National Cancer Institute-funded grants focused on synchronous telehealth cancer care delivery: a portfolio analysis.

BACKGROUND: Telehealth use increased during the COVID-19 pandemic and remains a complementary source of cancer care delivery. Understanding research funding trends in cancer-related telehealth can highlight developments in this area of science and identify future opportunities. METHODS: Applications funded by the US National Cancer Institute (NCI) between fiscal years 2016 and 2022 and focused on synchronous patient-provider telehealth were analyzed for grant characteristics (eg, funding mechanism), cancer focus (eg, cancer type), and study features (eg, type of telehealth service). Of 106 grants identified initially, 60 were retained for coding after applying exclusion criteria. RESULTS: Almost three-quarters (73%) of telehealth grants were funded during fiscal years 2020-2022. Approximately 67% were funded through R01 or R37 mechanism and implemented as randomized controlled trials (63%). Overall, telehealth grants commonly focused on treatment (30%) and survivorship (43%); breast cancer (12%), hematologic malignancies (10%), and multiple cancer sites (27%); and health disparity populations (ie, minorities, rural residents) (73%). Both audio and video telehealth were common (65%), as well as accompanying mHealth apps (20%). Telehealth services centered on psychosocial care, self-management, and supportive care (88%); interventions were commonly delivered by mental health professionals (30%). CONCLUSION: NCI has observed an increase in funded synchronous patient-provider telehealth grants. Trends indicate an evolution of awards that have expanded across the cancer control continuum, applied rigorous study designs, incorporated additional digital technologies, and focused on populations recognized for disparate cancer outcomes. As telehealth is integrated into routine cancer care delivery, additional research evidence will be needed to inform clinical practice.

Healthcare delivery research in older adults with cancer: A review of National Institutes of Health-funded projects.

BACKGROUND: Cancer is a disease of aging, and most people with cancer are older than 65. However, widespread uptake of evidence-based approaches that facilitate quality care delivery for older adults with cancer are lacking. This project aimed to review National Institutes of Health (NIH) grants funded in the last decade that focused on healthcare delivery in aging and older adults with cancer, and to examine grant-related characteristics, study designs, and scientific topics included. METHODS: A search was conducted of all extramural NIH research grants awarded between fiscal year 2012 to 2021. We examined NIH terms; keyword searches of titles, abstracts, and specific aims were implemented to maximize search efficiency. Extraction criteria focused on grant-related and study characteristics. A priori scientific topics for coding included geriatric assessment, care decision-making, communication, care coordination, physical and psychosocial functioning/symptoms, and clinical outcomes. RESULTS: A total of 48 funded grants met the inclusion criteria. A near-equal split was observed between R03, R21, and R01 grants. Most grants did not include family caregivers or focus on end-of-life care. Most grants included multiple cancers and were conducted during active treatment and in hospital/clinic settings. Common scientific topics included geriatric assessment, care decision-making, physical and psychosocial functioning/symptoms, communication, and care coordination. Few grants focused on cognitive functioning. CONCLUSIONS: Several gaps in the portfolio were identified, including family caregiver inclusion, end-of-life care, and studies focusing on cognitive functioning.

Current State of Funded National Cancer Institute Grants That Include Economic Analyses.

BACKGROUND: Health economics research is an integral part of the transdisciplinary research supported by the National Cancer Institute (NCI). To better understand NCI activities in this area, we conducted a portfolio analysis of funded NCI grants including health economics research. METHODS: We examined all competitive grants funded by NCI from fiscal years 2015 to 2020 that included economic analyses or outcomes. Grant titles, abstracts, and specific aims were independently reviewed by 2 study team members; content of included grants was then coded for analysis. RESULTS: A total 212 grants were identified from searches; 146 of these included economic analyses and were included in the portfolio analysis. These 146 grants represent approximately 0.9% of all NCI competitively funded grants awarded 2015-2020. Of these grants, 100 were R01 awards, representing approximately 2.4% of all NCI R01 grants funded 2015-2020. The most common study type was interventional randomized controlled-trial, followed by simulation or model. Screening and prevention were the most frequent grant cancer continuum topic; survivorship was included in only 16 grants (11.0%). Cost-effectiveness analysis was the most frequently listed economic outcome (97 grants, 66.4%), whereas policy impact (20 grants, 13.7%) and financial hardship (15 grants, 10.3%) were less-frequently included economic outcomes. However, economic outcomes differed by cancer control continuum topic, with financial hardship being included in a greater proportion of treatment and survivorship grants. CONCLUSIONS: Although relatively small, the NCI portfolio of funded grants including economic analyses is diverse, covering a range of cancer types, methods, and economic outcomes, and increasing over time.