scholarly journals Promoting Evidence-Based Practices for Breast Cancer Care Through Web-Based Collaborative Learning

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Mishka K. Cira ◽  
Allison Dvaladze ◽  
Robel Tesfay ◽  
Jo Anne Zujewski ◽  
Kalina Duncan

PURPOSE The objective of the Project ECHO (Extension for Community Healthcare Outcomes) for Knowledge Summaries for Comprehensive Breast Cancer Control (KSBC) was to strengthen the capacity to plan and implement evidence-based, resource-appropriate breast cancer control programs using virtual case-based learning within a global network of experts and peers. METHODS The KSBC ECHO was a collaboration between the US National Cancer Institute Center for Global Health, Women’s Empowerment Cancer Advocacy Network, and Breast Health Global Initiative in alignment with the Breast Cancer Initiative 2.5 campaign to reduce disparities in breast cancer outcomes. Using the ECHO model, we developed a 6-month Web-based program to support the development of locally relevant, resource-appropriate cancer control programs through mentorship and use of KSBCs. The course was advertised via existing networks, conferences, and social media. Breast cancer control project teams from around the world applied and were accepted to participate in the KSBC ECHO. Fourteen biweekly ECHO sessions were held via Zoom and included case presentations, didactic presentations, and discussion. Projects spanned the care continuum and sessions addressed preplanning, assessing need/barriers, setting objectives/priorities, and implementing/evaluating. Baseline and end point surveys were used to evaluate the ECHO program. Participants identified a mentor, completed worksheets, and presented on the project status. RESULTS Fifteen project teams from 11 countries—64 participants: advocates, clinicians, policymakers, and researchers—were enrolled. Twenty-eight participants (57%) completed the baseline and end point surveys. Analysis of the data using a paired t-test indicates that the knowledge increase was statistically significant: The average knowledge gain was 0.76 ± 0.89 (95% CI, 0.44 to 1.08; P < .0001). Additional feedback on the Web-based collaborative learning model will be presented. CONCLUSION The ECHO model encouraged interaction between policymakers, clinicians, advocates, and technical experts while using evidence-based tools to develop locally relevant, resource-appropriate implementation strategies and policy recommendations.

Cancer ◽  
2020 ◽  
Vol 126 (S10) ◽  
pp. 2394-2404 ◽  
Author(s):  
Anne F. Rositch ◽  
Karla Unger‐Saldaña ◽  
Rebecca J. DeBoer ◽  
Anne Ng’ang’a ◽  
Bryan J. Weiner

2021 ◽  
Vol 17 ◽  
Author(s):  
Noor Fatmawati Mokhtar ◽  
Hemaniswarri Dewi Dewadas ◽  
Juhara Haron ◽  
Maya Mazwin Yahya ◽  
Bachok Norsa’adah ◽  
...  

: High proportion of late presentation and poor survival of women with breast cancer in Malaysia does not reflect the country’s status as the third richest country in South East Asia. Herein, we examined, and collated research articles related to breast cancer trajectory i.e., primary, secondary, and tertiary prevention in Malaysia to understand, appreciate and recognize the achievements but also gaps which undermines Malaysia’s response in handling the disease. In summary, the integral task for Malaysia is to strategically align research to improve local data (research) on the extent of the country’s breast cancer problem thus from there, effective, comprehensive, evidence-based cancer control programme founded on resource level can be generated.


2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 46s-46s
Author(s):  
Ethan Thayumanavan ◽  
Catherine Duggan ◽  
Barri M. Blauvelt

Purpose Women with breast cancer in low- and middle-income countries (LMICs) have worse health outcomes than their counterparts in high-income countries (HICs). Improved outcomes in HICs are attributable to more rigorous breast cancer control policies, implementation of evidence-based guidelines, and greater national investment in health care. In resource-limited settings, identifying the most effective resource-appropriate policies can be a challenge. The proposed study will provide a framework to identify unmet breast cancer policy and infrastructure needs in LMICs and will aid in the prioritization of key elements of successful breast cancer control programs. Building on previous work, we will develop a framework for policy analysis and conduct a breast cancer policy needs assessment through a comparative analysis of attitudes and preferences for breast cancer control elements in 30 countries. Methods The proposed observational survey-based study will measure and compare attitudes and preferences for breast cancer control across 24 LMICs and six reference HICs from across the six WHO regions, stratifying countries by health care spending and mortality-to-incidence ratios. This study will be a cross-sectional survey of medical, policy, and advocacy experts in breast cancer from each of the selected countries. Research will be conducted in three phases. First, we will conduct key informant interviews of international breast cancer experts. Then we will develop and pilot a survey tool. Finally, we will conduct the full survey in countries. The study will use analysis of variance, conjoint analysis, and best-worst scaling to analyze survey results. Results This study will assess current breast cancer control needs, prioritize elements of a comprehensive breast cancer control plan, and determine attitudes about the potential of emerging technologies to improve breast cancer control. Conclusion This study will facilitate the improvement of health outcomes for women with breast cancer by assessing the specific unmet breast cancer policy and infrastructure needs in LMICs and prioritizing elements to improve breast cancer control programs. The study thus provides a resource-appropriate framework to improve breast cancer control policy, reform, and implementation. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Barri M. Blauvelt Stock or Other Ownership: AstraZeneca, Biogen, Celgene, Ecolab, Elite Pharmaceuticals Consulting or Advisory Role: Boehringer Ingelheim, Novartis


