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Burus T, Martinez J, DelNero P, Pepper S, Ratnayake I, Oh DL, McNair C, Krebill H, Mudaranthakam DP. Interinstitutional Approach to Advancing Geospatial Technologies for US Cancer Centers. JCO Clin Cancer Inform 2024; 8:e2400099. [PMID: 39079076 PMCID: PMC11296499 DOI: 10.1200/cci.24.00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/03/2024] [Accepted: 06/17/2024] [Indexed: 08/04/2024] Open
Affiliation(s)
- Todd Burus
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Josh Martinez
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Peter DelNero
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sam Pepper
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
- The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Isuru Ratnayake
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Debora L. Oh
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Christopher McNair
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Hope Krebill
- Masonic Cancer Alliance, The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Dinesh Pal Mudaranthakam
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
- The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, KS, USA
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Weaver SJ, Breslau ES, Russell LE, Zhang A, Sharma R, Bass EB, Marsteller JA, Snyder C. Health-care organization characteristics in cancer care delivery: an integrated conceptual framework with content validation. J Natl Cancer Inst 2024; 116:800-811. [PMID: 38419574 DOI: 10.1093/jnci/djae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
Context can influence cancer-related outcomes. For example, health-care organization characteristics, including ownership, leadership, and culture, can affect care access, communication, and patient outcomes. Health-care organization characteristics and other contextual factors can also influence whether and how clinical discoveries reduce cancer incidence, morbidity, and mortality. Importantly, policy, market, and technology changes are transforming health-care organization design, culture, and operations across the cancer continuum. Consequently, research is essential to examine when, for whom, and how organizational characteristics influence person-level, organization-level, and population-level cancer outcomes. Understanding organizational characteristics-the structures, processes, and other features of entities involved in health care delivery-and their dynamics is an important yet understudied area of care delivery research across the cancer continuum. Research incorporating organizational characteristics is critical to address health inequities, test care delivery models, adapt interventions, and strengthen implementation. The field lacks conceptual grounding, however, to help researchers identify germane organizational characteristics. We propose a framework identifying organizational characteristics relevant for cancer care delivery research based on conceptual work in health services, organizational behavior, and management science and refined using a systematic review and key informant input. The proposed framework is a tool for organizing existing research and enhancing future cancer care delivery research. Following a 2012 Journal of the National Cancer Institute monograph, this work complements National Cancer Institute efforts to stimulate research addressing the relationship between cancer outcomes and contextual factors at the patient, provider, team, delivery organization, community, and health policy levels.
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Affiliation(s)
- Sallie J Weaver
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Erica S Breslau
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Lauren E Russell
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Allen Zhang
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ritu Sharma
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eric B Bass
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jill A Marsteller
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Claire Snyder
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
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DelNero PF, Buller ID, Jones RR, Tatalovich Z, Vanderpool RC, Ciolino HP, Croyle RT. A National Map of NCI-Designated Cancer Center Catchment Areas on the 50th Anniversary of the Cancer Centers Program. Cancer Epidemiol Biomarkers Prev 2022; 31:965-971. [PMID: 35101903 PMCID: PMC9074106 DOI: 10.1158/1055-9965.epi-21-1230] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/22/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In 1971, the National Cancer Act created a process to recognize the leadership, facilities, and research efforts at cancer centers throughout the United States. Toward this goal, each NCI-designated cancer center defines and describes a catchment area to which they tailor specific scientific and community engagement activities. METHODS The geographically defined catchment areas of 63 NCI-designated comprehensive and clinical cancer centers are collated and presented visually. In addition, the NCI-designated cancer center catchment areas are geographically linked with publicly available data sources to aggregate sociodemographic and epidemiologic characteristics across the NCI Cancer Centers Program. RESULTS The national map portrays the size, shape, and locations for 63 catchment areas of the 71 NCI-designated cancer centers. The findings illustrate the geographic extent of the NCI Cancer Centers Program during the 50th anniversary of the National Cancer Act. CONCLUSIONS NCI-designated cancer centers occupy a prominent role in the cancer control ecosystem and continue to perform research to address the burden of cancer among their local communities. The strength of the NCI Cancer Centers Program is partly defined by the scope, quality, and impact of community outreach and engagement activities in the catchment areas. IMPACT The collation and geographic presentation of the distinct, but complementary, NCI-designated cancer center catchment areas are intended to support future research and community outreach activities among NCI-designated cancer centers. See related commentary by Vadaparampil and Tiro, p. 952.
