||1R21CA231192-01A1 Interpret this number
||University Of New Mexico Health Scis Ctr
||Women in Survivorship Healthcare (WISH): Implementation of a Nurse Navigation Model for Medically Underserved Breast and Gynecologic Cancer Survivors Using Project Echo
There are currently over 15 million cancer survivors in the US and this number is expected to exceed 20 million
by 2026 due to population aging and growth. In 2006, the Institute of Medicine (IOM) released a landmark
report outlining recommendations, including use of a survivorship care plan (SCP) to address the needs of
cancer survivors, and other organizations have issued guidelines to improve survivorship care. Despite this
recognition, research clearly documents the persistence of unmet needs among cancer survivors including less
than optimal preventive and cancer surveillance screening rates. Several barriers have been identified in the
effort to achieve optimal survivorship care: the current health care system is fragmented, difficult to navigate
and communication between oncologists and primary care providers is often minimal. Further, a predicted
shortage of oncologists/oncology services in relation to increases in cancer survivors highlights the need for
These circumstances underscore the urgent need to develop more effective models of care integration.
The IOM, American Cancer Society and the American Society of Clinical Oncology all emphasize the
importance of enhancing the role of primary care providers (PCPs)–general practice, family practice, obstetrics
and gynecology, geriatrics, and internal medicine–in survivorship care. The use of SCPs is increasingly
common, yet research has demonstrated implementation barriers that limit their effectiveness.
Despite research aimed at implementing integrated care models, systematic reviews conclude that no
standard of care exists for survivorship models. Encouragingly, studies have shown no differences in adverse
outcomes of patients cared for by PCPs as compared to oncologists for certain cancer types. Prior research
conducted by members of our research team, which serves as the basis for this proposal, found that both
PCPs and patients are willing to participate in a survivorship care model. New Mexico, a large, rural, minority-
majority state, with deep socioeconomic disparities that limit access to care, presents an ideal environment to
advance implementation of SCPs in a broader integrated care model. In order to systematically develop and
implement a survivorship care model, we have convened a partnership between community-based primary
care providers, researchers and clinicians in the University of New Mexico Comprehensive Cancer Center
(UNMCCC) and Departments of Family and Community Medicine, Obstetrics and Gynecology, and Project
ECHO (Extension for Community Healthcare Outcomes), an innovative telementoring platform. The overall
objective of the ECHO Women in Survivorship for Health (WISH) study is to implement and assess a
survivorship care model by training a network of primary care providers through Project ECHO and then
transitioning patients through nurse navigation and coordinated follow-up with a multidisciplinary specialist care
team at the UNMCCC.
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