# Symptom and Healthcare Access Reporting and Evaluation (SHARE) for Supportive Care Equity

> **NIH NIH K01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $160,106

## Abstract

PROJECT ABSTRACT
Cancer patients experience many troubling symptoms during treatment, including pain, insomnia, depression,
and anxiety. However, symptom burden is not equally shared across racial/ethnic groups, with Black cancer
patients reporting greater symptom burden than their White counterparts. Such disparities in symptom burden
are particularly concerning as poorly managed symptoms contribute to lower health related quality of life and
worse clinical outcomes. It is also well established, across multiple studies, that minorities report worse health
care access (HCA) than Whites, leading to disparities in health care outcomes. However, understanding of the
contribution of multiple, co-occurring HCA challenges to health care inequities is lacking, as is evidence on the
contribution of HCA to symptom burden inequities. My long-term goal is to become an independent researcher
with expertise in addressing inequities in supportive cancer care (i.e., care that optimizes comfort, function, and
social support across the cancer care continuum) through the use of innovative health informatics tools that
address systemic barriers to care. In collaboration with my mentoring team, I have developed a training and
research plan to achieve my career goal. Specifically, I will acquire intensive training in 1) structural equation
modeling approaches relevant to disentangling mediators of cancer care inequities; 2) health informatics
integration in clinical practice; 3) the application of patient-reported outcomes (PROs) in supportive cancer care;
and 4) longitudinal intervention study design and evaluation. I will leverage my career development training to
identify subgroups of cancer patients with similar HCA experiences, and examine the contribution of HCA to
racial differences in symptom burden in a cohort of Black and White cancer patients enrolled in the North Carolina
Health Registry Cancer Survivorship Cohort. With this understanding, I will then develop and test the feasibility
and acceptability of an electronic patient-reported outcome (e-PRO) tool designed to routinely monitor both,
symptoms and HCA in a cohort of Black and White cancer patients. Existing e-PRO tools rarely collect data on
HCA and, to my knowledge, have not been evaluated in racially-diverse cancer patients, potentially leading to
missed opportunities for identifying and addressing access-related challenges that might underlie or exacerbate
disparities in symptom burden. The rationale for this project is that routinely monitoring symptoms and symptom-
relevant HCA over time will lead to more timely and patient-centered symptom management, especially among
Black cancer patients who report greater symptom burden and worse HCA relative to Whites.

## Key facts

- **NIH application ID:** 10139002
- **Project number:** 5K01CA218473-04
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Cleo A Samuel-Ryals
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $160,106
- **Award type:** 5
- **Project period:** 2018-04-01 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10139002

## Citation

> US National Institutes of Health, RePORTER application 10139002, Symptom and Healthcare Access Reporting and Evaluation (SHARE) for Supportive Care Equity (5K01CA218473-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10139002. Licensed CC0.

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