The Bicultural Patient Advocacy and Breast Cancer Services Project - Howard County Health Department
This grant will offer breast cancer screening and follow-up support to Latina, Korean, South Asian and other ethnic minority women in Howard County who have limited or no health care coverage. The grant will fund two patient advocates - one Hispanic and one Korean - who speak English and either Spanish or Korean fluently and who are experienced with the Hispanic or Korean cultures. It will also fund contractual interpreters for women of various ethnic groups in Howard County.
Continuation of Breast Cancer Services to Minority Women in Baltimore County – Baltimore County Health Department
This grant will continue to provide breast cancer screening to three minority populations receiving culturally appropriate services to Baltimore County Department of Health. Hispanic, Korean, and African American women will receive breast cancer screening, diagnosis, and treatment. A Korean and a Latino outreach worker will provide culturally appropriate intervention during this process.
Closing the Gap: Hispanic Women and Breast Cancer - Wicomico County Health Department
This grant will employ a Hispanic patient advocate to identify, refer and enroll underinsured and uninsured Hispanic women in Wicomico and Somerset Counties into a breast cancer screening program. The patient advocate will also provide case management services such as interpretation/translation and transportation services.
Breast Friends - LifeBridge Health
This program is designed to support, educate and advocate for the unique needs of young survivors. The program will provide monthly professionally facilitated support groups where young survivors can share their experiences and learn about specific issues such as fertility and sexuality concerns, dating relationships, and caring for young children. The program will build on the educational component by providing outreach education to college women. In addition, professionally guided activities will be available for children whose loved one is dealing with breast cancer and an annual meeting will be held for husbands, caregivers or significant others of young survivors. The program will also continue advocacy efforts to educate the medical and legislative communities about the special issues and needs of this underserved group of cancer survivors.
Cancer Awareness, Resources, Exams, Screening (CARES) - Chase Brexton Health Services, Inc.
This project incorporates three main objectives. The first is to increase the number of annual mammograms and clinical breast exam screenings for women at CBHS through provision of accessible referral and patient navigation services to low-income, uninsured women over 40. The second is to ensure women with abnormal findings from mammography screening and clinical breast examination have access to available resources including transportation, financial support, and appropriate diagnostic testing. The third objective is to provide targeted outreach and education to medically underserved, minority (including lesbian, African American, and HIV-infected) women and bring them into wellness care through partnerships with agencies serving our target populations.
Providing Meals to Women in Treatment for Breast Cancer, as well as Dependent Children and Caretakers- Moveable Feast
This program will prepare and deliver meals and nutritional support to women undergoing treatment for breast cancer and their families. Families served may be underinsured, uninsured, or insured, but are facing financial ruin as a result of illness-related expense. These meals will ensure appropriate nutrition for a woman and her family while she is undergoing treatment, help to alleviate financial concerns, mitigate concerns about caring for family, and address emotional issues, such as loneliness and depression.
Just Us Women’s Outreach Project - Cecil County Health Department
This project representing church communities and other interested partners in Cecil, Harford and Kent Counties will provide screening services to women less than 40 who are at high risk for breast cancer, provide direct supportive services to eligible women who are receiving breast cancer treatment services at Union Hospital and address issues surrounding long term survivorship by conducting one workshop and two Meet and Talk Long Term Survivor Groups. The project will continue the training established in the past years of Just US! Outreach Teams; educating women about the importance of breast cancer screening, identifying resources in their communities and referring high risk women less than 40 years of age meeting eligibility criteria to receive breast cancer screenings and follow up services.
STEPs to a Continuum of Breast Health Services on the Mid-Shore - Shore Regional Breast Center
The objective of STEPs is to improve breast health care services to African-American, Hispanic, and medically underserved women in the Mid-Shore region of Maryland (Talbot, Dorchester, Queen Anne, and Caroline counties). Services include: breast cancer screening, diagnosis, and treatment; transportation and translation services; case management of the target populations; and ongoing education and outreach to referring physicians and community leaders about the services.
Survivors Offering Support Hospital Integrated Psychosocial Care Programs – Anne Arundel Medical Center
This program will provide psychosocial services including on site hospital sponsored mentoring programs and transitional support workshops offered to all breast cancer patients at Anne Arundel Medical Center, Franklin Square, Frederick Memorial, and Howard County General Hospitals and St. Joseph’s Medical Center.
Support for Core Services and Critical Expenses – The Red Devils, Inc.
This program will fund critical non-medical services such as transportation to and from medical appointment, home delivered meals and groceries and housecleaning. The Red Devils is expanding services from 22 hospitals in Baltimore City and surrounding counties to additional hospitals in Baltimore City, Anne Arundel County and western Maryland. The grant will also fund critical expenses such as drugs not covered by insurance or co-pays for drugs or treatment that may create additional financial duress.
