Circles of Care: Supporting African Americans with Cancer

Patients with advanced cancer need supportive and palliative care in addition to cancer-specific treatments, to overcome pain, reduce psychological and spiritual distress, and meet practical needs. African Americans are more likely to have advanced cancer, yet less often get effective pain management, cancer communication, or supportive care. To overcome barriers for African Americans with cancer, health systems need community partners.

Circles of Care are volunteer support teams for African Americans facing serious illness with cancer. After receiving training, teams in Orange, Wake, Durham, and New Hanover counties provide practical, emotional and spiritual support in a coordinated way. Teams typically form in churches or social networks; their formation and function are controlled by the wishes of the person with cancer.

The Health-e-NC grant funded a controlled study of the impact of Circles of Care volunteer support teams. The objective was to test the effect of volunteer support teams on cancer communication, quality of life and quality of supportive and palliative care for African Americans living with Stage III or IV lung, colorectal or breast cancer.

Findings:  Dr. Hanson and her team found that after 2 months, patients with support teams reported fewer needs for practical, emotional, and spiritual support, more often communicated with someone about their cancer care needs (48% vs.75%, p = .04), and were more aware of Hospice (25% vs 4%, p = .04). Coordinated volunteer support teams are a promising new model to provide peer support for African Americans facing cancer and other serious illnesses.This study demonstrated the feasibility of a new method for community-baed counter support in cancer cancer - the support team model. The model was successfully exported to a new region in eastern North Carolina. Further, both sites are continuing the program after the ending of Health-e-NC funding support.

Geographic area(s) served: Orange, Wake, Durham, and New Hanover Counties

Laura Hanson, MD, MPH, professor of geriatric medicine and adjunct associate professor of epidemiology (principal investigator); Giselle Corbie-Smith, MD, professor of social medicine; Racquel Daley-Placide, MD, clinical assistant professor, geriatric medicine; LaSonia Roberts-Melvin, Community Outreach Coordinator (New Hanover); Sandra Diehl, research assistant (New Hanover), Michelle Hayes, research assistant, and Melissa Green, project coordinator.

Community-based collaborators are Stacie Peacock and Steven Warnock from Project Compassion, Sharon Elliot-Bynum and Mary Pointer from the Community Health Coalition, and Rachel Vaughn from the RV Support Group (New Hanover).

UNC faculty and Lineberger Cancer Center members who are collaborating with Circles of Care include Samuel Cykert, MD, professor of medicine; Peggye Dilworth-Anderson, PhD, professor of health policy and management; Jo Anne Earp, ScD, professor of health behavior; and Donald L. Rosenstein, MD, professor of psychiatry.

For more information about the Circles of Care pilot research study, contact Melissa Green, project coordinator, at

This two-minute video link provides a great overview of the Circles of Care initiative. For more information, visit the Project Compassion website at or contact Stacie Peacock at