National Nonprofit Organization Research Articles

Evaluation of a Conference on Cancer-Related Financial and Legal Issues: A Potential Resource to Counter Financial Toxicity.

This study describes the conception, development, and growth of the Triage Cancer Conference hosted by Triage Cancer, a national nonprofit organization providing free legal and financial education to the cancer community. We conducted a retrospective analysis of post-conference participant surveys. Descriptive statistics were calculated for participant demographics, and acceptability, feasibility, and appropriateness were evaluated. From 2016-2021, 1239 participants attended the conference and completed post-conference surveys. Participants included social workers (33%), nurses (30%), and cancer patients/survivors (21%), with representation from over 48 states. Among those who reported race, 16% were Black, and 7% were Hispanic. For acceptability, more than 90% of participants felt that the conference content, instructors, and format were suitable and useful. For feasibility, more than 90% of participants felt that the material was useful, with 93-96% reporting that they were likely to share the information and 98% reporting that they would attend another triage cancer event. Appropriateness was also high, with >80-90% reporting that the sessions met the pre-defined objectives. Triage Cancer fills an important gap in mitigating financial toxicity, and formal evaluation of these programs allows us to build evidence of the role and impact of these existing resources. Future research should focus on adding validated patient-reported outcomes, longer-term follow-up, and ensuring inclusion and evaluation of outcome metrics among vulnerable populations.

Abstract PO5-08-03: Breastfeeding and Breast Cancer Screening Among Carriers of Pathogenic Variants in BRCA 1 and BRCA 2 and Other High Penetrance Genes: Knowledge and Perspectives

Abstract Objectives: Carriers of pathogenic variants in high penetrance mutations, including BRCA 1 or BRCA 2 face higher lifetime risks of developing breast and tubo-ovarian cancers, and possibly endometrial cancers, than non-carriers. In particular, relative risks are higher among carriers than non-carriers at younger ages, suggesting the value of early initiation of breast cancer screening and the use of sensitive imaging methods, such as magnetic resonance imaging (MRI). Further, breastfeeding appears protective for these three cancers in the general population, and potentially among mutation carriers, albeit based on limited evidence. Given that data related to knowledge and perspectives of carriers about these issues are limited, we surveyed mutation carriers regarding breastfeeding, cancer risk, and the deferral of breast cancer screening coinciding with reproductive events. These data may guide future cancer prevention research and developing of targeted communication campaigns. Methods: Researchers at Mayo Clinic, in collaboration with Facing Our Risk of Cancer Empowered (FORCE) – a large, national non-profit organization that addresses the needs of people and families affected by inherited mutations linked to cancer – designed and conducted a survey using the Mayo Clinic’s external RedCap system. The survey covered genetic testing and results, history of live births and breastfeeding history for mothers, history of risk-reducing surgery, personal cancer history, sources of information about cancer screening, breastfeeding knowledge, and breast cancer screening at various times, including during pregnancy, while breastfeeding, and after weaning. The survey was disseminated through FORCE’s electronic newsletter, website, social media pages, and advocacy partners. Survey responses were collected anonymously and analyzed descriptively using standard descriptive statistics, including frequency and percentages for categorical responses and means (SD) or medians (IQR) for continuously scaled responses. The open-ended responses were analyzed qualitatively using standard qualitative methodology. Results: Respondents included 253 women, of whom 88.7% were U.S. residents and 92.9% were white. The mean age + SD was 47(13) years, 61.7% were parous, with a mean age at first birth of 22.58 (13.16) years. Approximately 60% of women were carriers of mutations in BRCA1 or BRCA2 or both genes and all but two of the remaining women reported mutations in other genes linked to increased cancer risk. At the time of the survey, 92% of women had undergone a mammogram, with first screen at a mean age of 35 (6.49) years, and 85.3% had undergone breast MRI, with first screen at a mean age of 43 (12.39) years. Among 34.3% of participants, their 1st postpartum mammogram occurred >3 years after the birth of their last child and 57% had 1st MRI 3 years postpartum. Preliminarily, our analysis shows that nearly 90% of women were unaware of their mutation status prior to pregnancy and approximately 1/3 did not undergo radiologic screening until 3 years postpartum. While 62.6% of respondents believed that breastfeeding lowers breast cancer risk, 74.2% of participants responded that nursing had no effect on tubo-ovarian cancer risk, and 78.2% considered that nursing did not impact endometrial cancer risk. Discussion and Conclusions: Preliminarily, we conclude that most women in the surveyed population were unaware of their mutation status when pregnant years earlier and many had not undergone screening until years after delivery. Many participants did not consider breastfeeding a potentially protective factor for women’s cancers. These data raise issues about the potential value of discussing genetic testing with women when considering family planning and mutation carriers, addressing complex issues about breast cancer screening while pregnant and breastfeeding. Citation Format: Laura Pacheco-Spann, Mark Sherman, Susan Friedman, Diane Rose, Miriam Levi, Alex Hochwald, Jennifer Ridgeway, Sophia Blumenfeld. Breastfeeding and Breast Cancer Screening Among Carriers of Pathogenic Variants in BRCA 1 and BRCA 2 and Other High Penetrance Genes: Knowledge and Perspectives [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-08-03.