2020 ◽  
Vol 25 ◽  
pp. 100242
Author(s):  
M.K. Cira ◽  
R. Tesfay ◽  
J.A. Zujewski ◽  
D.T. Sinulingga ◽  
S. Aung ◽  
...  

2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jo Anne Zujewski ◽  
Allison L. Dvaladze ◽  
Andre Ilbawi ◽  
Benjamin O. Anderson ◽  
Silvana Luciani ◽  
...  

Breast cancer is the most common cancer in women worldwide, affecting > 1.6 million women each year, projected to increase to 2.2 million cases annually by 2025. A disproportionate number of the > 500,000 women who die as a result of breast cancer each year reside in low-resource settings. Breast cancer control is an important component of cancer control planning and women’s health programs, and tools are needed across the care continuum to reduce the cancer burden, especially in low-resource settings. Cancer control planning is complex and multifaceted. Evidence shows that outcomes are improved when prevention, early diagnosis, treatment, and palliation are integrated and synchronously developed within a country/region’s health plan. The Knowledge Summaries for Comprehensive Breast Cancer Control are the product of a multiyear collaboration led by the Union for International Cancer Control, Breast Health Global Initiative, Pan American Health Organization, and Center for Global Health of the US National Cancer Institute. Fourteen knowledge summaries distilled from evidence-based, resource-stratified guidelines, and aligned with WHO guidance on breast cancer control, build a framework for resource prioritization pathways and delivery systems for breast cancer control at four levels of available resources: basic, limited, enhanced, and maximal. Each summary contains relevant content to inform breast cancer policy, clinical care, and advocacy, aiding in the development and implementation of policies and programs. These tools provide a common platform for stakeholders, including policymakers, administrators, clinicians, and advocates to engage in decision making appropriate to their local setting. The goal is to facilitate evidence-based policy actions and urgently advance implementation of an integrated approach to reduce breast cancer mortality and improve quality of life.


2017 ◽  
Vol 3 (2_suppl) ◽  
pp. 17s-17s ◽  
Author(s):  
Allison Dvaladze ◽  
Catherine Duggan ◽  
Julie R. Gralow ◽  
Benjamin O. Anderson

Abstract 59 Background: Review of breast cancer control efforts in low- and middle-income countries (LMICs) has identified the need for a model to bridge the gap between evidence-based planning and implementation or scale-up of breast cancer diagnosis and treatment programs. We undertook this work to develop an evidence-based framework to guide systematic implementation of resource-stratified, effective, and sustainable systems to improve breast health care delivery in LMICs. Methods: On the basis of survey data and site visits, Breast Cancer Initiative 2.5 (BCI2.5) partners developed a phased implementation model for breast cancer management in LMICs. The model outlines an adaptable framework for step-wise implementation of health system requirements across the continuum of care, with successful and systematic management of clinically detectable (palpable) breast disease being a prerequisite to population-based screening. Prerequisites: Standardized protocols, guidelines, and trained health care workforce. Phase 1: Systematic triage and diagnosis of palpable breast disease; phase 2: adapted stage-appropriate treatment planning; phase 3: scaling-up of clinical breast exam to promote downstaging of clinically detectable disease; and phase 4: upgrading of image-based diagnostic systems and management of nonpalpable disease. Once these systems are in place, mammographic screening can be initiated. Results: Successful implementation of the Breast Health Global Initiative resource-stratified guidelines in northern Peru from 2011 to 2016 followed this phased implementation strategy and demonstrated that this approach can help advance specific aspects of a comprehensive cancer control plan in a systematic fashion, surmounting what may seem to be overwhelming barriers to improving early diagnosis. Conclusion: By using this model, BCI2.5 partners, in collaboration with the Government of Tanzania, are developing recommendations to inform the design, implementation, and scale-up of a breast cancer early diagnosis and treatment platform that can be achieved if adequately resourced and implemented in a phased fashion. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Allison Dvaladze Consulting or Advisory Role: Pfizer Travel, Accommodations, Expenses: Roche Catherine Duggan No relationship to disclose Julie R. Gralow Consulting or Advisory Role: Novartis, Genentech, Eli Lilly, Bayer, Pfizer Research Funding: Genentech (Inst), Novartis (Inst), Amgen (Inst) Benjamin O. Anderson Consulting or Advisory Role: Pfizer Research Funding: Pfizer, Roche


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