? The District of Columbia is unique in that minority populations are the majority, and it has the highest per capita breast cancer mortality in the US. African American women in DC are twice as likely to die of their breast cancers as white women despite the same or higher rates of screening mammography. Similarly, Latinas have a rate of screening mammography only slightly lower than non-Hispanic white women, but they present at later stages of the disease. These disparities suggest barriers navigating the health-care system, both to find timely diagnostic services and to get complete, high-quality care after diagnosis. To address these problems, with the goal of reducing these disparities, four major medical institutions -- George Washington University Cancer Institute (GWCI), Georgetown's Lombardi Comprehensive Cancer Center, Howard University Cancer Center, and Washington Hospital Center's Cancer Center -- will collaborate with two community partners -- Breast Cancer Resource Committee and Nueva Vida -- and the DC government's Department of Health in an unprecedented consortium to create a city-wide program that will evaluate different ways of helping African American and Latino women navigate the health-care system. The overarching aim is to conduct a randomized controlled trial comparing """"""""Standard-Concrete Navigation"""""""" with Standard Navigation plus Enhanced Navigation consisting of linguistically competent peer counseling.
The specific aims are to test these hypotheses: 1) That Enhanced Navigation combined with Standard-Concrete Navigation will be more effective than Standard-Concrete Navigation alone, in decreasing the time from suspicious finding to diagnostic resolution and from diagnosis to initiation of treatment. 2) While significantly more expensive, the combination will be sufficiently more effective in that it will be the most cost-effective strategy in terms of costs per quality-adjusted year of life saved. 3) In testing these hypotheses factors will also be assessed that mediate the intervention effects (coping styles, perceptions of communication with providers, attitudes, fatalism, etc.). Each Recruiting Intake Site has programs and community partnerships that will serve as the point of entry into the navigation program. Enhanced navigation will be delivered by Peer Counseling Sites: The Breast Cancer Resource Committee and Nueva Vida, which provide breast cancer peer-counseling for African American and Latino women, respectively ? ?

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project--Cooperative Agreements (U01)
Project #
1U01CA116937-01
Application #
6988595
Study Section
Special Emphasis Panel (ZCA1-SRRB-D (M1))
Program Officer
Cooper, Leslie
Project Start
2005-09-29
Project End
2010-08-31
Budget Start
2005-09-29
Budget End
2006-08-31
Support Year
1
Fiscal Year
2005
Total Cost
$653,938
Indirect Cost
Name
George Washington University
Department
Pharmacology
Type
Schools of Medicine
DUNS #
043990498
City
Washington
State
DC
Country
United States
Zip Code
20052
Whitley, Elizabeth M; Raich, Peter C; Dudley, Donald J et al. (2017) Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening. Cancer 123:312-318
Jean-Pierre, Pascal; Cheng, Ying; Wells, Kristen J et al. (2016) Satisfaction with cancer care among underserved racial-ethnic minorities and lower-income patients receiving patient navigation. Cancer 122:1060-7
Martinez, Diane J; Turner, Monique M; Pratt-Chapman, Mandi et al. (2016) The Effect of Changes in Health Beliefs Among African-American and Rural White Church Congregants Enrolled in an Obesity Intervention: A Qualitative Evaluation. J Community Health 41:518-25
Paskett, Electra D; Dudley, Donald; Young, Gregory S et al. (2016) Impact of Patient Navigation Interventions on Timely Diagnostic Follow Up for Abnormal Cervical Screening. J Womens Health (Larchmt) 25:15-21
Battaglia, Tracy A; Darnell, Julie S; Ko, Naomi et al. (2016) The impact of patient navigation on the delivery of diagnostic breast cancer care in the National Patient Navigation Research Program: a prospective meta-analysis. Breast Cancer Res Treat 158:523-34
Wells, Kristen J; Winters, Paul C; Jean-Pierre, Pascal et al. (2016) Effect of patient navigation on satisfaction with cancer-related care. Support Care Cancer 24:1729-53
Ko, Naomi Y; Snyder, Frederick R; Raich, Peter C et al. (2016) Racial and ethnic differences in patient navigation: Results from the Patient Navigation Research Program. Cancer 122:2715-22
Rodday, Angie Mae; Parsons, Susan K; Snyder, Frederick et al. (2015) Impact of patient navigation in eliminating economic disparities in cancer care. Cancer 121:4025-34
Wang, Bi-Dar; Ceniccola, Kristin; Yang, Qi et al. (2015) Identification and Functional Validation of Reciprocal microRNA-mRNA Pairings in African American Prostate Cancer Disparities. Clin Cancer Res 21:4970-84
Ramachandran, Ambili; Snyder, Frederick R; Katz, Mira L et al. (2015) Barriers to health care contribute to delays in follow-up among women with abnormal cancer screening: Data from the Patient Navigation Research Program. Cancer 121:4016-24

Showing the most recent 10 out of 27 publications