Translating research into practice: Protocol for a community-engaged, stepped wedge randomized trial to reduce disparities in breast cancer treatment through a regional patient navigation collaborative
Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine; UMass Worcester Prevention Research Center
Community-Based Research | Community Health and Preventive Medicine | Health Information Technology | Health Services Administration | Health Services Research | Neoplasms | Race and Ethnicity | Translational Medical Research
BACKGROUND: Racial and socioeconomic disparities in breast cancer mortality persist. In Boston, MA, Black, Non-Hispanic women and Medicaid-insured individuals are 2-3 times more likely to have delays in treatment compared to White or privately insured women. While evidence-based care coordination strategies for reducing delays exist, they are not systematically implemented across healthcare settings.
METHODS: Translating Research Into Practice (TRIP) utilizes community engaged research methods to address breast cancer care delivery disparities. Four Massachusetts Clinical and Translational Science Institute (CTSI) hubs collaborated with the Boston Breast Cancer Equity Coalition (The Coalition) to implement an evidence-based care coordination intervention for Boston residents at risk for delays in breast cancer care. The Coalition used a community-driven process to define the problem of care delivery disparities, identify the target population, and develop a rigorous pragmatic approach. We chose a cluster-randomized, stepped-wedge hybrid type I effectiveness-implementation study design. The intervention implements three evidence-based strategies: patient navigation services, a shared patient registry for use across academic medical centers, and a web-based social determinants of health platform to identify and address barriers to care. Primary clinical outcomes include time to first treatment and receipt of guideline-concordant treatment, which are captured through electronic health records abstraction. We will use mixed methods to collect the secondary implementation outcomes of acceptability, adoption/penetration, fidelity, sustainability and cost.
CONCLUSION: TRIP utilizes an innovative community-driven research strategy, focused on interdisciplinary collaborations, to design and implement a translational science study that aims to more efficiently integrate proven health services interventions into clinical practice.
Breast cancer disparities, Implementation science, Patient navigation, Social determinants of health, Stepped-wedge design
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© 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
DOI of Published Version
Battaglia TA, Freund KM, Haas JS, Casanova N, Bak S, Cabral H, Freedman RA, White KB, Lemon SC; TRIP Consortium. Translating research into practice: Protocol for a community-engaged, stepped wedge randomized trial to reduce disparities in breast cancer treatment through a regional patient navigation collaborative. Contemp Clin Trials. 2020 Apr 17;93:106007. doi: 10.1016/j.cct.2020.106007. Epub ahead of print. PMID: 32305457. Link to article on publisher's site
Contemporary clinical trials
Battaglia TA, Freund KM, Haas JS, Casanova N, Bak S, Cabral H, Freedman RA, White KB, Lemon SC. (2020). Translating research into practice: Protocol for a community-engaged, stepped wedge randomized trial to reduce disparities in breast cancer treatment through a regional patient navigation collaborative. Open Access Articles. https://doi.org/10.1016/j.cct.2020.106007. Retrieved from https://escholarship.umassmed.edu/oapubs/4209
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
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