The acceptability of Songs of Love for youth living with chronic pain.

Music is helpful to young people in healthcare contexts, but less is known about the acceptability of music-based interventions for youth living at home with chronic pain who may be struggling to attend school and participate in social activities. The Songs of Love (SOL) foundation is a national nonprofit organization that creates free, personalized, original songs for youth facing health challenges. The aims of this study were (1) to assess acceptability of SOL from the perspective of youth with chronic pain receiving a song and singer-songwriters who created the songs, and (2) to explore the role of music more generally in the lives of young people living with pain. Twenty-three people participated. Fifteen youth (mean age 16.8) were interviewed and received a song, and six singer-songwriters were interviewed about creating the songs. (Two additional people participated in pilot interviews.) Acceptability was assessed by (1) proportion of youth who participated in a second interview about their song and (2) results of reflexive thematic analysis (RTA) to determine acceptability. Themes addressing the role of music in the lives of youth with pain were also explored using RTA. The program was acceptable as 12 of 15 youth (80 %) participated in second interviews and themes met the definition of acceptability. Three themes addressing the role of music in the lives of youth living with pain were identified. This is the first report of the acceptability and experience of SOL and contributes to research on the benefits of music for pain management.

National nonprofit offering mental health training for PCPs

Observing the mental health workforce shortage, a national nonprofit organization is continuing its mission to ensure that children and families receive appropriate mental health care and is doing so by training primary care providers (PCPs), therapists and health care institutions in evidence‐based therapies to better diagnose, treat and manage child and adult mental health issues.

Machine learning-based prediction of abdominal aortic aneurysms for individualized patient care

ObjectiveThe United States Preventative Services Task Force guidelines for screening for abdominal aortic aneurysms (AAA) are broad and exclude many at risk groups. We analyzed a large AAA screening database to examine the utility of a novel machine learning (ML) model for predicting individual risk of AAA. MethodsWe created a ML model to predict the presence of AAAs (>3 cm) from the database of a national nonprofit screening organization (AAAneurysm Outreach). Participants self-reported demographics and comorbidities. The model is a two-layered feed-forward shallow network. The ML model then generated AAA probability based on patient characteristics. We evaluated graphs to determine significant factors, and then compared those graphs with a traditional logistic regression model. ResultsWe analyzed a cohort of 10,033 patients with an AAA prevalence of 2.74%. Consistent with logistic regression analysis, the ML model identified the following predictors of AAA: Caucasian race, male gender, advancing age, and recent or past smoker with recent smoker having a more profound affect (P < .05). Interestingly, the ML model showed body mass index (BMI) was associated with likelihood of AAAs, especially for younger females. The ML model also identified a higher than predicted risk of AAA in several groups, including female nonsmokers with cardiac disease, female diabetics, those with a family history of AAA, and those with hypertension or hyperlipidemia at older ages. An elevated BMI conveyed a higher than expected risk in male smokers and all females. The ML model also identified a complex relationship of both diabetes mellitus and hyperlipidemia with gender. Family history of AAA was a more important risk factor in the ML model for both men and women too. ConclusionsWe successfully developed an ML model based on an AAA screening database that unveils a complex relationship between AAA prevalence and many risk factors, including BMI. The model also highlights the need to expand AAA screening efforts in women. Using ML models in the clinical setting has the potential to deliver precise, individualized screening recommendations.

