Comparative Effectiveness Research for Eliminating Disparities

Abstract

This grant supports the development of comparative effectiveness research for eliminating disparities (CERED), including four cores: Research, Training, Data Infrastructure, and Dissemination.

The research project objective is to evaluate the effectiveness of a hospital-based patient navigation intervention strategy in mammography centers located in medically underserved areas (MUAs) on the adequacy of diagnostic and treatment services for breast cancer care among underserved women in Chicago. Our primary research outcome will be treatment adequacy and adherence to follow-up care in women with abnormal mammograms, as defined by The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines. This work will extend that of the ongoing comparative effectiveness research evaluating patient navigation in breast cancer care in a randomized clinical trial, in which the primary outcome is time to diagnostic resolution and treatment. In conjunction with the existing patient navigation research project, the proposed research effort will examine comparative effectiveness of patient navigation intervention on two primary outcomes among women with abnormal mammograms (with and without breast cancer): (1) adequacy and quality of follow-up care; and (2) patient's adherence to follow-up care and treatment. The two primary hypotheses are:

  • H1: Navigated patients with abnormal screening results will be more likely to receive adequate diagnostic evaluations and treatment as compared to usual standard of care.
  • H2: Navigated patients diagnosed with breast cancer will be more likely to complete appropriate follow-up care and treatment as compared to usual standard of care.

In carrying out the research project, training, data, and dissemination core activities aim to enhance scientific capital, data infrastructure, and dissemination of research findings to eliminate breast disparities. Health disparities exist in breast cancer screening, follow-up, treatment recommendation, and completion. Women of low socioeconomic status and minority groups tend to experience late diagnosis, inadequate treatment and adherence. The proposed study utilizes patient navigation to assess the adequacy of follow-up, treatment, and treatment completion. This project aims to establish CER mechanisms for research, data infrastructure, human capital, and dissemination to impact abnormal mammography follow-up and initial breast cancer care.

The overall objective of this revised CERED grant is to further develop the existing CEED minority health and health disparity research program to additionally support comparative effectiveness research for eliminating minority health and health disparities; we will achieve this objective by adding CER to the existing framework of the CEED parent grant.

Research Partner(s)

Roseland Community Hospital (45 W. 111th St., Chicago)
Trinity Hospital (2320 E. 93rd St., Chicago)

This study supplements the work of a center grant:

Center of Excellence in Eliminating Disparities
Funding Agency

National Center on Minority Health and Health Disparities with funding from the American Reinvestment and Recovery Act of 2009 (Grant No. P60 MD003424-02 S1)

 

Principal investigators
Elizabeth A. Calhoun, PhD
Carol Estwing Ferrans, PhD, RN, FAAN

 

Co-investigators
Young Ik Cho, PhD
Therese A. Dolecek, PhD
Kent Hoskins, MD
Charlotte Enns Joslin, OD, PhD
Sage Kim, PhD

Start date
07/31/2010
End date
07/30/2013
Total award
$1,399,955
About this grant

This grant is a supplement to the center grant, Center for Excellence in Eliminating Disparities, and builds on research by Elizabeth Calhoun and others in the Center for Population Health and Health Disparities (Project 1).