Abstract B105: Evaluating the racial equity of a digital health patient-reported symptom management system in patients receiving chemotherapy
Authors: Gullatte Mary , Iacob Eli , Donaldson Gary , Mooney Kathi 
Published: December 2023

Abstract
INTRODUCTION. The development of behavioral & supportive care interventions to improve quality of life for people receiving chemotherapy treatment for cancer, even with demonstrated overall efficacy, may unintentionally result in unequal benefit including across racial subgroups. The purpose of this study was to determine if Symptom Care at Home (SCH), is efficacious, digital health patient-reported outcome (PROs) symptom managment system, provide equitable benefit across racial subgroups. METHODS. A randomized trial was conducted to determine the active components of SCH. Participants reported daily on 11 common treatment symptoms through an Interactive Voice Response (IVR) telephone-based system that transmitted data through telephone lines. Continuous measures & standard deviations with ordinal & categorical measures, frequencies & percentages of the totals were summarized. Comparisons between participants across Georgia & Utah & between Black & White race were completed using Students t-test & chi-square tests. Statistical analyses were completed using a 5% level of significance. This analysis compared these two groups to determine if participation with the SCH digital health tool & symptom reduction benefits were equitable. RESULTS. Participants were 239 Black plus 13 Other or mixrd-race patients (251; 86%) as compared with the 118 White patients (32%) receiving chemotherapy treatment in Atlanta, Georgia. Blacks had slightly lower call compliance 67.59% (25.92%) versus (vs) Utah Whites 72.75% (22.45%) p=0.005; lower days in study Blacks 48.9% (29.9%) vs 80.8% (50.3%), p&lt;0.001; & lower completion of study all 3 cycles of chemotherapy & still calling (65.4% vs 75.2%), p&lt;0.001. Georgians also had significantly lower average total alerts 5.08% (10.69%) vs Utah 8.12% (15.20%), p&lt;0.001 and lower presence of at least one moderate/severe symptom for most of the 11 symptoms. Georgians were more likely to be Female (72.2% vs 49.2%, p&lt;0.001); Non-marreid (37.7% vs 72.9%, p&lt;0.001); Non-degree holder (59.9% vs 39.8%, p&lt;0.001); & have diagnosis of Breast Cancer (34.9% vs 12.7%). Blacks had slightly lower call complaince 65.17% (27.1%) vs Whites 72.75% (22.45%), p=0.005; but with no statistically significant difference in number of days in study 49.0% (30.2%) vs 48.6% (29.5%), p=0.911; no statistically significant difference in completion of all 3 cycles of chemotherapy (65.4% vs 63.5%, p=0.895); with difference in average number of total alerts 4.89% (10.93%) vs 5.48% (10.20%, p=0.621). CONCLUSIONS. This study found no racial diffrences in how participants engaged the SCH digital health platform or lenght of study, although the Black plus other raccial group reported daily symptoms 7.5% less days than the White grpup. The degree of benefit found from the SCH was equitably distributed across racial categories. Carefully designed digital health tools utilized to measure & manage PROs in patients receiving chemotherapy can achieve equitable symptom benefit across racial groups & may contribute to reducing racial diparities in cancer symptom care.
Citation Format: Mary Gullatte, Eli Iacob, Gary Donaldson, Kathi Mooney. Evaluating the racial equity of a digital health patient-reported symptom management system in patients receiving chemotherapy [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B105.