PROJECT SUMMARY/ABSTRACT
Research: Early palliative care (PC) for patients with advanced cancer is an understudied area of health
equity. Black women with metastatic breast cancer (MBC) disproportionality suffer from the psychological and
physical impacts of living with this serious condition. The purpose of this study is to develop and evaluate a
community-engaged, lay-navigator (LN) led, early PC intervention (‘ACCEPT-PC’) that targets distress and
symptom burden in Black women with MBC. The specific aims are to: 1) Conduct focus groups to assess the
early PC needs and preferred content, format, and delivery of a LN led community-based PC intervention; 2)
Iteratively develop and refine the ACCEPT-PC intervention; 3) Conduct a pilot randomized controlled trial
(RCT) of ACCEPT-PC to determine feasibility, including preliminary impact, in preparation for a fully powered
trial. To accomplish these aims, we will employ a sequential embedded, mixed method, community-engaged
design. Qualitative findings from focus groups with patients and stakeholders will guide the development of
ACCEPT-PC, which will be iteratively refined using cognitive interviews, and evaluated for feasibility and
preliminary impact in a pilot RCT. Candidate: The primary objective of this application is to support Dr. Melissa
Mazor’s career development from a mentored researcher to an independent nurse-investigator focused on
improving disparities in PC for underserved women with advanced cancer. This K08 award will provide her with
advanced training in the following four areas: 1) PC intervention development; 2) health disparities research; 3)
clinical trial design, leadership and evaluation; and 4) R01 grant writing, leadership, and professional
development. To achieve these goals, she has assembled a multidisciplinary mentoring team. Dr. Lin, her
primary mentor, is an accomplished clinician-investigator focused on breast cancer self-management. Dr.
Wisnivesky, her co-primary mentor, is a disparities health services researcher with formal training in
biostatistics. Dr. Smith, an oncologist trained in PC, will provide expertise in community-engaged research and
social determinants of PC disparities. Her scientific advisors include Dr. Goldstein, a health services
researcher in the area of community-based PC and Dr. Dionne-Odom, a nurse researcher who will provide
advanced training in LN coaching for cancer patients and clinical trials. Environment: The Icahn School of
Medicine at Mount Sinai has a strong tradition of outstanding research and is one of the top 20 medical
schools in NIH funding. The Division of General Internal Medicine is the largest division in the Department of
Medicine and has a well-established section of research and exceptional research infrastructure. The Tisch
Cancer Institute is an NCI-designated cancer center with well-established research and serves a large
population of diverse patients throughout New York City. The Brookdale Department of Geriatrics and
Palliative Medicine is one of the leading palliative care institutions with unparalleled research support.
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