Assessing cancer-related financial support needs by household income.

210 Background: Financial hardship associated with a cancer diagnosis can impact access to healthcare, treatment adherence, and overall quality of life. Family Reach, a national nonprofit, offers direct financial assistance grants for both medical and nonmedical expenses. Our analysis aimed to assess financial hardship, essential needs, and specific assistance requests amongst grant applicants based on household income level. Methods: Data from applications in March 2021-February 2022 were analyzed using descriptive statistics and univariate tests. Household income was assessed across 3 categories of the Federal Poverty Level (FPL): &lt;150% of FPL, 150-250% of FPL, and &gt;250% of FPL. Associations between FPL and race/ethnicity, gender, insurance, phase of treatment, self-reported financial concerns, and assistance requests were characterized. Results: 4077 patients with cancer applied for assistance in the 12-month period; 2398 (59%) were &lt;150% FPL, 845 (21%) were 150-250% FPL, and 834 (20%) were &gt;250% FPL. Common diagnoses included leukemia (25%), breast (19%), and brain (7%). 57% applicants were female and 42% male; racial/ethnic identity included 43% Non-Hispanic White, 24% Non-Hispanic Black, and 19% Hispanic/Latinx. 89% of applicants reported undergoing active treatment, with 7% in monitoring and follow-up. Lower household income was associated with more food insecurity, higher risk of utilities and phone being shut-off, and increased risk of homelessness (p&lt;0.001). Requests for unexpected aid, childcare, funeral expenses, and public transportation were all less common in higher income groups compared to those with incomes &lt;150% FPL. Requests for assistance with medical expenses and car payments/insurance were more common for those with higher household income. Conclusions: This analysis of patients with cancer who applied for financial assistance shows that support needs vary significantly by household income; families affected by cancer close to the poverty threshold had significant difficulties meeting essential needs, including food and shelter. Lack of individualized interventions may decrease effectiveness of aid and fail to fill gaps in financial coverage. Programs like Family Reach can serve as a blueprint for future individualized aid distribution to address financial barriers to optimal cancer outcomes.[Table: see text]

Promotion of physical activity among people who identify as women through the ParticipACTION mobile app

Objective Health and fitness mobile applications can increase users’ physical activity (PA) levels (Lister et al., 2014). ParticipACTION is a national non-profit organization that developed a mobile app to target PA among adults (Truelove et al., 2020). The aim of this research was to examine how women’s PA is related to their use of the ParticipACTION app. Methods and Measurement Using a mixed-methods design, participants (n = 3,493) completed a survey regarding their PA levels, motivation for PA (capability, opportunity, motivation; COM-B, Keyworth et al., 2020), and motivation for using the ParticipACTION app. Nine focus groups were conducted (n = 37) to discuss the mobile app further. Results Path analyses revealed that users’ app use was positively associated with motivations for various app functions (e.g. self-monitoring, seeking exercise guidance), however, only motivation in-turn predicted PA. Descriptive results indicated that many women in Canada who used the app do not meet national guidelines for PA per week. Qualitative findings highlight women’s motivation for using the app, concerns with app functionality, and feelings of guilt for not engaging in PA. Conclusion The ParticipACTION app may have some benefit for improving women’s PA; intervention studies are needed to determine efficacy of mobile applications.

