# Improving rural cancer care delivery

> **NIH AHRQ F32** · UNIVERSITY OF HAWAII AT MANOA · 2021 · $68,562

## Abstract

Project Summary/Abstract
Although advances in cancer treatment have improved patient survival overall, cancer mortality rates in rural
populations remain disproportionately higher than urban populations. Rural-urban disparities in cancer mortality
rates are thought to, in part, reflect suboptimal care coordination in rural areas. Cancer patients residing in rural
areas experience greater care coordination challenges including limited or lack of access to medical care, travel
burdens, shortages of specialists, and delays in receiving diagnosis and post-diagnosis intervention. Delays in
diagnosis and treatment initiation have been shown to adversely impact patient survival; such delays have been
associated with a three-fold cancer mortality risk. However, little is known about rural cancer patients’ perception
of care coordination, rural-urban differences in specific cancer care coordination processes, and the impact of
rural cancer care coordination on specific care delivery outcomes. The proposed research will address these
knowledge gaps and accomplish the following aims: Aim 1) To compare rural and urban cancer patients’
perception of care coordination and Aim 2) To examine the associations between rural cancer patients’
perception of care coordination and specific care delivery outcomes (time from first symptoms to diagnosis, time
from diagnosis to treatment initiation). These aims will inform specific care coordination processes that
disproportionately impact rural cancer patients and ways to improve rural cancer care delivery. Findings will
guide the development of future interventions focused on improving rural cancer care delivery and may contribute
to improved quality and value of cancer care, reduce burdens related to care delivery for rural cancer patients,
and address rural cancer health disparities. The proposed research advances the Agency for Healthcare
Research and Quality (AHRQ)’s focus on research and evaluation of health care delivery in a priority population
residing in rural areas. The proposed fellowship is designed to enhance the applicant’s knowledge and skills in
health services research under expert mentorship and a mentoring committee, and includes a larger training
plan developed to prepare the applicant for the next step in her career toward becoming an independent
investigator. Training and research will be conducted at one of the 70 National Cancer Institute-designated
cancer centers. Upon completion of the proposed research and training, the applicant will be ideally poised to
submit a complete K01 application focused on developing and testing an intervention aimed to improve cancer
care coordination in rural areas. Her current and future research aims will advance AHRQ’s mission by focusing
on the delivery of health care in a high priority population residing in rural areas.

## Key facts

- **NIH application ID:** 10225979
- **Project number:** 5F32HS027286-02
- **Recipient organization:** UNIVERSITY OF HAWAII AT MANOA
- **Principal Investigator:** Izumi Okado
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $68,562
- **Award type:** 5
- **Project period:** 2020-07-09 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10225979

## Citation

> US National Institutes of Health, RePORTER application 10225979, Improving rural cancer care delivery (5F32HS027286-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10225979. Licensed CC0.

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