Jean Steirn Cancer Program…Beyond Breast Cancer – Pro Bono Counseling Project
Jean Steirn Cancer Program …Beyond Breast Cancerprovides free mental health treatment and transportation to therapy appointments when necessary. This program links uninsured and low-income breast cancer patients and their family members, during any phase of their cancer from diagnosis to post-treatment or survivorship, with insured and licensed mental health therapists at no charge. In addition, educational workshops are held quarterly for volunteer clinicians addressing specific mental health concerns critical to breast cancer patients, survivors and family members.
Life After Breast Cancer: Return to Independence – Women Supporting Women
This program will provide direct access for forty breast cancer survivors to acupuncture, nutritional assessment, aqua therapy and training and education for upper extremity exercise. The participants will demonstrate a measurable decrease in pain, an understanding of the importance of nutrition and a measurable increase in functional independence. Overall, the participants will demonstrate a measurable improvement in quality of life.
Be Well Stay Healthy: A Support Program for Breast Cancer Survivors – Mercy Medical Center
Be Well Stay Healthy is a support program administered at the transition point from “patient” to “survivor” and has been shown to reduce symptoms of fatigue among breast cancer survivors and help them make sustained healthy lifestyle changes. The goals of the program are to offer a mind-body medicine program to reduce persistent fatigue and related symptoms and to maximize dissemination by conducting an educational workshop for health care providers to increase their awareness of the challenges facing their patients, help them better address patient needs and train them in program competencies to broaden program outreach.
High Risk Breast Cancer Screening – Allegany County Health Department
This project will provide screening services to high risk women under 40 who are un- or underinsured and meet financial guidelines. This project will also serve women who are under 40 who are having symptoms of breast cancer such as a lump or thickening in the breast, a change in the size or shape of the breast or sudden nipple discharge.
Enhancing Accrual to NCI-Sponsored Breast Cancer Clinical Trials at Johns Hopkins - JohnsHopkins University, School of Medicine, Sidney Kimmel Comprehensive Cancer Center
This grant will provide for a clinical trials research nurse to assist local surgeons, medical oncologists, and radiation oncologists to enroll patients to NCI sponsored clinical trials for breast cancer.
Increasing Patient Accrual to NCI Sponsored Breast Cancer Clinical Trials - Shore Regional Breast Center
This project will focus on continuing to accrue patients to NCI-sponsored clinical trials for breast cancer treatment and prevention. This will be done through the continuing work of a clinical trials research nurse, who will educate physicians, members of the community, and potential candidates about clinical trials and the potential benefits of participation. The nurse will also assist in the enrollment process and in data management. In addition, a part-time clinical research assistant will assist with data management and follow-up. The emphasis will remain on increasing the enrollment of all eligible women, but with a continuing focus on educating members of the African American community about clinical research and the need for involvement.
Improving Support and Accrual to NCI-Sponsored Breast Cancer Clinical Trials - University of Maryland Marlene and Stewart Greenebaum Cancer Center
This grant will fund a clinical trials coordinator to assist medical and radiation oncologists to make sure NCI sponsored clinical trials are open for accrual and continue to enroll new patients to these trials with an emphasis of maintaining a historical accrual rate of 30% African-Americans to breast cancer clinical trials.
MAKE A DIFFERENCE
Washington County Hospital New Collaborative Make a Difference Project Year 2 – John R. Marsh Cancer Center, Washington County Hospital
This program continues in its second year to focus on hard to reach women living in rural communities of Washington County as well as minority women who live in urban Hagerstown; these women will receive breast cancer awareness information and education, free clinical exams, immediate transportation to a free mammogram if indicated and follow-up case management and treatment as necessary. A Patient Navigator will facilitate timely and supportive access to any additional care. Outreach will also be expanded to minority and foreign-born immigrant women with translation services available. Alternative outreach strategies will be tested, such as advertising with radio and television stations, and the local baseball team.
The Beauty Within: Making a Difference in Baltimore City -- Baltimore Medical System
This program will provide outreach, education, screening and case management to 1600 low income women in Baltimore city to ensure these women receive clinical breast exams, complete their referrals to mammograms and follow through with needed diagnostic and treatment services. This year the program will utilize local beauty shops and a beautician school to educate women about breast health and to recruit them into care.
