Eberhart, Lindsay

School of Public Health

MHS / MA

Tanzania

Time to ACT: Implementing strategies for breast cancer control in Africa

Breast cancer is the most common cancer in women in both high- and low-resource settings. Although widely recognized as a significant public health concern in developed nations, breast cancer is becoming an increasingly urgent health issue in low and middle-income countries (LMICs). Both incidence and mortality in LMICs continue to increase, and the majority of breast cancer deaths now occur in developing nations. Global disparities in breast cancer mortality persist due to inequities in access to early detection and curative treatment.
The Mwanza region of Tanzania has enormous momentum to build cancer control programs. The region's Bugando Medical Center (BMC) is being developed as the nation's second private cancer hospital, serving approximately 13 million people and yet there is currently no coordinated plan to engage the target population, shift the focus to early detection, and overcome barriers along the breast cancer control continuum.
Recognizing the importance of evidence to inform action, we are using research methods from the emerging field of implementation science to Assess (local context), Couple (strategies to context), and Test (implementation strategies) within a larger effort to scale-up breast cancer programs in Tanzania. The overarching goal of the multidisciplinary "Time to ACT" study is to reduce breast cancer morbidity by developing a toolkit to design and implement contextually appropriate, evidence-based programs for breast cancer control. To achieve this objective, we specifically aim to:


Aim 1. Assess multi-level contextual factors affecting successful implementation of breast cancer control programs in Mwanza, Tanzania.
A. Describe patients seeking care for breast concerns, breast cancer burden and characteristics, and clinical care and outcomes in the catchment area of Bugando Medical Center.
B. Identify facilitators and barriers associated with both prior cancer prevention programs in Mwanza and those perceived for new breast cancer control programs from key stakeholders.
Aim 2. Develop and test the implementation of consensus-selected strategies for breast cancer control that are responsive to the local context of the Mwanza region.
A. Identify promising strategies through stakeholder consensus that overcome barriers and capitalize on key themes related to successfully reducing breast cancer morbidity.
B. Assess the feasibility, reach, and adoption of the selected implementation strategies using a pre/post-test design to demonstrate the ability of the strategies to ultimately reduce breast cancer morbidity.

This is a mixed method, multi-stage implementation science study which started in August 2017. 
 

PI Mentor: Anne Rositch

People

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program
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September 2019

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