Introduction: Current Aims and Center Theme. This proposal is for renewal of the UlC-Center for Population Health and Health Disparities (P50 CAI 0674). This Center is one of five that were funded in whole or in part by the National Cancer Institute as part of the initial NIH initiative. It is a Multiple Principal Investigator application. The center theme is: Understanding how our previous research identifying fundamental causes of disparities in stage at breast cancer diagnosis related to race/ethnicity can lead to interventions grounded in that research? The current aims of the proposed renewal of the Center are to address three questions that have emerged as central issues in understanding the disparity in stage at breast cancer diagnosis between White women and women of color based on our work to date. These are: I) To define how apparent disparities in early detection, diagnosis and treatment can be addressed in safety-net hospitals? 2a) Determine how community health clinics can more effectively identify and monitor patients at risk for aggressive breast cancer. 2b) Determine how patients at elevated risk can be engaged to participate in a tailored screening and monitoring program. 3) To determine how biological factors, specifically DNA methylation, promote aggressive breast cancer disproportionately among women of color? . There are three projects: .1) Patient Navigation in Medically Underserved Areas. (E. Calhoun, PI) 2) A Breast Cancer Screening Intervention to Improve Adherence to Cancer Control Guidelines in Underserved Minority Women (K. Hoskins, PI);DNA Methylation and Differential Cancer Aggressiveness by Race/Ethnicity (G. Rauscher, PI) and four cores: Administration (R. Warnecke (Contact) &E. Calhoun (Co-Core leaders);Policy and Dissemination (C. Ferrans, CL);Data Management and Evaluation (T. Johnson, (CL) and Training and Career Development (F Davis, CL ) Our continuing, long range vision is to test and establish interventions that address determinants of population health disparities by approaching them with a multilevel and multidisciplinary population health strategy. To accomplish this we will: 1) conduct research that impacts the policies that govern access to mammography and management of breast cancer and ensures equal access to the standard of breast cancer care regardless of where it is delivered and who requests it. 2) Enable women who are poor and underserved to recognize the need to access the care in ways that ensure the best outcomes. 3) To train young scholars in health disparities research incorporating a transdisciplinary research perspective.
This Center builds on on-going research that has identified some key, multilevel determinants of population heealth disparities. These determinants create a fundamental problem in that focusing on determinants of population health may in fact increase disparities as poor and underserved may not have access to the results. Thus, this center is focused on interventions that can be introduced through safety-net institutons and underlying biological determinants of poor prognosis or outcome that can be potentially monitored.
|Hoskins, Kent F; Tejeda, Silvia; Vijayasiri, Ganga et al. (2018) A feasibility study of breast cancer genetic risk assessment in a federally qualified health center. Cancer 124:3733-3741|
|Warnecke, Richard B; Campbell, Richard T; Vijayasiri, Ganga et al. (2018) A Multilevel Examination of Health Disparity: The Roles of Policy, Neighborhood Context, Patient Resources and Healthcare Facilities in Stage at Diagnosis. Cancer Epidemiol Biomarkers Prev :|
|E Anderson, Emily; Tejada, Silvia; B Warnecke, Richard et al. (2018) Views of Low-Income Women of Color at Increased Risk for Breast Cancer. Narrat Inq Bioeth 8:53-66|
|Kresovich, Jacob K; Gann, Peter H; Erdal, Serap et al. (2018) Candidate gene DNA methylation associations with breast cancer characteristics and tumor progression. Epigenomics 10:367-378|
|Glassgow, Anne Elizabeth; Molina, Yamile; Kim, Sage et al. (2018) A Comparison of Different Intensities of Patient Navigation After Abnormal Mammography. Health Promot Pract :1524839918782168|
|Molina, Yamile; Kim, Sage J; Berrios, Nerida et al. (2018) Patient Navigation Improves Subsequent Breast Cancer Screening After a Noncancerous Result: Evidence from the Patient Navigation in Medically Underserved Areas Study. J Womens Health (Larchmt) 27:317-323|
|Peterson, Caryn E; Khosla, Shaveta; Jefferson, Gina D et al. (2017) Measures of economic advantage associated with HPV-positive head and neck cancers among non-Hispanic black and white males identified through the National Cancer Database. Cancer Epidemiol 48:1-7|
|Molina, Yamile; Glassgow, Anne E; Kim, Sage J et al. (2017) Patient Navigation in Medically Underserved Areas study design: A trial with implications for efficacy, effect modification, and full continuum assessment. Contemp Clin Trials 53:29-35|
|Rauscher, Garth H; Silva, Abigail; Pauls, Heather et al. (2017) Racial disparity in survival from estrogen and progesterone receptor-positive breast cancer: implications for reducing breast cancer mortality disparities. Breast Cancer Res Treat 163:321-330|
|Tejeda, Silvia; Gallardo, Rani I; Ferrans, Carol Estwing et al. (2017) Breast cancer delay in Latinas: the role of cultural beliefs and acculturation. J Behav Med 40:343-351|
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