The CoGenerate Innovation Fellowship: Supporting Leaders of Intergenerational Initiatives

ABSTRACT This Case Report provides a detailed overview of the CoGenerate Innovation Fellowship, a 9-month fellowship that supports leaders of intergenerational initiatives developed by the national nonprofit organization, CoGenerate. It describes the Fellowship’s recruitment and cohort development strategies, monthly meetings and community-building efforts, end-of-Fellowship celebration, and post-Fellowship support. It summarizes findings from the two-year pilot’s process and outcomes evaluation and provides recommendations to individuals and organizations seeking to support social sector innovators who are leading intergenerational initiatives.

Assessing changes in cancer-related financial support needs across three waves of the COVID-19 pandemic.

e18584 Background: Cancer-related financial hardship is well-documented and associated with treatment/medication nonadherence and poor outcomes. Family Reach is a national nonprofit that aims to remove financial barriers to cancer treatment through education, resource navigation, financial coaching, and direct financial assistance. We sought to evaluate variation in patient financial support needs throughout three waves of the COVID-19 pandemic: March-December 2020 (Wave 1), January-December 2021 (Wave 2), and January-June 2022 (Wave 3). Methods: Applications for Family Reach services were evaluated. Descriptive statistics and univariate tests characterized responses, and multivariable analysis, considering age, race/ethnicity, insurance, gender, insurance, % of federal poverty level (FPL), and children &lt; 18 in the home, assessed associations between pandemic wave and self-reported financial and essential needs concerns. Results: From 3/2020-6/2022, 10679 applications were processed: 39% in 2020, 38% in 2021, and 24% in 2022. When relationship to the patient was specified (62%, n = 6647), most applications were submitted by a parent (53%) or the patient (28%). Common diagnoses included leukemia (26%), breast cancer (16%), sarcoma (8%), and lymphoma (7%). Patients were a median age of 30 years (IQR: 11-46); racial/ethnic identity included 41% Non-Hispanic White, 24% Non-Hispanic Black, 21% Hispanic patients; 53% had a child &lt; 18 years at home. Median %FPL was 123.2 (IQR: 68.3-207.6): 54% reported losing income because of the pandemic, with a greater than expected proportion experiencing income loss in the Wave 2 (Wave 1: 49%, Wave 2: 59%, Wave 3: 54%; χ2= 67.0, df = 2, p &lt; .001). Financial concerns across the entire sample included medical expenses (50%), nonmedical expenses (61%), childcare costs (17%), and food insecurity (42%). One-third (33%) were at risk of utility shut off within the past 90 days. In multivariable analyses, concerns about medical expenses were higher in Wave 2 (OR = 1.8, 95% CI: 1.5-2.1, p &lt; .001) and Wave 3 (OR = 3.2, 95% CI: 2.7-3.9, p &lt; .001), when compared to Wave 1. Past 90-day-risk of utility shut off (Wald = 26.0, p &lt; .001), food insecurity (Wald = 46.7, p &lt; .001), and childcare concerns (Wald = 26.0, p &lt; .001) were higher in Wave 1 when compared to Waves 2 and 3. General nonmedical needs were consistent across all three waves of the pandemic (Wald = 1.28, p = .53). Conclusions: Although the early months of the COVID-19 pandemic led to high rates of immediate essential needs in patients with cancer, nonmedical financial concerns remained consistent, and medical financial concerns rose over time. Given ongoing financial gaps in care delivery for the most vulnerable, financial assistance and other services through programs like Family Reach will continue to be a key resource for patients and families, but structural and policy-focused interventions are needed for sustainable change.

Strategies to Operationalize Health Equity in Island Area Health Departments.

Strategies to Operationalize Health Equity in Island Area Health Departments.