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Affiliation(s)
- Peter F. DelNero
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, 20850, USA
- Implementation Science, Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, 20850, USA
| | - Ian D. Buller
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, 20850, USA
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850, USA
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850, USA
| | - Zaria Tatalovich
- Statistical Research & Applications Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, 20850, USA
| | - Robin C. Vanderpool
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, 20850, USA
| | - Henry P. Ciolino
- Office of Cancer Centers, National Cancer Institute, Rockville, MD, 20850, USA
| | - Robert T. Croyle
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, 20850, USA
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Baker J, Krebill H, Kuo H, Chen RC, Thompson JA, Mayo MS, Mudaranthakam DP, Chollet-Hinton L. Rural–Urban Disparities in Health Access Factors Over Time: Implications for Cancer Prevention and Health Equity in the Midwest. Health Equity 2022; 6:382-389. [PMID: 35651355 PMCID: PMC9148661 DOI: 10.1089/heq.2021.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/12/2022] Open
Abstract
Purpose: Population-level environmental and socioeconomic factors may influence cancer burden within communities, particularly in rural and urban areas that may be differentially impacted by factors related to health care access. Methods: The University of Kansas (KU) Cancer Center serves a geographically large diverse region with 75% of its 123 counties classified as rural. Using County Health Rankings data and joinpoint regression, we examined trends in four factors related to the socioeconomic environment and health care access from 2009 to 2017 in rural and urban counties across the KU Cancer Center catchment area. Findings: The adult health uninsurance rate declined significantly in rural and urban counties across the catchment area (rural annual percent change [APC]=−5.96; 95% CI=[−7.71 to −4.17]; urban APC=−5.72; 95% CI=[−8.03 to −3.35]). Childhood poverty significantly decreased in rural counties over time (APC=−2.94; 95% CI=[−4.52 to −1.33]); in contrast, urban childhood poverty rates did not significantly change before 2012 (APC=3.68; 95% CI=[−15.12 to 26.65]), after which rates declined (APC=−5.89; 95% CI=[−10.01 to −1.58]). The number of primary care providers increased slightly but significantly in both rural and urban counties (APC=0.54; 95% CI=[0.28 to 0.80]), although urban counties had more primary care providers than rural areas (76.1 per 100K population vs. 57.1 per 100K population, respectively; p=0.009). Unemployment declined significantly faster in urban counties (APC=−10.33; 95% CI=[−12.16 to −8.47]) compared with rural counties (APC=−6.71; 95% CI=[−8.22 to −5.18]) (p=0.02). Conclusion: Our findings reveal potential disparities in systemic factors that may contribute to differences in cancer prevention, care, and survivorship in rural and urban regions.
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Affiliation(s)
- Jordan Baker
- Department of Biostatistics & Data Science, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Hope Krebill
- University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas, USA
- Masonic Cancer Alliance, Fairway, Kansas, USA
| | - Hanluen Kuo
- University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas, USA
- Masonic Cancer Alliance, Fairway, Kansas, USA
| | - Ronald C. Chen
- University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jeffrey A. Thompson
- Department of Biostatistics & Data Science, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
- University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Matthew S. Mayo
- Department of Biostatistics & Data Science, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
- University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Dinesh Pal Mudaranthakam
- Department of Biostatistics & Data Science, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
- University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Lynn Chollet-Hinton
- Department of Biostatistics & Data Science, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
- University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas, USA
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Xia Q, Mudaranthakam DP, Chollet-Hinton L, Chen R, Krebill H, Kuo H, Koestler DC. shinyOPTIK, a User-Friendly R Shiny Application for Visualizing Cancer Risk Factors and Mortality Across the University of Kansas Cancer Center Catchment Area. JCO Clin Cancer Inform 2022; 6:e2100118. [PMID: 35015561 PMCID: PMC9848578 DOI: 10.1200/cci.21.00118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE The University of Kansas Cancer Center (KU Cancer Center) recently developed a data warehouse to Organize and Prioritize Trends to Inform KU Cancer Center (OPTIK). The OPTIK database aggregates and standardizes data collected across the bistate catchment area served by the KU Cancer Center. To improve the usability of the OPTIK database, we developed shinyOPTIK, a user-friendly, interactive web application for visualizing cancer risk factor and mortality rate data across the KU Cancer Center Catchment area. METHODS Data in the OPTIK database were first consolidated at the county level across the KU Cancer Center catchment area. Next, the shinyOPTIK development team met with the KU Cancer Center leadership to discuss the needs and priorities of the shinyOPTIK web application. shinyOPTIK was developed under the R Shiny framework and consists of a user interface (ui.R) and a web server (server.R). At present, shinyOPTIK can be used to generate county-level geographical heatmaps; bar plots of demographic, screening, and risk factors; and line plots to visualize temporal trends at different Rural-Urban Continuum Codes (RUCCs), rural-urban status, metropolitan, or county levels across the KU Cancer Center catchment area. RESULTS Two examples, adult obesity prevalence and lung cancer mortality, are presented to illustrate how researchers can use shinyOPTIK. Each example is accompanied by post hoc visualizations to help explain key observations in terms of rural-urban disparities. CONCLUSION Although shinyOPTIK was developed to improve understanding of spatial and temporal trends across the population served by the KU Cancer Center, our hope is that the description of the steps involved in the creation of this tool along with open-source code for our application provided herein will serve as a guide for other research centers in the development of similar tools.
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Affiliation(s)
- Qing Xia
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS
| | - Dinesh Pal Mudaranthakam
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS,The University of Kansas Cancer Center, Kansas City, KS
| | - Lynn Chollet-Hinton
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS,The University of Kansas Cancer Center, Kansas City, KS
| | - Ronald Chen
- The University of Kansas Cancer Center, Kansas City, KS,Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS
| | - Hope Krebill
- The University of Kansas Cancer Center, Kansas City, KS
| | - Hanluen Kuo
- The University of Kansas Cancer Center, Kansas City, KS
| | - Devin C. Koestler
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS,The University of Kansas Cancer Center, Kansas City, KS,Devin C. Koestler, PhD, Department of Biostatistics & Data Science, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66106; e-mail:
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