# Achieving Equity through SocioCulturally-informed, Digitally-Enabled Cancer Pain managemeNT” (ASCENT) Clinical Trial

> **NIH NIH R61** · MAYO CLINIC ROCHESTER · 2022 · $824,748

## Abstract

Abstract
Cancer pain disparities are profound and uniquely harmful among Hispanic/Latinx and rural dwelling survivors as they
undermine their already limited ability to access, tolerate, and/or receive treatment for their cancer. Disparities are tied
to poor care, needlessly persistent and intense pain, as well as the over- and under-prescribing of opioids. Multi-modal
pain care (MMPC), a robustly validated, safer, and more effective alternative to a solely medication-based approach has
proven challenging to implement broadly, and virtually impossible in resource limited settings. The factors that impede
delivery of MMPC; provider bias, patients’ reluctance to report pain, and lack of patient-centered MMPC options, also
mediate disparities making them key targets for improvement. The Collaborative Care Model (CCM) provides a well-es-
tablished and validated framework that can neutralize factors that perpetuate disparities, guide MMPC delivery, and im-
prove pain detection and treatment. However, as currently configured the CCM’s single symptom emphasis needs to be
modified to address the multi-level drivers of pain disparities. Our team has developed and tested CCM iterations that inte-
grate elements of team-based care (TBC) to improve the CCM’s monitoring of sociocultural needs, as well as to accommo-
date MMPC’s multi-disciplinary care requirements. In addition, we have leveraged electronic health records (EHRs) to en-
able care teams to link symptomatic cancer patients with MMPC providers and resources. Our prior research deploying
CCM-TBC hybrid interventions with patient-and-care team-centered EHR-reengineering has also significantly improved
patient symptom reporting and deployment of MMPC. These efforts, while fruitful, have also shown us that a broader
EHR retrofitting is required to address the breadth of patients’ needs and the requirements of real-world clinical work-
flows. This experience suggests that a flexible, modular CCM-TBC hybrid system, supported by EHR enablement, can de-
liver high fidelity MMPC in a manner that improves care and mitigates disparities at multiple levels among Hispanic and
rural cancer survivors. We plan to evaluate the effectiveness of this approach in a clinical trial entitled “Achieving Equity
through SocioCulturally-informed, Digitally-Enabled Cancer Pain managemeNT (ASCENT ).” More specifically, we will part-
ner with our community stakeholders during an initial, 1-year R61 development phase to refine a culturally informed
version of our CCM-TBC hybrid that addresses Hispanic and rural survivors’ linguistic, social, and IT needs (Aim 1). After
confirming the functionality of the intervention’s components, we plan to transition to a 4-year R33 execution phase with
a 2-arm, parallel group randomized clinical trial. This trial (Aim 2) will be conducted in 4 semi-autonomous Health Care Sys-
tems and is designed to assess whether our culturally informed CCM-TBC hybrid intervention improves pain outcomes rel...

## Key facts

- **NIH application ID:** 10539159
- **Project number:** 1R61CA278594-01
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** Andrea Lynne Cheville
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $824,748
- **Award type:** 1
- **Project period:** 2022-09-06 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10539159

## Citation

> US National Institutes of Health, RePORTER application 10539159, Achieving Equity through SocioCulturally-informed, Digitally-Enabled Cancer Pain managemeNT” (ASCENT) Clinical Trial (1R61CA278594-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10539159. Licensed CC0.

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