Do Thank-You Calls Increase Charitable Giving? Expert Forecasts and Field Experimental Evidence

Calling to thank donors is considered a key fundraising strategy in the charitable giving industry. Yet the effectiveness of thank-you calls remains untested. We conduct field experiments with public television stations and a national nonprofit in which 500,000 new donors were randomized to receive a thank-you call or not. Fundraising professionals predicted that the calls—which followed standard practices in the industry—would increase donor retention by 80 percent. In stark contrast, we found a precisely estimated null effect of calls on donor retention. (JEL C83, C93, D64, D91, L31, L82)

What We Be

What We Be Camisha L. Jones (bio) An Ekphrastic poem after Beyoncé's Lemonade We the exhaleOur confidence We the pot of greensOur hands We the floorWe every grief We the waitOur mouths We the magnolia tree the submergea ripe orange the salt porkclean the grit the sinkfed to us the waitfill with leftovers its sweet the silencea vitamin cure the liquorgive and give the portions the kitchen's back doorat the breakfast table the push on in spite ofsour with thanks its shade We sit in a bed of no name flowers Our thorned feetOur callused handsOur voices lifted planted like rosesintertwined in the moon's shadowa blossoming song [End Page 103] Camisha L. Jones camisha l. jones is a 2022 Disability Futures Fellow and the author of Flare (Finishing Line Press, 2017), a poetry chapbook focused largely on her experiences with hearing loss and chronic pain. Her poems have been published in the New York Times, Poets.org, Button Poetry, The Deaf Poets Society, Beltway Poetry Quarterly, Typo, The Quarry, and elsewhere. For eight years, Jones served as managing director at Split This Rock, a national nonprofit that cultivates, teaches, and celebrates poetry that bears witness to injustice and provokes change. She is a coeditor for a forthcoming anthology of disability poetry with Travis Chi Wing Lau, Naomi Ortiz, and Michael Northen. You can find Camisha on Twitter and Instagram as @1Camisha. Copyright © 2023 Center for the Study of the American South

Abstract P6-05-60: People with metastatic breast cancer face barriers to finding information and support

Abstract People with metastatic breast cancer face barriers to finding information and support Background FORCE, a national nonprofit organization developed a health communication tool to help patients assess research relevance, key findings, and the quality of media reporting on cancer to support informed and shared health decision-making. People with metastatic breast cancer (mBC) are a priority population. Methods The organization conducted a survey about awareness of and access to breast cancer information and supportive services for people living with metastatic breast cancer. The organization promoted the survey through e-mail and social media, and a network of partner organizations that serve the metastatic breast cancer community. The survey invited respondents to volunteer to participate in focus groups and a follow-up survey in order to support efforts to serve this priority population. Results and Conclusions While interest in clinical trials was high, many users reported that thy do not know how to find an appropriate clinical trial. A majority of the 335 respondents were interested in information about clinical trials, treatment side effects, research findings, long-term health issues, diet/exercise, fatigue, and emotional health. Three quarters of the respondents indicated that they had never participated in a clinical trial, 67% indicated they would be interested in participating in the future, and about 40% indicated they did not know how to find a clinical trial recruiting people with metastatic breast cancer. Approximately one-third of participants were unable to obtain referrals to services they sought. Other barriers to services included lack of insurance coverage, lack of availability, and the COVID-19 public health emergency. Focus group responses indicate that women with mBC find the health communication tool to be useful, and appropriate in language, images, and tone. Results indicate that women with mBC are interested in finding information about clinical trials and other topics related to treatment side effects and quality of life. FORCE and partners are incorporating these results into tailored online resources to meet the needs of the mBC community. Citation Format: Robin H. Pugh-Yi, Piri Welcsh, Kelly Owens, Diane Rose, Erica Kuhn, Craig T. Dearfield, Susan Friedman. People with metastatic breast cancer face barriers to finding information and support [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-60.

