care consumers and providers, regardless of racial, ethnic, or socioeconomic status.

Recommendation 5-4: NCI should continue to assess its dissemination practices to identify effective cancer information delivery strategies among ethnic minority and medically underserved populations, revise and implement the strategic dissemination plan on the basis of the results of that research, and institute an ongoing system of monitoring to assess its effectiveness.

As part of the strategic planning process, NCI and NIH should:

  • Establish a formal reporting mechanism, perhaps through the National Cancer Advisory Board or the President's Cancer Panel, on the formulation and achievement of the strategic plan.
  • Establish baseline data regarding dissemination research for both researchers and their target populations. For instance, ethnic group and gender data should be recorded regarding (1) the principal investigators submitting research proposals, (2) the principal investigators eventually funded to do research, (3) the populations targeted in research, and (4) the practical impact of funded research on those populations. This process should use scientifically appropriate methods that would not bias the application review process.
  • Establish a more structured framework for disseminating cancer guidelines and recommendations both to health care consumers in ethnic minority and medically underserved communities and to the health care professionals who serve them. Among health care professionals, dissemination should target the continuum from undergraduate through postgraduate training and continuing education for those already in practice.
  • Establish a more structured framework for monitoring the knowledge and application of cancer guidelines and recommendations by health care consumers and providers, noting differences in minority, nonminority, and medically underserved populations.
  • Establish a framework in which implementation of guidelines by both consumers and providers can be planned.

Summary

The committee finds that the inclusion of minority and medically underserved populations in clinical trials and that the dissemination of information to minority and medically underserved communities and their health care providers is a critical link connecting scientific innovation with improvements in health and health care delivery. Enhancing this link is



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