Official websites use .gov

A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS

A lock ( 🔒 ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Need Help

I TITRATE PC: An Implementation based Community Health Worker Intervention to address Disparities in Palliative Care

Award Number: R01MD016935
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/20/2022
PERIOD OF PERFORMANCE END DATE: 11/30/2027

Group Awards By:

View Award Description

I TITRATE PC: An Implementation based Community Health Worker Intervention to address Disparities in Palliative Care - Palliative care can reduce physical and psychological symptoms, improve quality of life, and ensure goal-concordant care at the end-of-life for patients with advanced cancer. There are persistent and worsening disparities in end-of-life outcomes for African American patients which are confounded by the lower likelihood of this population to access and receive palliative care. The basis for these disparities are multi-factorial, and at the end of life, challenges include personal or cultural values in conflict with hospice philosophy, a lack of awareness of hospice services, concern about burdening family, economic factors, and/or mistrust of the healthcare system. The addition of individuals to the care team with a nuanced skillset focused on addressing such challenges to care is a promising approach to enhance palliative care uptake. Community Health Workers (CHWs) are non-clinician, culturally competent public health workers whose role is to promote access to services, provide health education, support care delivery, and promote advocacy in priority populations. CHWs supplement care for patients with advanced chronic diseases, including HIV/AIDS, tuberculosis, and cancer, and their impact on improving care in these settings is well-established. We developed an integrated CHW model – An Implementation based Community Health Worker Intervention to Address Disparities in Palliative Care (I TITRATE PC) – that utilizes CHWs as care team members to augment palliative care outcomes for patients with advanced-stage illnesses. In I TITRATE PC, CHWs are trained to provide advocacy, support, motivation, empowerment, and education regarding palliative and end-of-life care to patients and their caregivers. Our preliminary experience suggests that CHWs can improve palliative care outcomes and improve patient and caregiver satisfaction with care. Our long-term goal is to reduce barriers to palliative care receipt for African Americans with advanced cancer. Integration of CHWs as members of the healthcare team may be an effective means to improve access to and enhance the uptake of palliative care in this population. To explore this, we will conduct a randomized effectiveness-implementation pragmatic trial at four diverse cancer centers to 1. compare the effectiveness of the I TITRATE PC intervention versus standard care in improving palliative care outcomes, including quality of life, receipt of quality communication, advance care planning documentation/discussion, and hospice use, and 2. evaluate contextual factors that influence the effectiveness, fidelity, and adoption of the I TITRATE PC intervention. We anticipate this work will establish the effectiveness of a CHW-based palliative care intervention in a priority population and generate generalizable knowledge to guide the development and implementation of interventions to increase the use of palliative care services in underserved populations.


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: 2026 ( Subtotal = $584,422 )
2026	2026	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Minority Health and Health Disparities Research	002	4	2/22/2026	NON-COMPETING CONTINUATION	$58,442
2026	2026	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Minority Health and Health Disparities Research	000	4	1/12/2026	NON-COMPETING CONTINUATION	$525,980
2026	2023	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Minority Health and Health Disparities Research	001	2	2/10/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $584,422

Issue Date FY: 2025 ( Subtotal = $665,032 )
2025	2025	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Minority Health and Health Disparities Research	002	3	4/8/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$665,032
2025	2025	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Minority Health and Health Disparities Research	003	3	9/4/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2025	2023	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Minority Health and Health Disparities Research	001	2	4/8/2025	NON-COMPETING CONTINUATION	$0
2025	2023	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Minority Health and Health Disparities Research	000	2	10/24/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $665,032

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Minority Health and Health Disparities Research	000	2	4/23/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $741,408 )
2023	2023	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Minority Health and Health Disparities Research	000	2	3/10/2023	NON-COMPETING CONTINUATION	$741,408
														Subtotal = $741,408

Issue Date FY: 2022 ( Subtotal = $816,621 )
2022	2022	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Minority Health and Health Disparities Research	000	1	7/20/2022	NEW	$816,621
2022	2022	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Minority Health and Health Disparities Research	001	1	9/29/2022	NEW	$0
														Subtotal = $816,621

Grand Total All Awards = $2,807,483

Top

All Categories

About

Search

Reports

Data Submission

Award Information

I TITRATE PC: An Implementation based Community Health Worker Intervention to address Disparities in Palliative Care

Award Number: R01MD016935

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/20/2022

PERIOD OF PERFORMANCE END DATE: 11/30/2027

Federal Websites

Department of Health & Human Services

HHS Operating Divisions

HHS Staff Divisions

Download A Document Viewer