Supporting Young Breast Cancer Survivors, Metastatic Breast Cancer Patients, and their Families - The Michigan Department of Health and Human Services (MDHHS) Program for Breast Cancer in Young Adults (PBCYA) was established in 2019 and serves Young Breast Cancer Survivors (YBCS), those with Metastatic Breast Cancer (MBC) and caregivers. In the last five years it has worked with 103 local, state, and national programs, or organizations to identify and address quality of life issues. The program uses a population based problem-solving approach and has worked with 95 YBCS, MBC and caregivers of all types of backgrounds to define the problem, brainstorm new ideas, implement a new approach and evaluate the results and even more young adults to implement its programs. Michigan (MI) is a diverse state with all priority populations, ranging from metropolitan to frontier and remote. MI cancer surveillance data shows that disparities exist with Black young adults disproportionally experiencing late stage or MBC diagnosis and mortality. Late-stage diagnosis is an issue for Hispanic young adults. Based on these disparities and MI population size, the PBYCA will place much of its attention on Black and Hispanic YBCS and MBC. The geographic areas of Michigan with the highest burden and members of the LGBTQIA+ community, will also be included as specific populations of focus. However, with the assistance of partners, all socially and economically marginalized populations will receive focused attention. There are several planned outcomes with quality of life the long-term focus. Attention to more short-term outcomes will be used to achieve this. Increasing the understanding barriers to and access of culturally appropriate structural and psychosocial support services will assist with serving the underserved. Increasing YBCS and MBC serving partner engagement will expand the PBCYA’s reach into all underserved populations. The scope of this project is based on the support of PBCYA partners including the MDHHS Cancer Prevention and Control Section. A new health disparity workgroup will guide much of the work. Evidence based or promising practices including shared decision making will receive priority. New activities will include a specific focus on food insecurity, podcasts, and workgroup focused on cancer plan objectives. Many successful activities will continue including the listserv that serves over 4,000, its Young Breast Cancer Symposium, and the resource repository. The PBCYA will use evaluation and performance measurement to guide program improvement and determine the extent in which strategy implementation is contributing to its outcomes. Evaluation will seek to gain valuable, culturally responsive perspectives from underserved populations. An initial evaluation has been developed and will be finalized by March 2025 with a newly developed evaluation team which will guide the evaluation process and facilitate continuous program quality improvement. The PBCYA at MDHHS has the proven capacity to work with partners to develop and implement supportive services for YBCS, MBC and their loved ones. Program staff are leaders in efforts to reduce disparities in screening, diagnostics, treatment, and quality of life for cancer survivors. Its many partners each bring their own expertise and experience in serving this population and various underserved populations. The PBCYA will place a priority on learning from underserved YBCS, MBC, and their loved ones to identify gaps, improve communication and implement evidence-based interventions that will improve quality of life.
