Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 29:43:101387.
doi: 10.1016/j.conctc.2024.101387. eCollection 2025 Feb.

Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients

Laura C Schubel  1 , Ana Barac  2 , Michelle Magee  3   4 , Mihriye Mete  1   5 , Malinda Peeples  6 , Mansur Shomali  6 , Kristen E Miller  1 , Lauren R Bangerter  1   7 , Allan Fong  5 , Christopher Gallagher  8 , Jeanne Mandelblatt  9 , Hannah Arem  1   10
Affiliations

Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients

Laura C Schubel et al. Contemp Clin Trials Commun. .

Abstract

Background: Black individuals with cancer have a higher prevalence of comorbidities and a worse cancer prognosis than other racial groups in the US. As part of a quality improvement project, we aimed to demonstrate feasibility of self-monitoring and community health worker (CHW) support among managing comorbidities for Black individuals with breast or prostate cancer.

Methods: In a single arm, pre-post study, we enrolled patients with diabetes and/or hypertension who identified as Black and were diagnosed with 1) stage 0-IV breast cancer, or 2) prostate cancer and on long-term androgen-deprivation therapy. Participants received a home-monitoring device linked to a mobile app and worked with a CHW over six months to track their blood pressure (BP) and/or blood glucose (BG). PROMIS surveys assessed support and self-efficacy.

Results: Between May 2021-December 2022, 61 patients with breast or prostate cancer comorbid with hypertension (79 %) or hypertension and diabetes (21 %) enrolled. Once weekly self-recording of BP and BG was achieved in 92 % of individuals (with hypertension) and 77 % of individuals (with diabetes and hypertension). Participants (n = 47) who reported ≥4 readings in Months 1 and 6 demonstrated improved BP control (mean reduction = 4.07 mmHg); too few BG readings were collected to assess change. We observed a slight decrease in PROMIS scores for informational (mean 3.2, sd 8.0) and instrumental support (mean 3.6, sd 8.3).

Conclusions: A self-monitoring and CHW intervention is a feasible approach to monitor hypertension among Black cancer patients. Modifications are needed to improve BG monitoring and patient reported outcomes.

Keywords: Breast cancer; Community health workers; Diabetes; Health care delivery; Hypertension; Prostate cancer; mHealth.

PubMed Disclaimer

Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:The following conflicts of interest are noted in this work: Co-authors Malinda Peeples and Mansur Shomali are consultants for Welldoc, Inc., the home monitoring mHealth application used in this work. Co-author Christopher Gallagher is a member of the advisory boards for AstraZeneca/Daiichi Sankyo, Lilly Oncology, Pfizer, and Biotheranostics. The remaining authors declare that they have no competing interests related to the research, authorship, or publication of this paper.

Figures

Fig. 1
Fig. 1
Total number of individuals assessed for eligibility, reasons for declining enrollment, trial initiation, and trial completion.
Fig. 2
Fig. 2
In-target at baseline was defined as average systolic blood pressure <130 during the first month of the study and out-of-target was defined as average systolic blood pressure≥130.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Connor A.E., Schmaltz C.L., Jackson‐Thompson J., Visvanathan K. Comorbidities and the risk of cardiovascular disease mortality among racially diverse patients with breast cancer. Cancer. 2021;127(15):2614–2622. - PubMed
    1. Patterson R.E., Flatt S.W., Saquib N., Rock C.L., Caan B.J., Parker B.A., et al. Medical comorbidities predict mortality in women with a history of early stage breast cancer. Breast Cancer Res. Treat. 2010;122:859–865. - PMC - PubMed
    1. Patnaik J.L., Byers T., DiGuiseppi C., Denberg T.D., Dabelea D. The influence of comorbidities on overall survival among older women diagnosed with breast cancer. Journal of the National Cancer Institute. 2011;103(14):1101–1111. - PMC - PubMed
    1. Fowler H., Belot A., Ellis L., Maringe C., Luque-Fernandez M.A., Njagi E.N., et al. Comorbidity prevalence among cancer patients: a population-based cohort study of four cancers. BMC Cancer. 2020;20:1–15. - PMC - PubMed
    1. Edwards B.K.N.A., Mariotto A.B., Simard E.P., Boscoe F.P., Henley S.J., Jemal A., Cho H., Anderson R.N., Kohler B.A., Eheman C.R. Annual Report to the Nation on the status of cancer, 1975‐2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer Causes & Control. 2014;1(9):1290–1314. - PMC - PubMed

LinkOut - more resources