Wednesday, September 17, 2025 9/17/2025

Impact of the Therapeutic Alliance on Reduction of Disparities in Latino End-of-Life Cancer Care

Award Number: K08CA245193
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 08/01/2024
PERIOD OF PERFORMANCE END DATE: 04/30/2025

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Impact of the Therapeutic Alliance on Reduction of Disparities in Latino End-of-Life Cancer Care - PROJECT SUMMARY This proposal aims to develop and pilot test a theoretically-grounded, behavioral intervention to promote the development of a therapeutic alliance between oncologists and Latino advanced cancer patients. This intervention will be grounded in the theoretical model of the TA and a conceptual model of the TA in Latino cancer patients that we will develop through the proposed formative research. Based on data from the literature and our preliminary studies, this intervention will seek to improve oncologist TA by promoting trust, empathy, shared decision-making, and patient-centered communication. The intervention framework will be based on Self Determination Theory (SDT), which posits that behaviour change (improvement in TA) is more likely when conditions of autonomy, competence, and relatedness are met. First, mixed methods will be used to create a conceptual model of the TA between oncologists and Latino cancer patients to determine targets for the intervention (Fig 1). Aim1a will leverage data from an ongoing funded multi-site, prospective observational R01 on medical/religious/cultural beliefs, TA, and EOL care outcomes (n>270). For Aim 1b, we will conduct in-depth interviews and focus groups with oncologists (n=9) and Latino cancer patients (n=35) in order to gain a more nuanced understanding of the TA and refine our conceptual model. Once the intervention has been created, we will then refine the intervention using stakeholder (Aim 1b participants) feedback regarding its feasibility and acceptability. For Aim 3, an independent set of 8 oncologists and 50 patients will be studied, half (n=4 oncologists, 25 patients) will be randomized to training in the TA intervention, and the other half (n=4, 25) will be randomized in to usual care. We will examine feasibility (rate of intervention completion), acceptability (oncologists’ and patients’ satisfaction), and efficacy of the TA intervention for improving the TA between oncologists and Latino cancer patients, as measured by patient THC scores as the primary outcome. Secondary outcomes will include engagement in ACP and EOL care. Dr. Tergas’s long-term career goal is to establish a leading, independent program of research focused on the reduction of disparities in EOL care by implementing and disseminating effective, empirically-supported interventions for use in clinical practice. As a foundation for her independent research program, her short-term career goal is to develop an implementable, evidence-based behavioral intervention for improving therapeutic alliance between oncologists and Latino cancer patients. This K08 award application represents the cornerstone of her strategy to achieve my short- term goal and consists of cohesive and complementary research aims and training objectives. Specifically, in order to achieve her career goals, she needs training in intervention development and implementation science, as well as continued training and mentorship in EOL care disparities. Conducting the research detailed in my research aims will help me achieve this training and experience, as well as provide preliminary data for a future R01-level grant application.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	BECKMAN RESEARCH INSTITUTE OF THE CITY OF HOPE	1500 DUARTE RD	DUARTE	CA	91010	LOS ANGELES	USA	Cancer Research Manpower	000	6	8/4/2025	NON-COMPETING CONTINUATION	-$233,516
2025	2024	RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Cancer Research Manpower	001	7	8/4/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$233,516
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $237,924 )
2024	2024	BECKMAN RESEARCH INSTITUTE OF THE CITY OF HOPE	1500 DUARTE RD	DUARTE	CA	91010	LOS ANGELES	USA	Cancer Research Manpower	000	6	4/17/2024	NON-COMPETING CONTINUATION	$237,924
														Subtotal = $237,924

Issue Date FY: 2023 ( Subtotal = $236,952 )
2023	2023	BECKMAN RESEARCH INSTITUTE OF THE CITY OF HOPE	1500 DUARTE RD	DUARTE	CA	91010	LOS ANGELES	USA	Cancer Research Manpower	000	5	6/7/2023	NON-COMPETING CONTINUATION	$236,952
														Subtotal = $236,952

Issue Date FY: 2022 ( Subtotal = $241,812 )
2022	2022	BECKMAN RESEARCH INSTITUTE OF THE CITY OF HOPE	1500 DUARTE RD	DUARTE	CA	91010	LOS ANGELES	USA	Cancer Research Manpower	004	4	6/13/2022	NON-COMPETING CONTINUATION	$241,812
2022	2021	BECKMAN RESEARCH INSTITUTE OF THE CITY OF HOPE	1500 DUARTE RD	DUARTE	CA	91010	LOS ANGELES	USA	Cancer Research Manpower	003	3	1/4/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2022	2021	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Cancer Research Manpower	001	2	11/16/2021	NON-COMPETING CONTINUATION	-$10,817
2022	2021	BECKMAN RESEARCH INSTITUTE OF THE CITY OF HOPE	1500 DUARTE RD	DUARTE	CA	91010	LOS ANGELES	USA	Cancer Research Manpower	002	3	11/16/2021	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$12,790
2022	2020	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Cancer Research Manpower	000	1	11/16/2021	NEW	-$1,973
														Subtotal = $241,812

Issue Date FY: 2021 ( Subtotal = $245,592 )
2021	2021	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Cancer Research Manpower	000	2	4/30/2021	NON-COMPETING CONTINUATION	$245,592
2021	2021	BECKMAN RESEARCH INSTITUTE OF THE CITY OF HOPE	1500 DUARTE RD	DUARTE	CA	91010	LOS ANGELES	USA	Cancer Research Manpower	002	3	9/10/2021	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$234,775
2021	2021	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Cancer Research Manpower	001	2	9/10/2021	NON-COMPETING CONTINUATION	-$234,775
														Subtotal = $245,592

Issue Date FY: 2020 ( Subtotal = $250,884 )
2020	2020	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Cancer Research Manpower	000	1	4/24/2020	NEW	$250,884
														Subtotal = $250,884

Grand Total All Awards = $1,213,164

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Impact of the Therapeutic Alliance on Reduction of Disparities in Latino End-of-Life Cancer Care

Award Number: K08CA245193

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 08/01/2024

PERIOD OF PERFORMANCE END DATE: 04/30/2025

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