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GWCI Research Grants
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Active GWCI Grant Programs
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Minority populations in Washington, D.C. face barriers to quality cancer care, particularly when it comes to prostate, breast, colorectal, and cervical cancers—diseases that can be detected early with screening tests. Seeking to combat this disturbing disparity, GWCI is participating in a five-year study titled the “City-wide Patient Navigation Research Program,” funded by the National Cancer Institute’s Center for Research on Cancer Health Disparities. The study strives to develop operationally- and cost-effective patient navigation interventions that will minimize the time between finding an abnormal result and diagnosis or treatment. Specifically focused on breast cancer, this program enrolls patients with suspicious findings on mammograms or screenings. To determine the effectiveness of patient navigation, the time between first detection and diagnosis and, if a malignancy is detected, between diagnosis and initial treatment, is compared with non-navigated timelines. Through this unique program—the first of its kind in Washington, D.C.—GWCI has linked five unaffiliated Hospitals (including four cancer centers), two community clinic networks, and several community advocacy organizations, under the concept of "Network Navigation."
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A cancer diagnosis is only the beginning of an arduous journey full of medical visits, decisions, treatment, and recovery. Navigating the labyrinth of medical care is a struggle for many cancer patients, who also face a myriad of personal, physical, and emotional issues.
These patient navigation and survivorship concerns are the focus of GWCI’s Center for the Advancement of Cancer Survivorship, Patient Navigation, and Health Policy (ca-SNP), a three-year program funded by the Pfizer Foundation and Pfizer, Inc. The Center conducts local, regional, and national research and training aimed at advancing the principles of patient navigation and cancer survivorship. Further, the center seeks to explore these principles’ relationship with health care and health care policy. To learn more about caSNP, visit http://www.gwumc.edu/caSNP/.
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Prostate cancer is the 2nd most common type of cancer among men in the US, second only to skin cancer. Unfortunately, this disease goes unrecognized in many men who do not undergo screenings. Through a multi-year grant from the Amgen Foundation, GWCI developed a Men's Oncology Outreach Program focused on community education to increase prostate cancer screening among African American men—a group afflicted with a higher risk of this cancer. Using a social marketing approach and one-on-one interaction in everyday venues such as congregations, barbershops, and workplaces, the program encouraged African American men to participate in cancer prevention,. In addition, GWCI enlisted the help of African American women, who were targeted in a media campaign to encourage their male family members and friends to seek screening and cancer health care. The program achieved unprecedented success, and helped residents gain a better understanding of cancer, increase their trust in the health care system, and mitigate their aversion to screening.
Through ongoing funding from the AMGEN Foundation, pro bono hospital and clinical services, and monetary and time donations, GWCI is continuing to maximize the impact of this program on the African American community. Further, the program will be extended to the Hispanic community, expanded to include colorectal cancer, analyzed for Health Policy implications, and developed as a replicable, sustainable model for other communities.
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Certain types of cancer can affect different nationalities or populations more aggressively or severely. In order to better understand, and ultimately eliminate, these disparities, GWCI, in collaboration with Howard University and the J. Craig Venter Institute, created the Genomics of Cancer Disparities Center through a supplement to the City-wide Patient Navigation Research Program (PNRP) grant.
The project works to combine information about genomics and tumor biology in order to better understand their relationship. The findings can then be integrated for a systems approach to study gene regulatory networks and integrated pathways. Further, this data can be used to determine whether there are recurrent networks or connections specific to one population versus another population.
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The District of Columbia has nearly the highest breast cancer mortality rate in the country, as well as one of the highest rates of poverty. These rates disproportionately affect African American and Latina women, who are typically diagnosed at an earlier age and at a later stage than Caucasians. Such differences may be due to, educational disparities, cultural beliefs about health care, possible biological differences in cancers, and a lack of health insurance and access to health care. In particular, women in Anacostia, the poorest quadrant of Washington, D.C., suffer from the area’s absence of functional mammography facilities and its location over the Anacostia River.
Through a grant from the Avon Foundation, GWCI is able to provide breast cancer outreach, education, screening and patient navigation to women in Anacostia.Using the GW Mammovan, a mobile-mammography unit equipped with state-of-the-art digital mammography, GWCI provides 2,500 mammograms per year to underserved women right where they live and work. However, simply driving the Mammovan to certain communities does not guarantee optimal utilization, and thus it is supplemented with a network of business and faith-based community partnerships established by culturally competent outreach specialists. To ensure continual care, a Patient Navigator aids in follow-up of suspicious findings and clinical care.
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Colorectal cancer, the third most common cancer in the United States, particularly plagues Washington, D.C., where its mortality rate is one of the highest in the nation. Throughout the years, the overall mortality rate of the disease has declined, but sadly, the reverse trend is true for African Americans in the District. Through a one-year study funded by the D.C. Department of Health, GWCI seeks to overcome this disparity that may be caused by biological differences, gaps in cancer education and response, and structural and psychosocial/cultural barriers to seeking health care. The study’s multi-faceted approach includes the following activities:
- Community-based education intervention to address education gaps
- Screening by community-based FOBT for the uninsured and underinsured and clinic-based colonoscopy for the insured
- Patient navigation to overcome both structural and psychosocial/cultural barriers
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Each occurrence of cancer is as unique as the individual it strikes, making generalized treatments flawed. Thus, the field of cancer treatment is moving towards an individualized form of medicine where proteogenomic expression profiles will enable physicians to predict a person’s risk of disease, course of disease, and optimal treatment. Using information about the biology of each tumor., doctors will treat patients based on their predicted treatment-related outcomes.
This one-year, joint pilot grant program through GW’s Department of Engineering will develop and test algorithms for an Internet-based predictive application. Due to the highly-specific individual level of such a project, prediction and decision-making require computer algorithms that present outcome probabilities based on complex medical data analysis. These algorithms will be able to incorporate a multitude of predictive factors and therapeutic approaches that will in turn aid physicians in treatment decisions--ultimately benefiting patient outcomes. The development of algorithms will follow recent techniques in data mining, a bottom-up approach dependent on cluster analysis, and a top-down approach based on the concept of group testing.
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According to a recent study in the Journal of Clinical Oncology , most newly diagnosed cancer patients remember less than half of what their doctor tells them. This startling data suggests the need for doctors to supplement their dialogues with written information . This project aims to maximize supportive care utilization by providing written and audio materials to newly diagnosed cancer patients in addition to one-on-one patient resource navigation. The project will supply approximately 600 patients treated at The George Washington University Medical Center with new patient binders including:
- The ACS Personal Health Manager tool for patients to keep track of their medical records.
- A Treatment Summary and Survivorship Plan template to empower patients to seek out information treatment and wellness information, and coordinate their multi-disciplinary care.
- A list of support services available through the GW Medical Center
- Information on ACS and other community programs
- Audio modules about topics in cancer survivorship
Through this project, GWCI anticipates increased patient use of institutional and community support services, particularly by patients whose finances limit them from accessing such services.
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