Evaluating an evidence-based family history screening program adapted to increase reach and uptake of screening for brca-associated cancers in rural public health clinics

Active Project Grant Awarded Last action

Award ID
R37CA276317
Recipient
Awarding agency
Obligated
$3,004,204

Award facts

Assistance listing
93.393 Cancer Cause and Prevention Research
Completion date 66% complete
Place of performance
Atlanta, GA 30322, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
Brief and low-cost family history-based screening assessments to identify families at high risk for brca- associated cancers have been endorsed by national guidelines (e.g., uspstf) and public health organizations (e.g., CDC). Public health departments offer an infrastructure for systematically reaching women historically left out of cancer genomic advances (e.g., uninsured, black women, rural residents). Georgia is among the few states to have implemented statewide family history screening for brca-associated cancers. Despite its potential, current clinic-based approaches that identify at risk women are not sustainable and show limited reach. Additionally, uptake of follow-up cancer screening is suboptimal and solely focuses on women screened as high genetic risk. Therefore, we propose a two-phase study to adapt georgia's existing statewide family history screening program and evaluate its effectiveness to increase the number and diversity of women who receive family history assessment and the opportunity to access risk-stratified follow-up services. Guided by the exploration, preparation, implementation and sustainment (epis) framework, the aims of this two-phase study are: phase i (exploration & preparation stages), aim 1: conduct a multilevel adaptation of GA core's existing statewide family history screening program for brca-associated cancers to maximize sustainable program reach and improve communication suitability and effectiveness. Phase II (implementation stage), aim 2: use a multi- site, parallel group, cluster randomized controlled trial to evaluate effectiveness of the adapted program relative to the current screening program in promoting uptake of family history screening and correct screening result interpretation among women ages 25 and older who are receiving care in up to 6 of 14 public health clinics in southwest georgia. Secondary outcomes include the uptake of appropriate risk-stratified screening (e.g., high risk: genetic consultation and testing; low risk: appropriate breast imaging screening). Aim 3: use the RE-aim (reach, effectiveness, adoption, implementation, and maintenance) framework to conduct an implementation research evaluation to measure program process indicators (e.g., reach, fidelity, barriers/facilitators) that may influence program implementation and sustainability. Our application will be among the first to evaluate a sustainable multi-level population-based approach to implement evidence-based cancer genetic screening and to increase the likelihood for fair distribution of genomic advances among diverse populations in rural areas.

Transactions

Action Obligated Date
Amendment $598,628
Amendment $600,748
Amendment $573,462
Amendment $615,683
Original award $615,683

Subawards

Subrecipient Amount Awarded
Georgia Center For Oncology Research And Education, Inc. Evaluating an evidence-based family history screening program adapted to increase $198,562
Georgia Center For Oncology Research And Education, Inc. $29,700
Georgia Center For Oncology Research And Education, Inc. $200,936

Quick answers

Who received award R37CA276317?

R37CA276317 was awarded to Emory University by National Cancer Institute (National Institutes of Health) on July 6, 2023.

How much is award R37CA276317 worth?

$3,004,204 has been obligated on R37CA276317.

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