Volunteer support teams effective for African American patients with advanced cancer

Peer support interventions have traditionally and successfully been used to address health promotion and prevention, such as increasing cancer screening. UNC researchers have published the first study to examine whether enhancing the skills of community-based peer support can help people living with persistent and serious illness.

The UNC team partnered with Shaw University and several community groups to complete the study, including Project Compassion, Armstrong Center for Hope, and the Community Health Coalition and Healing with CAARE, Inc, all in Durham, NC.

In partnership with community organizations and African-American churches, they developed and evaluated two models of support for patients facing advanced cancer: lay health advisors and support teams called “Circles of Care.” They report that using support teams is superior to individual lay health advisors to help patients experiencing serious illness. Their findings were published in the October 2013 issue of the journal Health Education & Behavior.

Patients facing advanced cancer need effective treatment for pain, communication about treatment options and supportive care; however, African American patients face several hurdles. While advance care planning empowers patients to control what type of treatment they receive, African Americans are less likely to create these directives.  African American cancer patients experience less effective pain management and less hospice access.

The support team model, a form of peer support uniquely adapted to the needs of people with serious illness, involves members working together to provide practical, emotional and spiritual support to patients.

Investigators recruited volunteer individuals to become lay health advisors through African American church leaders and health ministries and trained them to provide support to seriously ill patients. The advisors met monthly to share outreach experiences, discuss barrier and suggest ways to improve peer support.  Investigators then recruited volunteer team members, promoting a teamwork model to provide support.  They called the teams “Circles of Care Support Teams.”  They recruited these tam members via community organizations and the social network of the patient.

"There’s a need for programs to innovate in supportive care for people facing advanced cancer by drawing together the unique abilities of community and professional caregivers," explains Laura Hanson, MD, MPH, professor of geriatric medicine and study lead author. "Our training reached 193 volunteers, and 104 of them were able to work together as support teams for 47 people facing serious illness.  Working together, these teams felt prepared to offer practical and emotional support, and provide help finding cancer and palliative care resources." Dr. Hanson co-leads the UNC Palliative Care Program and is a member of UNC Lineberger Comprehensive Cancer Center.

Other UNC authors are Melissa Green, MPH; Michelle Hayes, BA; Giselle Corbie-Smith, MD, MSc; Jo Anne Earp, ScD. Additional authors are Tonya Armstrong, PhD, MTS, with the Armstrong Center for Hope in Durham, NC; Stacie Peacock, MHA, with Project Compassion in Durham, NC; Sharon Elliot-Bynum, RN, PhD, with the Community Health Coalition and Healing with CAARE, Inc, in Durham, NC; and Moses Goodman, MRE, EdD, with Shaw University in Raleigh, NC. 

With support from the University Cancer Research Fund, this group of investigators has just completed a follow-up study extending Circles of Care support teams to more cancer patients, demonstrating direct patient benefits.  This research study has also been accepted for publication in Health Education & Behavior.