Analysis of Girls Inc.’s Redefining Beauty Curriculum in the Prevention of Eating Disorders

Background: Eating disorders are commonly diagnosed psychiatric disorders in adolescents. Because of the severity of disease and difficulty of treatment, means of prevention are important. Girls Inc. is a national non-profit organization that delivers evidence-based programming for people identifying as girls. Their four-week summer camp includes curriculum for building relationships, economic and media literacy, body image, and self-esteem. Here, the Girls Inc. curriculum “Redefining Beauty” is evaluated for efficacy of changing attitudes and behaviors correlated with development of eating disorders.&#x0D; Methods: Pre-and-post curriculum self-report surveys were administered to 11-14-year-olds (n=28) at the Girls Inc. summer camp. Group C1 consisted of 11-12 year-olds and C2 were 13-14 year-olds. All participants present for the camp the day of surveying were included in the study. Likert scales were used to assess body image and self -esteem. Collins Child Female Scale determined dissonance between current and ideal body image. Data was also collected regarding the use of dieting and exercise to lose weight.&#x0D; Results: No significant differences were found. In a Likert scale question on body satisfaction, there was no significant difference between pre-and post-curriculum answers (X2(t-1.7056, p=0.1036)). Body dissonance was measured to have no significant difference between pre-and post-curriculum answers (Paired t-test(t=0.8467, p=0.4077)). In a question asking if participants have been on a diet, 41.4% answered yes. This data was compared between two groups, and no significant difference was found (X2(z=0.1357, p=0.7125)) . &#x0D; Conclusion: This research can be used to aid Girls Inc. and similar programs in updating or creating eating disorder prevention curriculum. Because research has shown that increasing self-esteem and improving body image leads to decreased risk of developing eating disorders, it is important that curriculum aimed at preventing eating disorders is measured for its success in improving these factors.

Expectancy Theory, Diversity, and the Nonprofit Board

This study explores whether the expectations people have for joining a nonprofit board influence their satisfaction with board participation. In addition, it seeks to discover whether those expectations differ by race, gender, age, or lived experience with poverty. We sent a quantitative online survey to 600 board members of a national nonprofit organization with over 200 affiliates in the United States and had a response rate of 94%. We designed the survey questions using reasons for board membership from previous studies. Our findings indicate the correlation of many expectations with satisfaction, particularly influenced by board member age. Expectations do not differ significantly by gender or race though we noted trends which deserve further study. We identified seven predictors for board member satisfaction we believe deserve the focus of board leadership to improve board member retention. Our findings suggest when expectations are met, people express satisfaction and may be more likely to complete their time of board service. As nonprofit boards seek to understand the impact of diversity in member satisfaction, future research focused on the influence of expectations for targeted groups may be useful for ensuring successful recruitment, inclusion, and retention.

Building a National Nonprofit Platform of Academic Information Resources: Practice and Prospect of the National Center for Philosophy and Social Sciences Documentation

Building a National Nonprofit Platform of Academic Information Resources: Practice and Prospect of the National Center for Philosophy and Social Sciences Documentation

Resilience in Recovery? Understanding the Extent, Structure, and Operations of Nonprofits Meant to Address Disaster Survivors’ Unmet Needs

Climate change is increasing the likelihood and magnitude of disaster impacts. The nonprofit sector’s ability to address disaster survivors’ needs will become an increasingly important aspect of adapting to a changing climate. Disaster recovery also provides time for nonprofits to affect community resilience to future disasters and climate change. This article analyzes a unique phenomenon of the sector during disaster recovery: Long-term Recovery Groups. These groups are increasingly encouraged by government and national nonprofits, yet little academic research exists on them. We assess the existence and location of groups, their missions and tasks, and their legal structure. We find heterogeneity in structure and location but similarity in stated goals of addressing failures of government and private sector recovery practices. These groups emerge, as expected, in areas with disaster losses and in areas with slightly greater social vulnerability. Most groups, though, miss the opportunity to include climate change as part of their mission.

