Abstract PO2-10-10: Developing a Continuum of Care Model to Address Healthcare Disparities in Breast and Cervical Cancer: The Promise Fund's Approach
Authors: Nancy Brinker, Donna Shalala, Edith Mitchell, Haywood Brown, Wayne Frederick, Jane Mendez, Deeptee Jain, David Dodson, David Brodsky, Lillie Shockney
Journal: Cancer Research (2024)

Abstract The Promise Fund is creating a systemic change in healthcare service delivery through its Continuum of Care model in which patients are provided health education, navigation for breast and cervical health, affordable early detection screenings, diagnostics, treatment, and/or support services through an established network of providers, reducing healthcare costs, alleviating the burden of our complex healthcare system, and improving patient outcomes. This model, established in Palm Beach County, has potential to be scaled across Florida and beyond. The Promise Fund's primary focus is to eliminate preventable deaths and stop the progression of breast and cervical cancer among women in South Florida. The region faces significant healthcare disparities, with over 80,000 uninsured women in Palm Beach County alone. Disproportionately affecting minority groups, these women often experience delayed diagnoses and higher mortality rates compared to White women. Barriers such as transportation, translation, education, and childcare further contribute to suboptimal survival rates, despite high cure rates exceeding 95% for breast and cervical cancer. Through public and private partnerships, the Promise Fund established a Women's Health Center co-located at a Palm Beach County Federally Qualified Health Center (FQHC). FHQCs are community-based facilities that provide comprehensive primary care services to uninsured or low-income individuals in areas of high need. At this strategically selected FQHC, the Promise Fund supplies state-of-the-art equipment for breast and cervical cancer screenings, such as a 3D Genius Mammography Machine, donated by Hologic, Inc., ultrasounds, LEEP, and colposcopy. To facilitate access, the Promise Fund employs over 20 patient navigators positioned in FQHCs, free clinics, and community-based organizations across South Florida. These navigators connect women to resources, engage in outreach, and enroll at-risk individuals into the program. The impact of the navigators is significant, with over 20,000 women engaged, over 80 cancers treated, more than 5,000 women finding medical homes, and over 19,000 women receiving education and outreach. Additionally, the program has facilitated over 4,000 mammograms and 2,000 pap tests, all provided at little to no cost to the patients. Promise Fund Patient Navigators are well-trained, culturally competent, and bilingual. They help patients overcome barriers to care, arranging transportation, childcare, and translation services. Our navigators are carefully selected from the community and undergo rigorous training in breast and cervical health, navigation, and reporting. Moreover, the Promise Fund supports patients throughout their cancer journey by brokering low-cost or free treatment from private hospitals. Despite the prevailing healthcare disparities, the Promise Fund's patient-centered approach has yielded positive outcomes. Over 98% of women navigated by the organization comply with receiving their screening mammogram, drastically surpassing the national average. Research has consistently demonstrated that patient navigators significantly improve patient outcomes by facilitating early screening and timely access to treatment, thus reducing disease progression and healthcare costs. Additionally, the Promise Fund’s expansive Continuum of Care model effectively decreases the time patients have to wait between diagnosis and starting treatment, as well as decreases the overall treatment time for patients. The success of the Promise Fund's inaugural Women's Health Center has led to the replication of this model in three additional FQHCs in Palm Beach and Broward County, ensuring that no woman in these areas should go without essential breast and cervical cancer resources. Citation Format: Nancy Brinker, Donna Shalala, Edith Mitchell, Haywood Brown, Wayne Frederick, Jane Mendez, Deeptee Jain, David Dodson, David Brodsky, Lillie Shockney. Developing a Continuum of Care Model to Address Healthcare Disparities in Breast and Cervical Cancer: The Promise Fund's Approach [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-10-10.