# Social Determinants of Health Research Project

> **NIH NIH U19** · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · 2024 · $480,592

## Abstract

SUMMARY– THE COMMUNITY GATEWAY TO HEALTH EQUITY STUDY (SDOH STUDY)
The Community Gateway to Health Equity Study, our SDOH study, aims to investigate the impact of a
multi-level approach to target pathways by which social determinants impact cancer control outcomes
in the health care delivery system and community. The Gateway Study embodies the theme of our Center,
which is advancing cancer control equity by strengthening the capacity of community health centers (CHCs) to
deliver evidence-based cancer screening and tobacco treatment and by promoting social, civic, and digital
connection among patients and their communities. By focusing on four key SDOH—social capital, civic
engagement, digital skills and technology access, and access to evidence-based cancer control care — we will
build community capacity and strength for improving community resources for cancer equity, increase
opportunity for civic engagement, improve resident access to resources, and ensure that CHCs have the
support needed to provide evidence-based care. The community-level intervention is an innovative approach
to build social capital and civic engagement, led by Union Capital, a non-profit designed to amplify resident
voice and power through resource exchange and collaboration. This will enable residents to access resources
that they need by building social ties and engaging in community opportunities. It will also support residents to
come together to engage with institutional structures, such as local government, that could change laws or
policies to reduce the impact of SDOH (e.g., living wage laws, tobacco product sales to minors). The health
care system-level intervention includes: (1) point-of-care population management tools for breast, cervical, and
colorectal cancer screening and tobacco use, and implementation support to increase their use; and (2)
screening and navigation to get needed resources for digital skills and technology.
We will use a cluster-randomized, stepped-wedge study design in 12 CHC sites to determine the impact of the
community- and systems-level interventions. Cancer control will target breast, cervical, and colorectal cancer
screening rates and tobacco use. Outcomes will be measured at community, systems, and patient levels.
The proposed study, a partnership between academic and community-based researchers, aims to link CHCs
and communities in ways that can impact structural factors that produce cancer control inequities. The
interventions are designed to maximize sustainability and scalability. Our community-level intervention is
conducted in partnership with an existing organization focused on social capital and community engagement,
and the systems-level intervention increases use of existing population management strategies and tools that
can be integrated into CHC infrastructure, but are significantly underutilized.

## Key facts

- **NIH application ID:** 10929697
- **Project number:** 1U19CA291431-01
- **Recipient organization:** HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH
- **Principal Investigator:** Rebekka Mairghread Lee
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $480,592
- **Award type:** 1
- **Project period:** 2024-08-16 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10929697

## Citation

> US National Institutes of Health, RePORTER application 10929697, Social Determinants of Health Research Project (1U19CA291431-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10929697. Licensed CC0.

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