(Boston) – Dec. 7, 2017 – Boston Medical Center (BMC) clinicians are helping lead the way toward reducing disparities in Boston for women diagnosed with breast cancer.

Through a five-year, $8.65 million award from the National Institutes of Health’s (NIH) National Center for Advancing Translational Sciences (NCATS), BMC is collaborating with leading health care institutions in Massachusetts to implement an integrated, evidence-based health care delivery system to reduce breast cancer disparities among minority, low-income women.

African American women with breast cancer face disparities in time-to-treatment, quality of treatment and delayed follow up to abnormal tests. Although breast cancer mortality rates have declined significantly in the United States, African American women have a 40 percent higher chance of dying from breast cancer than white women, according to the Centers for Disease Control and Prevention. In Boston, breast cancer mortality rates decreased from 2001-2012 (the greatest decrease occurring among Latina women); however, African American women were still 25 percent more likely to die from the deadly disease, according to the Boston Public Health Commission.

In partnership with the Boston Breast Cancer Equity Coalition, a diverse group of local community stakeholders whose mission is to achieve equity for all women with breast cancer, TRIP researchers found that three evidence-based strategies known to reduce delays in care have failed to make it into practice as a result of persistent patient and health system barriers:

  • A navigator for every vulnerable patient to solve problems and provide support and guidance through the complex health care system
  • A regional registry to help providers and navigators track their patients
  • Resources to help navigators identify social determinants of health (e.g., food and housing insecurity)

The TRIP project will integrate these strategies into a cohesive package across six hospitals, with the goal of assisting 1,100 women seeking breast cancer care over the next five years.  A key aspect of the project is to test the effectiveness of the combined approach. If successful, TRIP can be adapted to the treatment of any disease in other communities impacted by health disparities.

TRIP will be led by principal investigators Tracy Battaglia, MD, MPH of BMC and Boston University Clinical and Translational Science Institute (CTSI); Karen Freund, MD, MPH of Tufts CTSI; Jennifer Haas, MD, MPH of Brigham and Women’s Hospital and Harvard Catalyst (the Harvard Clinical and Translational Science Center); and Stephenie Lemon, PhD of University of Massachusetts Center for Clinical and Translational Science. The six participating clinical sites are Boston Medical Center, Brigham & Women’s Faulkner Hospital, Beth Israel Deaconess Medical Center, Dana-Farber Cancer Institute, Massachusetts General Hospital, and Tufts Medical Center. Boston Breast Cancer Equity Coalition, Boston Patient Navigator Network, the University of Chicago, and the Institute for Translational Medicine will build a coalition of stakeholders and provide community engagement support.

“The rapid rate of scientific discovery far outpaces the ability of our health care system to integrate evidence into every day practice, especially in cancer care for low income, racial ethnic minority patients who remain less likely to receive timely, quality treatment,” said Battaglia. ”Sustainable solutions require collaboration among all community stakeholders, including patients, providers, public health practitioners, health systems and scientific investigators. Community engaged research conducted in real life settings is necessary to ensure scientific discoveries reach all populations.”

“We know that for many women, breast cancer is not the worst thing in her life.  Many women   work hard to make sure there is enough money for food and rent,” said Freund. “Many women use their time off work to get to the pediatrician’s office.  This means that her own health and care go on the back burner.  A navigator can mean all the difference, and make sure her health is a priority.”

Once TRIP is completed, this community engaged program will demonstrate the feasibility of community-academic partnerships to provide innovations in information-sharing and systems implementation that will translate into reductions in health disparities for vulnerable patients facing any disease.

TRIP is supported by the NCATS of the NIH under Award Number U01TR002070, and by the NIH Office of Behavioral and Social Sciences Research. The content of this release is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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