Need: Low-income and minority women residing in the rural and medically underserved areas of Texas, including the Brazos Valley region, suffer from significantly higher morbidity and mortality rates associated with breast and cervical cancer (B&CC). Women’s B&CC prevention (screening and education services) and care (treatment and follow-up) in rural and medically underserved areas have been the focus of significant and prolonged concern in Texas. Family medicine physicians, nurses, and staff practicing in rural and underserved areas play an important role in providing B&CC screenings, diagnostics, and treatment.

This project will increase the capacity of the Texas A&M Family Medicine Reside...

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Low-income and minority women residing in the rural and medically underserved areas of Texas, including the Brazos Valley region, suffer from significantly higher morbidity and mortality rates associated with breast and cervical cancer (B&CC). Women’s B&CC prevention (screening and education services) and care (treatment and follow-up) in rural and medically underserved areas have been the focus of significant and prolonged concern in Texas. Family medicine physicians, nurses, and staff practicing in rural and underserved areas play an important role in providing B&CC screenings, diagnostics, and treatment.

This project will increase the capacity of the Texas A&M Family Medicine Residency, College of Nursing, School of Rural Public Health, and community health worker/promotores (CHW/P) training programs to provide evidence-based B&CC screening and diagnostic services, patient care, and treatment through a unique transdisciplinary B&CC program housed in an academic family medicine clinic.

This B&CC prevention program uses a transdisciplinary training approach for family medicine residents, nursing students, public health students, and CHW/P. The program seeks to bring enhanced B&CC screening and prevention services to safety-net women in rural and underserved communities in the nine-county Brazos Valley region of Texas. Expanding on existing interdisciplinary collaborations among the Texas A&M University Health Science Center’s (TAMHSC) College of Medicine-Family Medicine Residency, College of Nursing, School of Rural Public Health, and existing clinical networks and community partners, the program will provide education, screening, and treatment services for B&CC to medically uninsured, low-income women.

Building on the strengths of our academic medical, nursing, and public health programs and partnerships, we will: 1) Provide and facilitate access to B&CC screening and diagnostic services, across the continuum of care, for women in nine Texas counties; 2) Provide interdisciplinary (simulated and live) culturally-appropriate joint training to family medicine residents, nursing students, and CHW/Ps in various aspects of women’s breast and cervical screening, diagnostic procedures, and patient care; 3) Utilize CHW/Ps, staff, students, and volunteers to provide community outreach and education about the value of B&CC screening and the importance of vaccination against human papillomavirus (HPV) to the public; and, 4) Improve family medicine, nursing, and public health practice related to evidence-based, culturally-appropriate care in women’s cancer services.

The distinguishing, innovative feature of this CPRIT program will be the adoption and translation of evidence-based programs into Family Medicine Residency, nursing, and public health training curriculum that focus on rural and underserved populations in Texas. The proposed program will increase dramatically the numbers of women’s preventive cancer screening and diagnostic services in the Brazos Valley and throughout Texas, thus creating a model for improving women’s B&CC prevention, screening, and cancer care throughout Texas and nationally. Of particular importance will be the numbers of diagnostic and post-screening services available to our participants.  This project will incorporate a team of state-certified CHW/Ps as patient educators and navigators to reduce barriers to screening and other health services due to fear, medical mistrust, or transportation.

Organizationally, the TAMHSC is uniquely qualified to offer transdisciplinary B&CC screening training to residents and nursing students. The professional residency clinic venue is unique because of its patient-centered medical home organizational model, designed to improve patient access, knowledge, and ability to navigate our complex healthcare system.

The sheer numbers of B&CC-related preventive services associated with this project, may dramatically impact B&CC incidence rates for the Brazos Valley. This B&CC transdisciplinary screening and prevention program will serve as a state and national model for addressing the significant need for greater numbers of providers, nurses, public health specialists, and community health workers who are prepared to provide evidence-based cancer care – across the cancer continuum – to low-income, safety-net women in rural and underserved areas of Texas.

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