# An Implementation Study to Integrate a Self-Management Support Model Into Routine Cancer Care for Rural Patients

> **NIH NIH K00** · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2021 · $74,160

## Abstract

Project Summary. The nearly 3 million US cancer survivors residing in rural areas experience 10% higher
cancer mortality compared to their urban counterparts, in part due to poorer cancer treatment adherence.
Reasons for rural-urban disparities in cancer treatment adherence are not fully understood. The majority of
research to-date has focused on health claims data and small-sample survey data. Moreover, extant data has
often neglected the protective and enabling factors that are characteristic of rural communities. A deeper
understanding of factors driving cancer treatment non-adherence in rural populations is necessary to design
targeted, asset-based interventions to reduce rural health disparities and improve outcomes. The premise of
the proposed research is that multi-level factors contribute to the observed rural-urban differences in cancer
treatment adherence and outcomes, including sociodemographic inequities and diminished access to
healthcare, psychosocial services, and technological advances. Rural cultural factors serve as barriers and
facilitators to treatment adherence and may be positively impacted by digitally-mediated interventions. The
purpose of the proposed research is to elucidate social and behavioral factors encompassing rural culture as it
relates to oncology treatment non-adherence and delineate factors amenable to targeted, tailored approaches
to improve rural oncology outcomes. These goals will be accomplished by a rigorous mixed methods approach
utilizing population-based surveys, semi-structured interviews, and ecological momentary assessment,
supported by community engagement across study phases to capitalize on strengths of rural culture while
minimizing barriers. A highly qualified multi-disciplinary team has been assembled to support my research and
training goals in mixed methodology and rural community engagement. The proposed F99/K00 application
targets the NCI's emerging priority of rural cancer control and aligns with current NCI funding initiatives in rural
oncology and implementation science. Completion of this unique pre to post-doctoral fellowship transition
award will provide me with the skills and experience necessary to be a highly trained cancer control researcher
with specific expertise in 1) rural populations, 2) health disparities, 3) patterns of care, and 4) care coordination
and delivery - four of the seven NCI Division of Cancer Control and Population Sciences areas of research
emphasis, thus expertly preparing me to advance the field of rural cancer control through the development of
innovative and scalable interventions addressing the self-management support needs of this underserved
population.

## Key facts

- **NIH application ID:** 10452052
- **Project number:** 4K00CA245799-03
- **Recipient organization:** WAKE FOREST UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Bonny Morris
- **Activity code:** K00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $74,160
- **Award type:** 4N
- **Project period:** 2021-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10452052

## Citation

> US National Institutes of Health, RePORTER application 10452052, An Implementation Study to Integrate a Self-Management Support Model Into Routine Cancer Care for Rural Patients (4K00CA245799-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10452052. Licensed CC0.

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