# Research Project 2

> **NIH NIH U54** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2024 · $131,116

## Abstract

Implementation of integrated care for rapid breast cancer diagnosis
ABSTRACT
Consistent with the second pillar of WHO's Global Breast Cancer Initiative for improving
breast cancer (BC) control in LMICs, our long-term goal is to improve the timeliness of
breast cancer diagnosis in Mexico. The goal of the proposed study is to develop and test
implementation strategies designed to improve integrated care for rapid BC
diagnosis across health system levels among women presenting with BC in primary
care settings. The Specific Aims are:
(1) Assess barriers, facilitators, and organizational readiness for implementation of
rapid BC diagnosis system. We will conduct qualitative interviews with healthcare
personnel (informed by CFIR and ISF frameworks) to identify barriers and facilitators
for implementation. Also, we will cross culturally adapt the R=MC 2 measure and assess
organizational readiness across the 166 primary care centers that serve the uninsured
population in Monterrey, Nuevo León. (2) Develop strategies to improve the
implementation of a rapid BC diagnosis system. Using Implementation Mapping in
collaboration with the key stakeholders, we will design contextually appropriate
implementation strategies (including practice facilitation) to address barriers and
strengthen organizational readiness for implementation of integrated care that will
enable rapid diagnosis. (3) Evaluate the impact of practice facilitation on
implementation of a rapid BC diagnosis system and determine effectiveness on patient
outcomes. We will conduct a hybrid type 2 implementation-effectiveness study using a
cluster randomized stepped-wedge design. Primary implementation outcome: reduction
in the time between symptomatic presentation at the primary care clinics and arrival to
the diagnostic clinic. Effectiveness outcome: down-shift in the stage of BC. The proposed
study will address a pressing need in BC control in Mexico (and other LMICs), and
advance implementation science by adapting and validating a Spanish language
organizational readiness measure and evaluating the use of practice facilitation to
improve readiness for implementation of cancer control practice change in LMICs.

## Key facts

- **NIH application ID:** 10933445
- **Project number:** 5U54CA284109-02
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Karla Unger-Saldaña
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $131,116
- **Award type:** 5
- **Project period:** 2023-09-20 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10933445

## Citation

> US National Institutes of Health, RePORTER application 10933445, Research Project 2 (5U54CA284109-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10933445. Licensed CC0.

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