Need: Breast cancer is the second most common cause of cancer death in Texas. Cancer disparities are often found in incidence, prevalence, mortality, survivorship, burden of illness, stage at diagnosis, and screening rates. Women with lower socioeconomic status and particularly African American (AA) women have been identified as having worse treatment outcomes and higher mortality rates with breast cancer than women with higher socioeconomic status and white women. Texas Southern University (TSU), uniquely positioned through years of unparalleled trust and relationship building with AA communities across the state, proposes to expand the Breast Cancer Screening and Prevention Center (BCSPC)...

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Need: Breast cancer is the second most common cause of cancer death in Texas. Cancer disparities are often found in incidence, prevalence, mortality, survivorship, burden of illness, stage at diagnosis, and screening rates. Women with lower socioeconomic status and particularly African American (AA) women have been identified as having worse treatment outcomes and higher mortality rates with breast cancer than women with higher socioeconomic status and white women. Texas Southern University (TSU), uniquely positioned through years of unparalleled trust and relationship building with AA communities across the state, proposes to expand the Breast Cancer Screening and Prevention Center (BCSPC) through $1,000,000 from CPRIT to provide 1) breast cancer screening and diagnostic services 2) patient navigation/barrier reduction services, and 3) evidence-based culturally appropriate breast cancer awareness and education services for AA women living in Harris, Grimes, Matagorda, Walker, and Wharton counties. TSU is located in the Third Ward in Harris County which is a medically underserved area and predominantly AA. This program will target AA women in Third Ward and other surrounding medically underserved communities with similar demographics in Harris County. The 4 additional counties of the BCSPC service area are medically underserved, non-metropolitan counties with AA populations ranging from 11 to > 24% . Although BCSPC will leverage TSU’s unique standing and reputation among AA communities to impact AA women, it should be noted that non-AA eligible ethnic minority women will also be included in the program. Overall Project Strategy: Based on evidence from several national guidelines (National Comprehensive Cancer Network, Society of Breast Imaging, and the American College of Radiology), annual screening mammograms from the age of 40 for average risk women and under 40 for high risk women significantly impact breast cancer morbidity and mortality. Leveraging the trust and relationship that the AA community has with TSU, an Historically Black College/University, this initiative is tailored to provide mammograms to 1350 eligible AA and other ethnic minority women who are 1) first time or rarely screened 2) uninsured or underinsured 3) 40 or above or high risk if younger than 40 and 4) living in Harris, Grimes, Matagorda, Walker, and Wharton counties. Partnerships with community churches, centers, and libraries as well as partnerships with Federally Qualified Health Centers (FQHCs) Avenue 360 and El Centro De Corazon will be instrumental to recruitment and outreach efforts. Mobile mammography will be provided by The Rose and Assured Imaging for the convenience of the women who need it. In-clinic mammograms will be available at the 7 different Houston Methodist Breast Cancer Centers. Timely patient navigation services will be provided to any women with abnormal mammograms and these women will be followed by the patient navigator until they are deemed to not have breast cancer or until they have established breast cancer care. Barrier reduction services will be provided such as scheduling services, appointment reminders, and transportation assistance. In addition to screening, these women will be offered breast cancer prevention education (n=1950), patient navigation (n=180), and barrier reduction services (n=750). Evidence-based, culturally appropriate breast cancer education sessions (group, one-on-one, virtual) will be provided to 1950unique women. The TSU BCSPC) website will also be used to disseminate educational materials and program information. Specific Goals: TSU BCSPC will provide no-cost screening mammogram for 1350 unique uninsured women (450/yr) over 36 months. About 180 unique women with abnormal results (60/yr) diagnostic workup. About 60 unique women with breast cancer diagnosis (20/yr) will receive treatment cost assistance services made available through TSU BCSPC. 45 unique women (15/yr) with advanced stage breast cancer (stage 3 or stage 4) or Triple negative breast cancer will receive breast cancer treatment at HMH with cost covered at 100% through the HMH Patient assistance/charity care program. Education sessions will be provided to 1950 unique women (650/yr). Transportation assistance will be provided for 750 unique women (250/yr).Scheduling assistance, appointment reminders, and patient navigation services for all women (450/yr). We will reach 10000 with education through our website. Significance and Impact: As a result of CPRIT funding, the we will be able to provide screening and diagnostic services, patient navigation and barrier reduction services, and evidence-based culturally appropriate breast cancer awareness education to eligible women in 5 counties in our service coverage area thereby decreasing the incidence of breast cancer and breast cancer-related morbidity and mortality in AA (and other) women who are uninsured or underinsured and medically underserved.

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