UNC Lineberger and OHSU Win $4 Million Grant to Improve Cancer Screening Access
Researchers at the UNC Lineberger Comprehensive Cancer Center and Oregon Health & Science University received a multi-phase UG3/UH3 award of $4 million over six years from the National Cancer Institute to bundle outreach for multiple cancer screenings at safety-net community clinics across North Carolina and Oregon.
Addressing Persistent Screening Gaps in Rural and Safety-Net Clinics
Safety-net community clinic populations experience notably low screening rates due to structural obstacles like poor health literacy, transportation deficits, long wait times, and out-of-pocket medical expenses. According to data highlighted by the institutions, only 53% of eligible women in North Carolina federally qualified health centers have been screened for cervical cancer, while just 44% have completed colorectal cancer screenings. In Oregon, state Medicaid numbers show 52.4% completion for colorectal screenings and 60.7% for mammograms. These metrics expose deep inequities in healthcare access across rural and vulnerable jurisdictions.
“The American health system can be exceedingly difficult to navigate,” said Stephanie Wheeler, PhD, MPH, an expert on health care access in vulnerable populations at UNC Lineberger. Wheeler is co-leading the grant alongside Alison Brenner, PhD, MPH at UNC and Melinda Davis, PhD, MCR at OHSU.
The Mechanics of Screening Bundling and Proactive Outreach
To combat administrative inertia and intimidating healthcare hurdles, the six-year project deploys a patient-centered approach combining proactive outreach strategies. Rather than treating individual oncological tests as isolated milestones, researchers will bundle multiple screening prompts together. The initiative will utilize population-level reminders, direct-to-home mailings of human papillomavirus (HPV) and colorectal screening kits, and dedicated one-on-one patient navigation support.
“This bundling strategy can not only help people approach multiple cancer screenings as one singular healthcare issue to tackle on their to-do list, but it also allows us to use more innovative approaches,” Wheeler stated, emphasizing the utility of bypassing transportation barriers via home-test delivery. When vulnerable populations face complex health demands, streamlining administrative touchpoints remains vital.
Workflow Integration and Participatory Implementation
Beyond patient-facing tools, the research team is conducting qualitative interviews with patients, clinic staff, and physicians. These interviews aim to weave new interventions smoothly into existing clinical workflows rather than imposing burdensome administrative steps on overstretched providers. According to Alison Brenner, a health services researcher at the UNC School of Medicine, current systems remain unoptimized. “We wanted to figure out how we can grease the wheels of the healthcare system,” Brenner noted. “The wheels are there, they’re just cumbersome, and not everybody on the inside, outside, middle, up, and down knows which wheel to go to next.”
Melinda Davis, director of the Oregon Rural Practice-based Research Network (ORPRN) and an expert in participatory implementation science, underscored the project’s direct responsiveness to clinical partners.
Researchers intend to track how effectively bundled outreach transforms clinical participation rates, offering a potential blueprint for safety-net systems nationwide struggling to bridge persistent health disparities.