University of Maryland School of Nursing
The University of Maryland, School of Nursing is in year 2 of an innovative three-year Komen Maryland grant. This partnership will heighten the awareness, knowledge and skills of both faculty and students at all levels of the curriculum about the current state of science concerning the prevention and detection of breast cancer and the treatment and care of people living with the disease. There are four arms to the Komen Maryland/School of Nursing partnership. The Komen Visiting Professor will introduce external and evidence-based expertise selectively sought by the school to augment the existing curriculum with regard to breast cancer. The Komen Distinguished Lectureship is an annual lecture on breast cancer during the month of October. The speaker will be from the best and most provocative in the field of breast cancer. Komen Conferees are selected faculty and students who will be awarded a stipend to support registration and travel expense to participate in national state of the art science conference. Komen Educational outreach will allow students to shadow community health workers and advocates; selected presenters will hold a SON/Komen focus mini conference or series of workshops. This program will generate expertise for nurses who will be uniquely poised to work in the field of breast cancer and to advocate for their patients.
In an effort to be responsive to requests that arise throughout the year, Komen Maryland offers small grants of up to $5,000. Small grants are available to promote the mission of Komen Maryland and to increase the capacity of breast health programs. Among other things, this year Komen Maryland funded small grants to support selected local health departments to screen additional women through the Breast and Cervical Cancer Program.
NATIONAL RESEARCH GRANTS FUNDED BY KOMEN MARYLAND
Strategies for Health after Breast Cancer: A Survivorship Guide for African American Women –
University of Maryland Marlene and Stewart Greenebaum Cancer Center
Some cancer survivors are able to initiate changes in their lives that improve their health and cancer outcomes, but many are not. Even fewer are able to sustain these changes over time. Developing feasible plans of self-care, which target the health status and lifestyles of survivors, can be a daunting task. These issues are particularly important for African American (AA) women, who are significantly less likely to survive breast cancer for 5 years than their Caucasian (Cau) counterparts. Our earlier studies with AA and Cau breast cancer survivors found that many participants had no clear plan of follow-up care valued over others as a means for reducing their risk of cancer recurrence. AA survivors emphasized the importance of support from networks of other survivors in developing and maintaining their plans for self-care, particularly in the years following initial diagnosis and treatment. However, few guidelines are available for survivors that specify what to expect after breast cancer treatment, or how to obtain appropriate follow-up care afterwards. To address this need, our goal for the video educational program (VEP) will be to feature the experiences and perspectives of AA survivors about their medical care. These testimonials will be translated into a program that offers both education and distinct guidelines for self-care to other survivors after completing their primary breast cancer treatment. Members of the Sisters Network Inc, a national AA breast cancer survivors' network, will collaborate with us in producing this VEP, and will be featured in group discussions, individual testimonials, and patient-physician vignettes. This VEP will include modules on: a) understanding the disparities and special needs of African American women with breast cancer; b) dealing with concerns after treatment; c) creating a follow-up and survivorship plan of action d) ways to prevent recurrence; e) communicating with doctor(s) about follow-up care; and f) obtaining social support. It will be evaluated by survivors and physicians who deliver their follow-up care, as a tool for increasing the knowledge and skills of members of AA support networks in assisting other survivors to develop plans of follow-up care, which target the context of their health status and lifestyles. It will be based on a model we previously used to produce a VEP which delivered education about breast cancer screening, risk factors, prompt symptom care through AA church-based networks.
Post-Doctorate Research Fellowship
The Role of p21 in Tamoxifen Agonism – Abde Abukhdeir, PhD – Johns Hopkins University
Increased exposure to estrogen over a woman’s lifetime may increase her risk for developing breast cancer. Drugs used to treat this disease either compete with targets of estrogen (Selective Estrogen Receptor Modulators, SERMS) or prevent the production of estrogen (aromatase inhibitors). The drug Tamoxifen (a SERM) is a first line of treatment for primary breast cancers that express estrogen receptor. Currently, the standard of care for pre-menopausal women with estrogen receptor positive breast cancers is to take Tamoxifen for five years as adjuvant therapy. However, many breast cancers develop Tamoxifen resistance, and in some cases this resistance is associated with Tamoxifen stimulated growth of the breast cancer. We have identified a patient demonstrating this phenomenon. Furthermore, we have strong evidence to suggest that this Tamoxifen-resistant disease was due to the silencing of a gene called p21. Based on this data, we have developed a model system that recapitulates this situation. Our data and the data of others suggest that the loss of the p21 gene or loss of p21 function leads to Tamoxifen-resistant breast cancer. In addition, we have used this model system in a high throughput drug screen to identify drugs that specifically target this phenomenon. In this study, we will elucidate the molecular mechanisms of this particular form of Tamoxifen resistance. Furthermore, we will molecularly characterize the effects of the lead compounds we have identified that specifically target Tamoxifen resistant/dependent cells. The work proposed here may lead to a better understanding of how our new drugs target Tamoxifen-resistant cancers and will allow for the development of more advanced drug therapies with fewer toxic side effects for the treatment of breast cancers.