The Advancing Breast Health in Central Texas 2 (ABH-CTX 2) program is designed to comprehensively address significant breast cancer screening barriers in a nine-county area of central Texas (Public Health Region 7). Our target area has 2.9 million residents, comprises both rural and urban areas and has communities with challenging socioeconomic conditions, a high proportion of individuals from minority backgrounds, a high burden of cancer, access barriers and limited cancer prevention opportunities. Women in these counties have higher breast cancer incidence and mortality rates and suboptimal screening completion rates compared to national data and these differences are heightened furth...

Read More

The Advancing Breast Health in Central Texas 2 (ABH-CTX 2) program is designed to comprehensively address significant breast cancer screening barriers in a nine-county area of central Texas (Public Health Region 7). Our target area has 2.9 million residents, comprises both rural and urban areas and has communities with challenging socioeconomic conditions, a high proportion of individuals from minority backgrounds, a high burden of cancer, access barriers and limited cancer prevention opportunities. Women in these counties have higher breast cancer incidence and mortality rates and suboptimal screening completion rates compared to national data and these differences are heightened further among those without access to care, that have low income or are from racial/ethnic minority backgrounds. Overall Project Strategy The ABH-CTX 2 program is comprised of a large coalition of partners that have come together to reduce breast cancer burden in Central Texas. Through this collaboration, the Addressing Cancer Together Coalition, Dell Medical School, and the Lone Star Circle of Care system have established a successful mobile mammography-based screening program and a diagnosis and treatment pathway for underinsured and uninsured women in the region. The ABH-CTX program integrates clinical recommendations with evidence-based navigation strategies to facilitate completion of mobile screening, diagnostic testing and connection to treatment for low-income women. The program serves CPRIT priority populations of geographically isolated, rural, cultural/ethnic minorities, low income and underserved populations. It has exceeded original screening goals and has created an ecosystem of care for low income and uninsured women. Our expansion application is informed by a new needs assessment and will build on the success of the program by expanding the service area from three to nine counties with new fixed testing sites and will add new components to address additional levels of the socioecological model for health by adding evidence-based culturally tailored health education, new clinical service delivery pathways, and enhanced patient navigation. Our collaborations include a multitude of organizations such as clinics, hospitals, radiology service providers and community- serving organizations (e.g., low-income housing projects, food banks, faith-based organizations, schools, community colleges, public health departments, the American Cancer Society, the 3-1-1 program, community centers, and media entities). This project will continue to expand mobile mammography screening whilst also adding 24 new fixed testing sites to meet the need for screening and testing and 17 new clinic referrals sites throughout the nine-county area to reach additional women. Our new partners serve populations experiencing disparities such as safety net populations, African Americans, refugee populations and the uninsured. The PD and research team have extensive experience in developing and implementing successful cancer prevention programs in underserved communities and have overseen the delivery of over 47,000 screening tests, 5,350 diagnostic tests, detection of 116 cancer cases including 72 breast cancers cases. Specific Goals Program goals aim to 1) Effectively expand the Advancing Breast Health Screening Program among underserved Central Texas women; 2) Integrate new outreach and evidence-based education approaches to maximize impact; 3) Ensure all patients with abnormal screening results will be navigated to receive diagnostic testing and all patients diagnosed with cancer will be navigated into treatment. Achievable targets based on the first grant cycle and prior experience are to provide over 22,000 direct services, including 8,387 clinical services, 5,976 navigation services and 8,000 education services. Innovative new components of this expansion grant include: 1) An expanded network of community partners and clinic systems in the entire nine county target area; 2) Creation of an integrated community outreach and education network; 3) Implementation of direct outreach with community health workers to potential participants throughout the target area; 4) Development of multilingual culturally tailored health educational materials and videos; and 5) A comprehensive evaluation strategy. Significance and Impact The ABH-CTX 2 program can have a significant impact on breast cancer outcomes throughout Central Texas as it expands a successful program to provide additional components and alternative options including both mobile and fixed site locations for screening, diagnosis and connection to care. This work helps to move forward the goals of the Texas Cancer Plan to improve breast cancer screening rates and increase timely access to diagnostics and treatment through the implementation of sustainable and effective programs that prioritize the underserved and reduce cancer disparities throughout Texas.

Read Less