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Pilot Trial of a "Divine Intervention" to Improve End-of-Life Cancer Care for Black Patients

Award Number: R21MD017652
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: 08/21/2023
PERIOD OF PERFORMANCE END DATE: 11/30/2025

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Pilot Trial of a "Divine Intervention" to Improve End-of-Life Cancer Care for Black Patients - Project Summary Most advanced cancer patients report that religiousness and/or spirituality (R/S) are important to them, yet most also say that the medical system has not met their R/S needs. Support of dying patients' R/S needs may prove especially beneficial to those who are religious, including African American (hereafter, “black”) patients who often rely heavily on religion to cope with cancer. Healthcare chaplains work within medical systems to provide R/S care. Among advanced cancer patients, visits with healthcare chaplains are associated with patients' peaceful acceptance of terminal illness, which is associated with higher rates of advance care planning (ACP), which in turn has proved an effective way to enhance a dying patient's quality of life and receipt of value-concordant end-of-life (EoL) care. Additionally, preliminary data suggest that healthcare chaplain visits are associated with higher rates of completing do-not-resuscitate (DNR) orders among black advanced cancer patients. At present, healthcare chaplains work predominantly in inpatient settings. Thus, advanced cancer patients in outpatient settings have not benefited from the many positive effects of healthcare chaplaincy, including having unmet spiritual needs addressed and the benefits of incorporating spiritual care into EoL decision-making and the cancer care experience. To date, there has not been a randomized controlled trial (RCT) of effects of early integration of healthcare chaplain-led spiritual care on EoL cancer care. We propose here to determine the feasibility of conducting such a trial and to explore potential effects of healthcare chaplain-led spiritual care on spiritual well-being and readiness to engage in ACP among black advanced cancer patients in outpatient settings. Specifically, we propose: Aim #1: Will determine the feasibility of conducting an RCT of effects of early integration of healthcare chaplain-led spiritual care into outpatient oncology care on EoL care. Aim #2: Will explore potential effects of healthcare chaplain-led spiritual care on spiritual well-being and ACP among black advanced cancer patients in outpatient settings. Aim #3: Will explore potential mechanisms by which healthcare chaplain-led spiritual care in outpatient settings affect black advanced cancer patients' EoL care outcomes. Impact: Results will provide evidence of the feasibility of conducting an RCT of the effects of early outpatient (in advance of a terminal inpatient) healthcare chaplain-led spiritual care on spiritual well-being and ACP among black advanced cancer patients. Integration of healthcare chaplain-led spiritual care into outpatient oncology services for advanced cancer patients may be an impactful, scalable way to improve the EoL cancer care experience among black patients with advanced cancer.


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 = $209,101 )
2025	2025	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Minority Health and Health Disparities Research	000	2	11/28/2024	NON-COMPETING CONTINUATION	$188,191
2025	2025	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Minority Health and Health Disparities Research	001	2	6/3/2025	NON-COMPETING CONTINUATION	$20,910
														Subtotal = $209,101

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Minority Health and Health Disparities Research	001	1	7/2/2024	NEW	$0
2024	2023	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Minority Health and Health Disparities Research	000	1	5/13/2024	NEW	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $286,273 )
2023	2023	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	1300 YORK AVE	NEW YORK	NY	10065	NEW YORK	USA	Minority Health and Health Disparities Research	000	1	8/21/2023	NEW	$286,273
														Subtotal = $286,273

Grand Total All Awards = $495,374

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Pilot Trial of a "Divine Intervention" to Improve End-of-Life Cancer Care for Black Patients

Award Number: R21MD017652

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: 08/21/2023

PERIOD OF PERFORMANCE END DATE: 11/30/2025

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