University of Pennsylvania Philadelphia, Pennsylvania
Assistant Professor of Medicine
American Association of Cancer Research
Improving breast cancer outcomes for Black patients by increasing access to care and adherence to treatment.
Recent advances in breast cancer screening and newer therapies for the treatment of breast cancer have led to a decrease in cancer deaths in the last three decades, however racial and ethnic disparities in breast cancer deaths persist. Black individuals diagnosed with breast cancer have higher risk of death compared to white individuals. Social determinants of health (SDoH) are important factors that influence access to care and contribute to racial and ethnic disparities in health outcomes. SDoH influence access to screening, oncology clinic appointments and treatment retention, which lead to disparities in health outcomes. Timely initiation and adherence to cancer treatment appointments influence the dose intensity of treatment and breast cancer survival outcomes. Current data show a higher rate of missed oncology clinic appointments in Black patients compared to white patients, potentially leading to adverse health outcomes for Black patients. Intervening early could lead to improvements in cancer outcomes.
The Penn Individualized Management for Patient-Centered Targets (IMPaCT) model is a standardized community health worker (CHW) program with proven effectiveness in chronic disease management by increasing access to primary care, increasing patient perceived quality of care, and reducing hospitalization and readmission rates. The IMPaCT program has currently been scaled up to 50 organizations in 20 states and the Veterans Administration health system, but the effectiveness of this model has not been previously studied in patients with cancer. For her AACR award supported by BCRF, Dr. Martei is evaluating cancer outcomes in patients enrolled in IMPaCT across the University of Pennsylvania Health System from 2013-2022 who received any cancer diagnosis following enrollment in IMPaCT. Additionally, she and her team are piloting implementation outcomes of a breast cancer-adapted CHW program integrated into breast cancer care delivery. Thus far, Dr. Martei and her team have successfully recruited and trained 2 CHWs as well as a part-time research coordinator for the project. The CHWs are integral to bridging care between the navigation team within the Penn Health system and cancer patients in the community.
Dr. Martei and her team have received the outcomes data and will be proceeding with data analysis. The team is now enrolling participants for the CHW program, and they will monitor and evaluate the impact of the CHWs’ work on patient-facing and health system utilization outcomes as the project progresses.
Yehoda M. Martei, MD, MSCE is an attending physician in the Division of Hematology-Oncology at Penn. She completed her medical degree at Yale School of Medicine and residency at University of California, San Francisco Medical Center and Hospital, followed by a fellowship at Hospital of the University of Pennsylvania. Dr. Martei’s research focuses on evaluating and improving access to cancer medicines and treatment outcomes in breast cancer patients in sub-Saharan Africa and assessing the impact of access to essential medicines for cancer treatment, on clinical outcomes among cancer patients in low- and middle-income countries. Dr. Martei has also worked on the World Health Organization Steering Committee/Union for International Cancer Control Task Team for updating the Model List of Essential Medicines for Cancer and the Steering Committee for the Medicine Patent Policy: “Feasibility of expanding the Medicines Patent Pool’s scope to include all patented essential medicines.”
2023
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