an opportunity for communication and collaboration between program sites as well as shared learning around best practices and common challenges. Marcie S. Wright, Ph.D., MPH, Deputy Director of the Alliance (NPO) and Associate Director of the VCU Center on Health Disparities, gave an overview of the event and Alliance goals before kicking off grantee presentations.
Program Sites Share Challenges and Solutions
Day one of the meeting consisted primarily of grantee presentations which included an overview of each program site’s intervention approach, challenges and successes to date as well as proposed evaluation metrics. Derek Falk, Ph.D., M.S.W., of Case Western Reserve University, facilitated discussions among in-person and virtual attendees around common barriers faced by grantees. While many sites shared unique challenges based on their program, the forum shed light on a number of common pain points.
For example, an Alliance member shared the difficulties patients can face when travel and location negatively impact their access to care. Janette Merrill, M.S., C.H.E.S., Senior Director of Policy Programs at Conquer Cancer®, the ASCO Foundation, described physical barriers some patients face in Montana. “People have to drive 60 miles to the nearest cancer center and people will forgo treatment because of it," she said.
Many grantees discussed how they are leaning on technology to overcome access barriers, such as satellite technology, telehealth options or application-based solutions for patients to more effectively communicate with their care team. Another challenge that resonated with the group was the difficulty of going through the various steps to get treatment once diagnosed with cancer. Suggested solutions included creating a more uniform system and providing specific training for patient navigators to help patients overcome barriers to get the care they need.
Enhancing Capacity for Community Outreach & Policy Change
Community Outreach & Policy Panel, (left to right) Monica Dean, HON-OPN-CG, Director, Patient Navigation Program Development, Academy of Oncology Nurse & Patient Navigators, Kelly Fitzgerald, Vice President, Grassroots Development, Alliance Group, Darcie Green, Executive Director, Latinas Contra Cancer
A critical component of the Alliance is building upon and leveraging community partnerships inside and outside the health system. A panel of experts shared the importance of such relationships and insight into ways the Alliance can play a more prominent role in patient advocacy and cancer policy.
Panelists included Monica Dean, HON-OPN-CG, Director of Patient Navigation Program Development at the Academy of Oncology Nurse & Patient Navigators, a patient navigation expert; Darcie Green, Executive Director of Latinas Contra Cancer, who has 20 years of community activism and public policy experience; and Kelly Fitzgerald, Vice President of Grassroots Development for the Alliance Group, an advocacy leader with over 20 years of experience in government relations. The discussion was facilitated by Alyssa Schatz, M.S.W., Senior Director of Policy & Advocacy, National Comprehensive Cancer Network.
Additional topics included inequalities in health care as it relates to undocumented individuals and how working with key public officials may help move the needle towards more equitable care for vulnerable populations. In a lightning round session, the panel left attendees with the following thoughts to keep in mind:
- “You don’t have to solve all health care - what is the piece I am doing today?”
- “On your local level, your constituents work for you. You can be your patients' voice.”
- “Be that strong voice collectively in oncology – every patient deserves a navigator.”
A Two-Pronged Evaluation Approach
Attendees participated in working group sessions to share knowledge around evaluation efforts.
A primary role of the NPO is to facilitate an evaluation of the five-year initiative. This consists of a two-pronged approach: a cross-site evaluation across all Alliance efforts and a local evaluation conducted by each grantee. Day two of the meeting was dedicated to refining core measurements for the cross-site evaluation and streamlining the evaluation design and site-specific data collection efforts, including how data will be obtained from partners. Attendees participated in working groups that were focused on one of the four overarching Alliance goals:
- Improve coordination of cancer care for vulnerable, underserved populations
- Build sustainable community partnerships to address barriers to cancer care
- Strengthen patient-provider communication and patient engagement in treatment decisions
- Disseminate findings and program results to improve the delivery of equitable cancer care
Emmanuel A. Taylor, MSc, DrPH, Co-Director for the Alliance (NPO) and lead evaluator, led the working group discussions. “When we leave here, we will truly be an alliance,” he said. Taylor also serves as the associate director for Diversity, Equity and Inclusion at VCU Massey Comprehensive Cancer Center.
Attendees left energized with a renewed spirit of their charge and a toolkit of resources and best practices to share with their respective organizations. “We envision a world where all people have access to high-quality health care,” said Leslie M. Hardy, MHS, Executive Vice President of the Merck Foundation who represented the Merck Foundation at the two-day event. She continued, “what we value and elevate is working as one, bringing different perspectives together – collaborating, learning, sharing – it is quite deliberate to call this an Alliance, to work as a collaborative.”
The Alliance will convene annually for the duration of the initiative to facilitate further information sharing and relationship building to ensure successful coordination of all Alliance efforts.
Written by: Jennifer Drummond