Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA.
J Natl Cancer Inst. 2022 Dec 8;114(12):1628-1635. doi: 10.1093/jnci/djac171.
Cancer patients and survivors with food insecurity, housing instability, and transportation-related barriers face challenges in access and utilization of quality cancer care thereby adversely impacting their health outcomes. This portfolio analysis synthesized and described National Cancer Institute (NCI)-supported social risk research focused on assessing food insecurity, housing instability, and transportation-related barriers among individuals diagnosed with cancer.
We conducted a query using the National Institutes of Health iSearch tool to identify NCI-awarded extramural research and training grants (2010-2022). Grant abstracts, specific aims, and research strategies were coded for research characteristics, study population, and outcomes.
Of the 30 grants included in this analysis, most assessed transportation-related barriers as patient-level social needs. Grants focused on community-level social risks, food insecurity, and housing instability were largely absent. Most grants included activities that identified the presence of social risks and/or needs (n = 24), connected patients to social care resources (n = 10), and engaged community members or organizations to inform the research study (n = 9). Of the grants, 18 focused on a single type of cancer, primarily breast cancer, and more than half focused on the treatment and survivorship phases.
In the last decade, there has been limited NCI-funded social risk research grants focused on food insecurity and housing instability. Findings highlight opportunities for future cancer care delivery research, including community and health system-level approaches that integrate social and clinical care to address social risks and social needs. Such efforts can help improve outcomes of populations that experience cancer health and health-care disparities.
面临食物无保障、住房不稳定和交通相关障碍的癌症患者和幸存者在获得和利用高质量癌症护理方面面临挑战，从而对他们的健康结果产生不利影响。本组合分析综合并描述了美国国立癌症研究所（NCI）支持的社会风险研究，重点评估了确诊癌症患者的食物无保障、住房不稳定和交通相关障碍。
我们使用美国国立卫生研究院 iSearch 工具进行了查询，以确定 NCI 授予的校外研究和培训赠款（2010-2022 年）。根据研究特点、研究人群和结果，对赠款摘要、具体目标和研究策略进行编码。
在这项分析中包含的 30 项赠款中，大多数评估了与交通相关的障碍作为患者层面的社会需求。关注社区层面社会风险、食物无保障和住房不稳定的赠款基本上不存在。大多数赠款包括确定社会风险和/或需求存在的活动（n=24）、将患者与社会护理资源联系起来的活动（n=10）以及让社区成员或组织参与研究的活动（n=9）。在这些赠款中，有 18 项专注于单一类型的癌症，主要是乳腺癌，超过一半的赠款专注于治疗和生存阶段。
在过去十年中，NCI 资助的关于食物无保障和住房不稳定的社会风险研究赠款有限。研究结果强调了未来癌症护理提供研究的机会，包括社区和卫生系统层面的方法，将社会和临床护理结合起来解决社会风险和社会需求。这些努力可以帮助改善经历癌症健康和医疗保健差异的人群的结果。
