Jessica D. Austin, Ph.D.

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• Achieving Equity through Socioculturally-informed, Digitally-Enabled Cancer Pain Management (ASCENT) - Main Trial Rochester, Minn., Scottsdale/Phoenix, Ariz.

  The purpose of this study is to test a validated collaborative care model-based intervention aimed at improving pain control among rural dwelling and Hispanic cancer survivors by promoting multimodal pain care (MMPC)  to reduce inappropriate opioid use and by  addressing social determinants of health (SDOH) that impede patients’ access to appropriate care.

• CARE: Cancer Risk Perception and Women of Color (CARE) Jacksonville, Fla., Scottsdale/Phoenix, Ariz.

  The purpose of this study is to understand how women of color from diverse racial and ethnic backgrounds conceptualize their current and lifetime risk for breast cancer (BC) and to identify which risk factors most resonate with perceptions of BC risk.

   

• Exploring Cultural Acceptability of Community Breast Cancer Risk Assessment Among Hispanic Women in Maricopa County Scottsdale/Phoenix, Ariz.

  The objective of this study is to explore the perceptions of under- and uninsured, Hispanic women living in Maricopa County around mammography screening to understand if deploying a BRCA model in community settings is a culturally acceptable strategy for reducing disparities in mammography access and use.

  In 2019, breast cancer (BC) was the leading cause of death among Hispanic women in Maricopa County, Arizona (AZ) – Mayo Clinic Arizona’s (MCA) primary catchment area where Hispanics comprise 30% of the population. Mammography screening has been associated with a nearly 25% reduction in mortality, but Hispanic women have a lower incidence of mammography screening and are twice as likely to report barriers to accessing care compared to non-Hispanic White women. Federally Qualified Health Centers (FQHCs) are safety net providers that can help reduce disparities in mammography screening by providing screening services on site or referring patients to other clinics. Unfortunately, there is the only one FQHC in the County that provides screening on site. Preliminary data and feedback from community stakeholders suggest that the limited presence of mammography facilities, challenges accessing and affording health care, as well as other contextual factors (cultural beliefs, transportation, age, literacy) may explain disparities in BC screening and mortality.  

  Risk-based screening may bring considerable benefits by directing the limited screening and preventive resources available in Maricopa County to women most in need. Guideline recommendations call for the implementation of individualized breast cancer risk assessment (BRCA) in primary care settings, but implementation may prove challenging for FQHCs in Maricopa County that are chronically overburden and underresourced. This proposed research is significant for its potential to reduce disparities in BC screening and mortality by exploring the use of BRCA models in community settings as a strategy to identify Hispanic women at increased BC risk for targeted interventions.

  Before this innovative strategy is introduced, we must understand women’s perceptions around risk, barriers to accessing mammography screening, and acceptability (i.e., attitudes, beliefs, barriers, and facilitators) of BRCA. The objective of this pilot study is to explore the cultural acceptability of performing BCRA in community settings as a strategy to promote access and use of mammography screening among under and uninsured, Hispanic women in Maricopa County.  

• Mayo Clinic Community Research Registry Rochester, Minn., Jacksonville, Fla., Scottsdale/Phoenix, Ariz.

  The primary goal of this study is to establish a database of underrepresented populations who consented to be contacted for biomedical research including clinical trials and bio-specimen research. The database will serve as sampling frames for selecting healthy individuals who initially meet specific study eligibility criteria.

• Pilot Test of a Pain Management Intervention Preparatory to a Future Pragmatic Trial (ASCENT) (ASCENT) Rochester, Minn., Scottsdale/Phoenix, Ariz. This clinical trial tests how well a pain management intervention preparatory to a future pragmatic trial works in rural dwelling and Hispanic cancer survivors. Cancer pain is a key case study in health disparities in the United States. Cancer pain is prevalent, under treated, and remains a major cause of suffering, impairment, and disability for millions of Americans. Individual pain interventions and care models show promise for cancer pain in controlled settings. Hispanic and rural-dwelling cancer survivors stand to benefit the most from electronic health record innovations, as each of these health disparities populations experience profound disparities in pain outcomes, including marked under- and over-prescribing of opioids. Additionally, Hispanics not only comprise a steadily growing proportion of cancer survivors, but are also increasingly immigrating to rural communities, potentially placing them at "double risk" for poor outcomes. This trial will allow for the refinement of pain management intervention components that could help the management of cancer-related pain in rural dwelling and Hispanic cancer survivors.