Refining research on access to gynecologic cancer care: The DIMeS framework

Background. Despite its importance, there is no consensus de finition of access to care, and several fundamental philosophical questions about access remain unanswered. Lack of clarity impedes interventional research designed to develop and test methods of correcting barriers to access. To help remedy this problem, we propose a conceptual framework to help guide empirical research about access to gynecologic cancer care. Methods. Relevant philosophical and empirical literature was reviewed and analyzed to highlight key elements needed to re fine research on access to care. Results. The DIMeS framework involves 1) choice and justi fication of a De finition of access to cancer care that will guide research; 2) Identi fication of essential gynecologic cancer care services for which access disparities are ethically unacceptable; 3) quantitative MEasurement of speci fic parameters that affect access to care; and 4) Selection of a target threshold on measured parameters above which access is acceptable. Conclusions. The DIMeS framework provides clarity and reproducibility for investigators seeking to develop and test interventions to improve cancer health equity. This framework should be considered for use in research on access to gynecologic cancer care. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.