MDHHS’s Cancer Prevention and Control Section is proposing development of the Program for Breast Cancer in Young Women. The Program will convene 21 partners to implement a multi-level public health approach to increase support to young breast cancer survivors (YBCS), young women with metastatic breast cancer (MBC), and caregivers (those who care for them at home). In this project, MDHHS and its partners will improve services at local, state and national levels.
Michigan is a diverse state and encompasses all priority populations. Data shows the largest disparity identified in Michigan is for Black women. In 2016, the incidence rate of breast cancer in women under the age of 45 was similar among White and Black women, with Black women having a higher diagnosis rate of triple negative and metastatic breast cancer. Michigan’s Black YBCS mortality is higher than the national average. This disparity will be an important focus of The Program. To assure success, the project will start with four underserved populations (African American, American Indian, LGBTQ and rural women) and focus on improving services and support for these populations. New target populations will be added each year.
There are several planned outcomes, with the primary one being improved quality of life of for YBCS, MBC and caregivers. This outcome will be achieved by looking at a variety of needs including sexual health, reproductive health, mental health, healthy lifestyles, genetic counseling, financial support and advance care planning.
An Advisory Council made up of healthcare providers, priority, and underserved populations will guide this work. Interventions to meet the needs of YBCS will include 1) increasing the understanding and knowledge of providers; 2) policy, system, and environmental change; 3) increasing access to and use of lifestyle programs;4) increasing emotional and psychosocial support; 5) engaging patient navigators and community health workers to improve services for underserved populations; and 6) disseminating promising practices.
The Program will use a stepwise evaluation approach which will capture information about activities and outcomes and facilitate continuous program quality improvement. Evaluation will seek to gain valuable, culturally responsive perspectives from underserved populations. Every step of the evaluation will use a culturally responsive lens. An initial evaluation plan has been developed and will be finalized by March 2020.
MDHHS has the proven capacity to work with partners to develop and implement supportive services for YBCS, MBC and caregivers. Program staff are leaders in efforts to reduce disparities in screening, diagnostics, treatment, and quality of life for cancer survivors. The 21 partners each bring their own expertise and experience in serving YBCS, MBC and caregivers. The Program will place a priority on learning from and YBCS, MBC, caregivers and the underserved in order to identify gaps and implement evidence-based interventions that will improve their quality of life.