Pilot Project 1: Mexican immigrants' biological and behavioral cancer risk based on stress

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PROJECT SUMMARY/ABSTRACT The unprecedented burden of the COVID-19 pandemic has critical consequences for the delivery of cancer care: patients present greater vulnerability to the disease and newly implemented treatment pathways and protocols may affect long-term survival because of suboptimal or delayed care. For racial and ethnic minority women receiving treatment for breast cancer, institutional measures implemented to regulate access of patients to medical settings and modifications in therapy sequence may exacerbate the existing disproportionate burden of the disease. Therefore, understanding the impact of COVID-19 on the cancer care received by minority groups and identifying potentially modifiable factors to inform future models of care delivery is critical. The U-HAND (University of Houston/MD Anderson) Program to Reduce Cancer Disparities (P20CA221697; 9/22/17-8/31/21) is a collaborative partnership between the University of Houston and The University of Texas MD Anderson Cancer Center that supports excellence in educational programming and innovation in research that affects health equity among racial/ethnic groups disproportionately affected by cancer disparities. The proposed Administrative Supplement application is a natural extension of the aims of the UHAND partnership and it is reflective of its overarching mission to execute innovative social/behavioral science aimed at mitigating cancer inequities for Black and Hispanic groups. Specifically, the proposed Supplement will be an extension of this goal by investigating the impact that the COVID-19 pandemic has on the receipt of optimal breast cancer care among women from racial and ethnic communities disproportionately affected by the illness and its psychosocial sequelae. This proposal is a logical next step building upon the Administrative Applicant’s expertise on the intermediate determinants of cancer-related outcomes. Pilot data collected will assess differential rates of cancer care disruption and health-related quality of life among Black and Hispanic women diagnosed with early-stage breast cancer (as compared with non-Hispanic white women), and examine how proximal, intermediate, and distal determinants of disparities contribute to these outcomes. It is envisioned that the study will yield information about “at-risk” patients and ways to leverage existing social resources. Finally, these findings will be used to inform future multilevel interventions able to sustain effective models of care delivery in a post-acute COVID-19 environment. During the one-year Administrative Supplement grant period, research and mentored training activities will help the applicant complete the research aims of the proposed project, and develop skills that will support her understanding of mechanisms that contribute to disparities in both health care utilization and outcomes among diverse groups to foster a successful career in reducing and eliminating cancer disparities.