Thursday, August 21, 2025 8/21/2025

Lay Coach-led Early Palliative Care for Underserved Advanced Cancer Caregivers

Award Number: R37CA252868
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/10/2020
PERIOD OF PERFORMANCE END DATE: 06/30/2027

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Lay Coach-led Early Palliative Care for Underserved Advanced Cancer Caregivers - Each year in the United States, more than 600,000 individuals die from cancer, with most receiving intensive support in their final months from family and friend caregivers (FCGs). Historically under-resourced FCGs are especially likely to experience high-intensity caregiving with fewer supports and resources. This context has been linked to worse outcomes for both patients and caregivers at the end of life (EOL), including elevated distress, poor quality of life (QOL), and increased healthcare utilization. After the patient’s death, bereaved caregivers from these populations are also more vulnerable to prolonged psychological and emotional challenges. Despite their critical role, few interventions have been tested to determine whether early palliative care (PC) can improve long-term outcomes for historically under-resourced FCGs and their care recipients. This project seeks to address that gap by extending follow-up and outcome evaluation in an ongoing randomized hybrid type I effectiveness-implementation trial of ENABLE Cornerstone, a lay navigator-led early PC intervention tailored to the needs of historically under-resourced FCGs of patients with newly diagnosed advanced cancer. Rooted in Pearlin’s Stress-Health Process Model, the intervention includes six structured sessions plus monthly follow-up from diagnosis through early bereavement. Lay navigators provide support in stress management, coping, help-seeking, caregiving skills, and decision-making. The proposed study will leverage an ongoing trial and focus on longitudinal caregiver and patient outcomes through the EOL period and 24 weeks post-patient death. Specifically, Aim 1 will test whether Cornerstone improves caregiver distress, QOL, and burden in the 24 weeks prior to death. Aim 2 evaluates effects on patient distress, QOL, quality of death and dying, and EOL healthcare utilization. Aim 3 assesses bereavement outcomes for caregivers, including distress, resilience, burden, grief, and QOL up to 24 weeks post-loss. This work is directly responsive to calls for research on interventions to support adult cancer caregivers. It also addresses critical gaps identified by the National Cancer Institute, the National Institute of Nursing Research, and the National Academies, including the lack of attention to under-resourced populations and insufficient evidence of long-term impacts. If successful, this highly scalable intervention could meaningfully improve caregiver and patient outcomes during the most critical stages of the cancer journey, while informing future dissemination and policy efforts aimed at optimizing EOL care and bereavement.


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 = $963,323 )
2025	2025	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH STREET	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	000	6	8/12/2025	EXTENSION WITH OR WITHOUT FUNDS	$963,323
														Subtotal = $963,323

Issue Date FY: 2024 ( Subtotal = $445,512 )
2024	2024	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH STREET	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	000	5	7/1/2024	NON-COMPETING CONTINUATION	$445,512
														Subtotal = $445,512

Issue Date FY: 2023 ( Subtotal = $541,965 )
2023	2023	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	000	4	6/6/2023	NON-COMPETING CONTINUATION	$541,965
														Subtotal = $541,965

Issue Date FY: 2022 ( Subtotal = $711,060 )
2022	2022	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	000	3	6/23/2022	NON-COMPETING CONTINUATION	$553,026
2022	2022	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	001	3	7/1/2022	SUPPLEMENT FOR EXPANSION	$158,034
2022	2022	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	003	3	9/13/2022	SUPPLEMENT FOR EXPANSION	$0
2022	2021	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	002	2	9/13/2022	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $711,060

Issue Date FY: 2021 ( Subtotal = $723,185 )
2021	2021	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	000	2	7/9/2021	NON-COMPETING CONTINUATION	$553,026
2021	2021	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	001	2	9/17/2021	SUPPLEMENT FOR EXPANSION	$170,159
														Subtotal = $723,185

Issue Date FY: 2020 ( Subtotal = $475,263 )
2020	2020	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Cancer Cause and Prevention Research	000	1	7/10/2020	NEW	$475,263
														Subtotal = $475,263

Grand Total All Awards = $3,860,308

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Lay Coach-led Early Palliative Care for Underserved Advanced Cancer Caregivers

Award Number: R37CA252868

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 07/10/2020

PERIOD OF PERFORMANCE END DATE: 06/30/2027

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