The Role of Policy in Prevention: Protecting People and the Environment

While the role of governments in promoting health policies and regulations to protect and support all its citizens, particularly those more vulnerable, needs to be reaffirmed, the work of non-profit organizations should be highlighted. Nsedu Obot Witherspoon discusses the mission, contributions, and actions of a national non-profit organization–the Children’s Environmental Health Network–that strives to foster equity, protect all children from environmental hazards, and promote safe and healthy environments for children to thrive in. This commitment is challenged by the traditional approach to environmental health laws and regulations that is based on proving harm from environmental hazards, such as carcinogens, before measures are taken to protect all, especially the most vulnerable. The goal of fostering a cancer free society is a collective and shared endeavor, which requires to acknowledge and address the troubling effects of systemic discrimination and racism on low wealth, Black, Indigenous, and People of Color communities.

Preliminary evaluation of A Home Within psychotherapy with clients with a history of foster care

Children and youth in foster care often experience numerous traumas both in and out of the child welfare system, and as a result many need access to mental health support. Researchers report low utilization rates of mental health services among individuals who have lived in foster care, often attributed to barriers to both access and receipt of consistent mental healthcare. A Home Within is a national nonprofit organization that aims to reduce these barriers to mental healthcare for those with past or current involvement in foster care by facilitating their access to consistent pro bono psychotherapy for “as long as it takes.” Eighty-five A Home Within therapists completed interviews with trained research assistants at two time points. Interviews included 44 closed- and open-ended questions regarding therapist demographics, client demographics, clients’ presenting concerns and mental health status, and treatment description. Repeated measures analysis of variance (ANOVA) models showed significant decreases in all five outcomes from baseline to termination of treatment. The associated effect sizes for length of time in treatment were medium to large for depression, anxiety, conduct disorder, and perpetrating aggression/violence. There was a small to medium associated effect size for peer relationship problems and the effect of time was not significant for cohabitation relationship problems. Findings provide preliminary support for continued development and evaluation of mental health services facilitated through A Home Within among clients currently or previously in foster care.

Disparities in NCI and nonprofit organization funding and effect on cancers with high incidence rates among Black patients and mortality rates.

1509 Background: National Cancer Institute (NCI) and nonprofit organization (NPO) funding is critical for research and advocacy, but may not be equitable across cancers or racial and ethnic groups. Methods: This study evaluated funding from the NCI and NPOs supporting lung, breast, colorectal, pancreatic, hepatobiliary, prostate, ovarian, cervical and endometrial cancers, leukemia, lymphoma and melanoma from 2015-2018. The primary objectives were to assess for disparities in NCI and NPO funding across different cancers compared to their incidence and mortality and their incidence rates across age, racial and ethnic groups. We also investigated if underfunding correlates with fewer clinical trials. Correlations between NCI and NPO funding for each cancer and its incidence, mortality and number of clinical trials were analyzed using scatter plots and Pearson correlation coefficients (PCCs). Results: Diseases with the largest combined NCI and NPO funding were breast cancer ($3.75 billion) and leukemia ($1.99 billion). Those with the least funding were endometrial ($94 million), cervical ($292 million), and hepatobiliary cancers ($348 million). Disease-specific funding correlated well with incidence, but correlated poorly with mortality (PCCs: 0.74, p = 0.006 and 0.30, p = 0.346, respectively). Breast cancer, leukemia and lymphoma were consistently well-funded, while colorectal, lung, hepatobiliary and uterine cancers were consistently underfunded. These data are summarized in the Table. NCI and NPO funding increased proportionately as incidence increased for White patients (PCC: 0.73, p = 0.007), Hispanic patients (PCC: 0.66, p = 0.02), Asian/Pacific Islanders (PCC: 0.77, p = 0.003) and Native Americans and Alaskans (PCC: 0.72, p = 0.008) while cancers with higher incidence in the Black population were underfunded (PCC: 0.52, p = 0.08). The amount of combined NCI and NPO funding for a particular cancer correlated strongly with the number of clinical trials for that disease (PCC: 0.91, p &lt; 0.0001). Conclusions: Many cancers with high incidence and mortality are underfunded, including those with higher incidence among Black patients. Underfunding strongly correlates with fewer clinical trials, which could impede future advances in underfunded cancers. [Table: see text]