Supporting Young Breast Cancer Survivors, Metastatic Breast Cancer Patients, and their Families - Project NEXUS: Next Expansion of XRAY throughout the U.S. The purpose of Project NEXUS is to address the unmet needs and health disparities faced by young breast cancer survivors (YBCS), young women with metastatic breast cancer (YWMBC) and young high-risk women (YHRW), their relatives and caregivers to help them gain access to psychosocial and structural support services, navigation services, information, and care plans to facilitate shared decision making with care providers. NEXUS will build on the success of our current CDC-support cooperative agreement, known as Project EXTRA. To meet these needs, we will expand upon our current resources, with an emphasis on creating robust partnerships, mentoring community-based organizations and disseminating tailored, evidenced-based information to reduce disparities, especially in communities that have been socially and economically marginalized. We will focus efforts on reaching these priority populations: Black, Latine, American Indian and Alaskan Native communities, transgender, D/deaf and hard of hearing, and autistic individuals, and people and families with an inherited mutation associated with an increased risk for breast cancer. We will partner with more than 50 organizations and individuals to achieve the following outcomes: • Short-term: 1) Increased number of organizations that serve YBCS, YHRW and YWMBC, their families and caregivers who contribute to structural and psychosocial support services. Increased engagement and contribution of these organizations to the provision of these support services for these patient groups; 2) Increased informed decision making among YBCS, YHRW and YWMBC as it relates to treatment, follow up, and preventative care by improving access to care plans, expert guidelines and navigation pathways personalized for their diagnosis, genetic testing status, stage, and situation; 3) Increased use of culturally appropriate interventions to expand program reach among YBCS, YHRW and YWMBC from various cultures, identities, and backgrounds; • Intermediate: 1) Established and maintained structural and psychosocial services in settings that are readily patronized by YBCS, YHRW, YWMBC, families, and caregivers; 2) Increased HCP education on physical and mental health needs of YBCS, YHRW and YWMBC; • Long-term: 1) Increased equitable access to psychosocial and structural support services for YBCS, including MBC patients, and their families by supporting organizations and entities that serve this population; 2) Improved quality of life among all YBCS. We will employ 7 strategies to accomplish our goals: 1) Increase the number of nongovernmental organizations that represent and serve priority populations who join the NEXUS Steering Committee (SC) and participate in NEXUS activities. 2) Foster collaborative relationships with Comprehensive Cancer Control coalitions to support the implementation of initiatives that support YBCS. 3) Educate and inform survivors, caregivers, family members, and friends on 1) assistance in coping with the effects of treatment and 2) provision of cancer care plans. 4) Develop processes to identify, prioritize and implement PSE change goals, with a goal of selecting and making progress toward one change goal for each project year. 5) Increase number of HCP receiving innovative continuing education. 6) Increase number of community health workers, patient navigators, promotoras and librarians trained to reach groups that have been economically and/or socially marginalized to enhance their access to and utilization of YBCS services, programs and clinical trials. 7) Support YBCS, YWMBC, YHRW, and their families to decrease emotional distress, increase social support, enhance relationships with family and physicians, and improve symptom control.
