Wayne State Creates Digital Engagement and Cancer Outcomes Center

Wayne State University and the Barbara Ann Karmanos Cancer Institute researchers have secured a grant from the American Cancer Society (ACS) to establish the Digital Engagement and Cancer Outcomes (DECO) Center. 

The center’s goals are to better understand the impact of the digital environment and digital inclusion on outcomes and disparities among Black cancer patients, survivors and caregivers, and advance interventions that both integrate and impact hospital and community resources to improve outcomes at the individual level.

Funded by a four-year, $4 million ACS Cancer Health Research Center grant, the center will be housed at the Karmanos Cancer Center in Detroit. 

Researchers will build and strengthen connections with Detroit’s digital equity ecosystem; link cancer patients, survivors and caregivers disadvantaged by the digital divide with a range of resources that promote digital inclusion; and, ultimately, improve cancer care and outcomes.

Racial disparities in cancer care are well-documented, with many challenges experienced by Black cancer patients and survivors in Detroit. Findings by the center’s research team have shown lower health-related quality of life among Black cancer survivors compared to White survivors, as well as an association between greater financial hardship and lower quality of life. Other research has found that oncologists rated higher in implicit racial bias had shorter interactions with Black patients, and patients rated those oncologists’ communication as less patient-centered and supportive.

The researchers note that there is growing evidence that challenges confronted by cancer patients and post-treatment survivors can be effectively addressed through digital health tools. However, digital inclusion is a major hurdle in Detroit. Internet access, specifically access to broadband service and reliable high-speed internet, has been described as a “super determinant” of health, yet according to a recent U.S. Census American Community Survey, only 57.6% of Detroiters have broadband service.

“We are incredibly grateful and excited for this opportunity to expand research and programs that focus on digital inclusion and help to ensure that all individuals and communities can access and use digital health tools to support optimal cancer outcomes,” said Hayley Thompson, Ph.D., the principal investigator of the grant and the DECO Center, and professor of Oncology at the Wayne State School of Medicine, in a statement. 

Thompson also is associate center director for Community Outreach and Engagement at Karmanos. “It’s significant that the past decade has seen greater effort to address the social determinants of health -- the non-medical factors affecting health like employment, housing and food access -- in health care settings,” she added. “However, the digital divide and digital inclusion have not consistently been part of that conversation. In fact, digital inclusion is now being considered a super-determinant of health, especially broadband access, which has been shown to be associated with area-level health outcomes.”

Thompson, also a member of the Population Studies Research Program at WSU and Karmanos, said the research also takes into account meaningful use of digital tools for patients. Some questions she suggests need to be part of the research are:
• Can patients access and use their patient portal?
• Can they find and enlist services that offset their financial challenges?
• Can they find reliable, trustworthy cancer information online?
• Can they connect with others affected by caner online and find more social support?

“This is especially important in Detroit, where the majority of residents are Black, one-third of residents live in poverty and cancer disparities are striking,” Thompson said. “The good news is that Detroit and the metro area already have leaders in this domain and digital inclusion expertise through organizations and networks. They also provide a firm foundation for the work we have proposed.”

The center, in its inaugural research, includes three core projects:
• “MI-COST Digital+: Development and pilot of a digital financial navigation intervention and digital support for Black cancer survivors in Detroit” will seek to increase digital inclusion through collaboration with a community-based digital equity organization and integration of its services into MI-COST, an online financial intervention designed to increase financial knowledge and access to resources.

• “Digital Health Navigation to Address Disparities in Cancer Care” proposes the creation of a Digital Health Navigator role be embedded in a multidisciplinary treatment team to provide high-quality technical support to Black cancer patients and increase the use of patient portals. This project provides career development support through the Clinician Scientist Development Grant program.

• “Advancing Equity in Cancer Digital Inclusion: Investigating Clinician Bias and Black Patient Uptake of Health-Related Digital Tools” will be the first study to examine the association between providers’ implicit racial bias, the extent to which they recommend digital solutions to Black patients and the impact on Black patients’ use of digital tools. 

In addition to the three studies, the DECO Center includes more than 30 community partners and organizations as collaborators, including cancer patients and caregivers, and organizations that support digital inclusion and access. Two organizations collaborating during the project are Human-I-T, a social enterprise offering low-cost new and refurbished devices at a range of price points and options for low-cost high-speed internet, and the Patient Empowerment Network, a national non-profit organization focusing on technology use and providing informational and educational resources to support patients and caregivers throughout every phase of their cancer experience. 

The DECO Center will also integrate Karmanos’ Technology Assistance for Cancer Patients and Caregivers Program, based on resources developed by the Patient Empowerment Network.