Supporting Young Breast Cancer Survivors, Metastatic Breast Cancer Patients, and their Families - Breast cancer is among the most diagnosed cancer, and second leading cause of cancer death, among women. When diagnosed in women younger than age 45, it is often more aggressive, presents at an advanced stage, shortens life expectancy, and results in physical, psychosocial, and financial challenges. Moreover, a significant proportion of young women with breast cancer will develop metastatic breast cancer (MBC). Among young breast cancer survivors (YBCS), Ashkenazi Jewish women are at increased risk due to founder mutations in the breast cancer genes (BRCA1/2; 1:40), and are in critical need of additional, culturally appropriate survivorship support. Sharsheret (Hebrew for “chain”), the national Jewish not-for-profit breast cancer organization, was founded in 2001 to provide culturally relevant psychosocial and structural support services to young Jewish women at high risk for, diagnosed with, or surviving breast cancer and their caregivers. Today, Sharsheret also has the capacity to aid in closing the gap in disparities and inequities in the survival and quality of life of women in these high risk, economically, and socially marginalized groups, including the Ashkenazi Jewish community, and women in racial/ethnic subpopulations (e.g., African American, Asian/Pacific Islanders, Hispanic, Native American women), LGBTQIA+ communities, low socio-economic groups, rural communities, and women with physical or mental/emotional disabilities. Sharsheret successfully collaborated with the CDC under the three previous program cycles, DP11-1111, DP14-1408, and DP19-1906: it will use both proven and new, innovative health equity strategies to build on previous programming to foster meaningful collaborative organizational relationships and educate and provide access to emotional and psychosocial support systems and resources for YBCS, MBC patients (MBCP), and their families. Sharsheret will increase equitable access and availability of psychosocial and structural support services for YBCS, MBCP, and families and improve patient-provider interactions during follow-up and subsequent care through the proposed LINK® Program – Equitable Access Initiative: Supporting Young Jewish Breast Cancer Survivors, Jewish Metastatic Breast Cancer Patients, and their Families (LINK-EAI). LINK-EAI will implement health equity-enhancing strategies through: (a) increasing the availability of psychosocial support services for Jewish YBCS, MBCP, and families across seven existing, structured, culturally appropriate breast cancer support services that have been subject to evaluation commissioned by CDC, (b) establishing and providing cultural competency trainings and proven and innovative distance education opportunities for health care providers (HCP), patient navigators (PN), and community health workers (CHW) focusing on incorporating palliative care early in the cancer trajectory, navigating difficult conversations, and raising cultural awareness, competency and humility, and (c) improving post-treatment opportunities for all YBCS and MBCP survivor groups, including established and pioneering web-based, social media, and in person modalities. Sharsheret will improve quality of life, equitable access to, and availability of, psychosocial support services and education for an increased number of Jewish YBCS, MBCP, and families from among 100,000 to among 150,000 and will improve education of an increased number of HCP, CHW, and PN from among 14,000 to among 21,000 to facilitate patient-provider interactions, reducing the gap in disparities and inequities in survival and quality of life. Project findings will be evaluated and disseminated to facilitate replication and adaptation among other underserved YBCS and MBCP populations, and allied educational and change intervention programs, to control and prevent breast cancer - including among vulnerable and historically marginalized communities.
