New Hanover Regional Medical Center
Wilmington, NC

Hanover Regional Medical Center
Zimmer Cancer Center
2131 South 17th Street
Wilmington, NC 28401
http://www.nhrmc.org

PI: Patrick D. Maguire, MD

The New Hanover Regional Medical Center (NHRMC) is part of the New Hanover Health Network, the largest provider of health care services in Southeastern North Carolina. NHRMC is the network's 769-bed tertiary, teaching facility. Affiliated with the School of Medicine at the University of North Carolina at Chapel Hill and the Coastal Area Health Education Center, it offers residency programs in surgery, obstetrics and gynecology, family practice, and internal medicine. Its 4,400 employees, 490 physicians and 900 volunteers serve one of the nation's fastest growing communities and retirement-age populations. The network's service area includes New Hanover, Pender, Brunswick, Columbus, Bladen, Duplin, Onslow, Robeson, and Sampson counties in North Carolina. The county-owned public hospital network receives no local county tax support and will provide more than $65 million in Fiscal Year 2003 in indigent and uncompensated care. NHRMC is accredited by the Joint Commission on the Accreditation of Health Care Organizations.

The Zimmer Cancer Center
The Zimmer Cancer Center, on NHRMC's main campus, is Southeastern North Carolina's only community cancer center dedicated solely to the diagnosis, treatment, and support of people with cancer. The Zimmer Cancer Center provides access to board-certified medical, surgical, radiation, and gynecological oncology physicians and consolidates services such as infusion therapy, chemotherapy, radiation oncology, and support services. Clinic services are available for diagnosis and follow-up care. The Commission on Cancer of the American College of Surgeons has approved the oncology program at NHRMC as a Teaching Hospital Cancer Program. Zimmer Cancer Center patients have access to board-certified gynecological, medical, radiation and surgical oncologists, a national clinical cancer research program, comprehensive services dedicated to the diagnosis and treatment of almost any form of cancer. The cancer program offers access to a 24-bed inpatient unit and other services at NHRMC.

Patient Population
New Hanover Regional Medical Center serves a population that is heavily concentrated with African-American and poor persons. According to the 2000 Census, 12.3% of the United States population is African-American; in North Carolina, 21.6% of the population is African-American; in the nine counties served b the NHRMC, 22.5% of the population is African-American, and the percentage ranges from 14.4% in Brunswick county to 37.9% in Bladen county. Moreover, the median per capita income for all persons in the United States is $21,587, and in North Carolina, it is $13,548, and for black Americans in the counties of interest, the median income ranges from $9,624 to $14,083.

Finally, for the United States as a whole, 12.3% of the people of all ages live in poverty; the corresponding figure for North Carolina is 12.2% and, for Southeastern North Carolina is 15.8%. For the country, 23.5% of African-Americans live in poverty compared with 21.8% in North Carolina and 27.4% in the counties of interest.

Grant Staff Contact Information New Hanover Regional Medical Center 2131 South 17th Street Wilmington, NC 28401 Principal Investigator: Patrick D. Maguire, MD Radiation Oncologist Phone: (910) 251-1839 E-mail: jmaguire@ec.rr.com Clinical Research Coordinator Laurie Graham, RN, MSN, AOCN Phone: (910) 343-2862 Email: laurie.graham@nhhn.org Coastal Area Health Education Center 2131 South 17th Street Wilmington, NC 28401 Mary Sue Hamann, PhD Co-Investigator / Grant Manager Director of Research Phone: (910) 343-0161 E-mail: sue.hamann@coastalahec.org Administrative Specialist Judy Bennett Coastal AHEC Department of Research Phone: (910) 343-0161 Email: judy.bennett@coastalahec.org

University of North Carolina at Wilmington School of Nursing and Department of Psychology 601 South College Road Wilmington, NC 28403 Co-Investigator Perri J. Bomar, PhD, RN Associate Dean of Research and Community Partnerships Phone: (910) 962-3066 Email: bomarp@uncw.edu Co-Investigator James Johnson, PhD Department of Psychology Phone: (910)-962-3066 Email: johnsonj@uncw.edu Nora Noel, PhD Phone: (910) 962-3066 Email: noeln@uncw.edu Primary Partner Institution University of North Carolina at Chapel Hill Department of Radiation Oncology UNC School of Medicine, CB# 7512 Chapel Hill, NC 27599-7512 http://www.unc.edu Co-Investigator Joel Tepper, MD Phone: (919) 966-0400 Email: tepper@radonc.unc.edu Co-Investigator Julian Rosenman, MD Phone: (919) 966-0400 Email: rosenman@cs.unc.edu

Consortium:

Coastal Area Health Education Center
http://www.coastalahec.org

University of North Carolina at Wilmington
School of Nursing and Department of Psychology
http://www.uncw.edu

Cancer Disparities Research Partnership Program Project Summary

Project Title: Improving Cancer Outcomes for African-Americans.

Southeastern North Carolina is a rural area with concentrations of poverty and a large proportion of African-American residents. Within the nine-county service area of the New Hanover Health Network are almost 170,000 African-American residents. African-Americans in North Carolina have higher mortality rates, compared with whites, for cancers of the uterine cervix, lung, and bronchus, prostate, larynx, oral cavity and pharynx, breast, colon, and rectum, and soft tissue. Participation by African-American cancer patients in federally sponsored radiation oncology group clinical trials has the potential to articulate more clearly the factors that contribute to these disparities.

Our goal is to increase accrual of African-American cancer patients to radiation therapy group clinical trials through the following: 1) Developing a collaborative partnership with an experienced academic institution that can provide continuing education, consultation, and training in the areas of radiation oncology treatment and research; 2) Identifying and addressing the local factors that inhibit participation in radiation clinical trials; and 3) Developing mechanisms to communicate with patients and providers in surrounding rural areas to provide consultation and facilitate appropriate referrals for radiation trials.

This project will permit us to contribute to the advancement of medical knowledge and medical practice that will eventually lead to the reduction or elimination of racial disparities in cancer outcomes.

New Hanover Regional Medical Center's Patient Navigator Program

The Patient Navigator will assist in mitigating some of the economic and social barriers to cancer treatment, particularly radiation oncology group trials, for African American patients. The Patient Navigator will assist patients in applying for federal, state, and private assistance for treatment costs, in reducing access problems such as transportation, and in enhancing familial and social support systems for cancer patients. In addition, the Patient Navigator will work as a health educator for cancer patients. The Patient Navigator will assist cancer patients from underserved populations in navigating the cancer care system of New Hanover Regional Medical Center and affiliated medical offices, thereby helping patients to close the gap between detection and appropriate treatment delivery. The Patient Navigator will assist cancer patients in receiving timely diagnosis, timely treatment, information and education relating to cancer treatment and clinical trials.

The Patient Navigator will have the following duties:

• To initiate communication with newly identified cancer patients, particularly minority patients;
• To inform patients of services and resources;
• To increase health awareness among cancer patients and their families;
• To assist patients in securing financial resources for treatment (medical insurance, government medical assistance);
• To provide psycho-social support to patients, individually and in groups;
• To coordinate patient services;
• To build relationships with other Patient Navigators; and
• To track interventions and outcomes.