Barriers to Care. Plans are underway to conduct research on factors that inhibit or are barriers to the participation of minorities and other special populations in prevention programs, screening, clinical trials, and effective treatment.

Extramural Research Program

Very little ACS extramural research is devoted to health services research, even when broadly defined to include behavioral, psychosocial, and quality-of-life research. Information from the ACS on institutional, research, and training grants in effect as of September 1, 1998, indicates that less than 5 percent of the total $171,336,000 grant program is allocated to health services research (Box 7.11). The brief descriptions of research projects included in the grant summary list do not always provide sufficient detail to allow one to distinguish between health services and other kinds of research. Consequently, this list may under-or overestimate the level of health services research support.

BOX 7.11 ACS Extramural Grant Program Health Services Research Support (as of September 1998)

Breast Cancer

  • Breast cancer recurrence: Promoting patient and family quality of life
  • Community breast cancer screening
  • Assessing and improving interval mammography screening
  • Measuring quality of life utilities in BRCA1 and BRCA2 patients
  • Psychological treatment of black women with breast cancer
  • Telephone social support and education for adaptation to breast cancer

Colon Cancer

  • Identification and targeting of counties deficient in colon cancer screening
  • Colorectal cancer prevention in rural black churches

Prostate Cancer

  • Development of the Cochrane Collaboration prostate cancer review
  • Outcome studies of screening for prostate cancer
  • Quality-of-life outcomes in men with localized prostate cancer
  • Psychoeducational support groups for prostate cancer patients
  • Patient utilities for health states in early-stage prostate cancer
  • Quality of life and utilities for patients with prostate cancer


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