Enhanced BReast and cErvical cAncer screening in Kenya THROUGH implementation science research and training (The BREAKTHROUGH Center)

While considerable evidence is available for screening and early treatment of breast and cervical cancers, huge gaps remain in sustainably translating this knowledge into practice and policy, especially in sub-Saharan Africa. In Kenya, gaps in screening and treatment result in late-stage presentation of breast and cervical cancers, profound preventable morbidity and mortality, and disproportionate hindrance to health. To close these gaps, the Enhanced BReast and cErvical cAncer screening in Kenya THROUGH implementation science research and training (BREAKTHROUGH) Center coalesces trans-disciplinary expertise at Emory University, Kenyatta National Hospital (KNH), University of Washington, and Queen’s University. BREAKTHROUGH will include an Administrative and Engagement Core that engages community, clinical, and government stakeholders and scientific partners, and coordinates [Overall Aim 1] our interrelated Research Capacity Building Core and two Research Projects. Our multi-institutional, collaborative partners bring considerable breadth and depth of implementation science and oncology expertise, a substantial research base, matched resource commitments (>$125,000 in contributions), international gravitas, and >10 years of working together. To grow implementation science in cancer control and conduct impactful research, BREAKTHROUGH has a training framework that engages investigators across the career spectrum (faculty, fellows, students) to sustainably strengthen capacity by supporting trainees to become mentors [Overall Aim 2]. We provide didactic training; engagement in Research Projects; and access to stakeholders, technologies, networking, and enrichment activities. BREAKTHROUGH’s projects will map and co-design (with stakeholders) strategies that overcome barriers to cancer control. We then test feasibility, implementation, effectiveness, and sustainment of context-specific, theoretically-informed strategies for overcoming complex barriers to adoption and integration of breast and cervical cancer screening and referral linkages in primary care [center theme; Overall Aim 3]. We also utilize these projects as training platforms to strengthen local capacity and research administration for implementation science at KNH. Project 1 is entitled “accelerating aDoption of pAtient-centereD cervicAl cancer screening and treatment LINKage in Kenya” (DADA LINK) and Project 2 is entitled “a Multi-level strATegy for InTegrating Information technologY and mobile health to strengthen linkAges to breast caNcer screeninG and early detection among women Utilizing primary care in Kenya (MATITI YANGU). The Center, Cores, and Projects will produce actionable, mixed methods, user-friendly evidence and bidirectionally engage with key stakeholders as advisors and disseminators, maximizing reach, uptake, and sustainability. BREAKTHROUGH is well-integrated across Cores and Projects and embodies an ethos of promoting collaboration in our institutions, research, and our impacts.