CREATING BRIDGES TO WOMEN'S HEALTH CARE IN YOUNG SURVIVORS
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Introduction: Ten percent of breast cancer survivors in the U.S. were diagnosed with cancer when they were younger than 45 years old. These young breast cancer survivors (YBCS) often experience significant women’s health issues that result in poorer quality of life, including infertility, limited birth control options, and hot flashes and sexual symptoms. YBCS are often not able to access high quality women’s health care at cancer diagnosis and post-treatment in order to prevent infertility, choose effective and acceptable birth control, treat hot flashes, and improve sexual function. This occurs because there are barriers at multiple levels that prevent widespread women’s healthcare, and effective strategies to overcome these barriers have not been developed. Common barriers include knowledge and access barriers. One potential strategy to improve YBCS knowledge is an evidence-based survivorship care plan (SCP) that provides up-to-date information on managing fertility, family planning, and estrogen deprivation symptoms. For Spanish-speaking Latina YBCS, such a tool must be culturally and linguistically relevant. Patient navigation to address emotional, insurance, and information barriers is another potential strategy. Finally, the advent of mobile health technology now supports telehealth counseling, which may be a strategy to overcome geographic barriers. 
 
 
 Questions: 1. What adaptations to the women’s health SCP, developed and tested in English-speaking, predominantly white YBCS, will be acceptable, appropriate, and culturally and linguistically responsive to meet the women’s health care needs of Spanish-speaking Latina YBCS? 
 2. How do we design the implementation strategies of the women’s health SCP, patient navigation and telehealth counseling to fit the needs of this community in delivering women’s health care to YBCS? 
 3. How feasible, acceptable and appropriate are these implementation strategies in facilitating women’s health care in newly diagnosed YBCS at a rural community oncology program? 
 
 
 General methodology: The investigator team will modify the women’s health SCP for Spanish-speaking Latina YBCS through systematically reviewing the scientific literature and clinical society practice guidelines, using medical translation to generate the SCP in Spanish, and undertaking a series of interviews and focus groups with Spanish-speaking YBCS, YBCS patient navigators, and oncology providers to modify the SCP. Next, the researchers will assess how YBCS and their oncology and fertility care settings can incorporate the SCP, telehealth, and patient navigation to support delivery of women’s health care. This work will involve a series of interviews and focus groups with stakeholders. Finally, we will deploy the proposed implementation strategies at ECRMC with newly diagnosed YBCS and study their impact. The impact of this work is not only to learn about how to deliver specialty care to YBCS in rural and medically underserved regions, but also to support the development of the collaboration between the Cancer Resource Center of the Desert, El Centro Regional Medical Center, and UC San Diego Moores Cancer Center. 
 
 
 Innovative elements: This proposal is innovative in the development of a multi-strategy approach to implementation of women’s health care for YBCS in rural community oncology settings. Development of a culturally and linguistically appropriate SCP to address women’s health needs in Latina YBCS is novel, as is studying the deployment of telehealth for women’s health care in this population. Finally, testing of the implementation strategies with newly diagnosed YBCS rather than post-treatment survivors is innovative and key to a future implementation clinical trial. 
 
 
 Community involvement: The community involved in this proposal includes YBCS in Imperial County, their families, and their healthcare providers. The project is a collaboration among CRCD, UC San Diego, and additional community stakeholders including the ECMRC, San Diego State University – Imperial Valley nursing program, YBCS, and community funders. Stakeholders from the community are participants incorporated into every aspect of the conduct of this study. 
 
 
 Future Plans: Developing sound strategies to promote implementation of women’s health care in YBCS, particularly with reach to rural and medically underserved populations, is needed prior to testing their efficacy in a clinical trial. As CRCD and UC San Diego researchers and clinicians grow their collaboration through this project, they will gain experience as a team to propose testing the developed interventions in a future trial.