Comparative Modeling to Inform Cervical Cancer Control Policies - Moonshot Supplement

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Project Summary/Abstract While disparities in access to health care and health outcomes have long been apparent, the COVID pandemic has laid bare the structural and interpersonal racism that contribute to the disproportionate morbidity and mortality for people who identify as Black, Indigenous, Latinx, and other minoritized groups. These health disparities are often mediated by complex social factors stemming from discriminatory practices. Prior studies of cancer care disparities have focused primarily on characteristics at the patient or provider level, but increasingly we recognize the importance of macro-level social exposures, particularly those that occur in the community and health care settings. METRICS and CISNET- Cervical investigators propose an administrative supplement to advance our scientific conceptualization of how to measure and model structural racism and discrimination (SRD) and intermediate social exposures (ISEs) to promote equity in cervical cancer screening. We propose to (1) conceptualize measures of and policies directed at SRD and ISEs that are relevant to the cervical cancer screening process and catalogue possible measures available at METRICS healthcare systems; (2) conceptualize the integration of multi-level characteristics into existing CISNET cervical cancer models to estimate the effect of SRD and ISEs on racial/ethnic disparities in cervical cancer outcome; and (3) develop an analytic and collaborative plan to evaluate the impact of a measure/policy related to SRD or ISEs on Black- White cervical cancer disparities, leveraging existing and potentially new data from METRICS and the multi-level CISNET models. This collaboration will extend the scientific scope of our currently funded work and serve as a blueprint for examining the impact of SRD and ISEs on other cancers, among other racial/ethnic groups, and across different health care settings.