Background/Rationale: As clinicians, we witness daily how disparities in cancer outcomes persist across diverse populations, influenced by race, ethnicity, age, socioeconomic status, and geography.
Methods: We designed and implemented a clinician-integrated EDI initiative within a life-course cancer care pathway: 1) Needs Assessment: Chart audits and patient interviews identified specific access barriers (e.g., transportation for elderly patients, childcare for young adults, cultural mistrust) and gaps in communication. 2) Theoretical Model:Guided by a patient-centered care model adapted for lifespan diversity and social determinants of health (SDOH). 3) Interventions:Clinician Actions:Mandatory cultural humility/anti-bias training; integration of standardized SDOH screening tools into electronic health records; co-development (with patients/community) of age/culturally tailored education materials; implementation of flexible scheduling and telehealth; active use of patient navigators. System Actions:Revising clinical trial eligibility criteria and recruitment strategies (e.g., community-based satellite clinics, multilingual consent); establishing age-specific survivorship and palliative care pathways. 4) Outcomes:Tracked reduced no-show rates, improved patient-reported understanding/trust, increased diversity in clinical trial enrollment, and enhanced symptom management scores across age and racial/ethnic groups.
Practice Implications:This initiative demonstrates that clinicians are pivotal in driving equitable care.
Discussion: Proactive clinician engagement is essential for sustainable EDI in cancer care. Key lessons: Community partnership is non-negotiable for designing relevant interventions; institutional support for clinician time and resources is critical; disaggregated outcome data reveals actionable insights. Challenges include managing implicit bias in real-time clinical decisions and securing resources for navigation/support services. Future directions: Developing clinician-focused EDI competencies and audits; leveraging technology (e.g., AI for bias detection in notes, tailored patient portals) responsibly; advocating for policy changes addressing structural barriers (insurance, transportation); and expanding lifespan-focused supportive care models. We clinicians must lead this transformation for equitable outcomes across all patients' lives.