by Jersen Telfort

---

Students of Public Health focuses on research projects and other contributions students are making to advance public health. This series is guest edited by Johanzynn Gatewood, an MPH candidate in Social and Behavioral Sciences at the University of Florida-Gainesville [Full bio].

STUDENT VOICES — As a second-year Master of Public Health candidate at the Mailman School of Public Health at Columbia University, I had the unique opportunity this past summer to work on an innovative study designed to increase the uptake of chemoprevention measures in women with a high risk of breast cancer. Our study used web-based decision support tools to assist in the communication between providers and patients.

As a research intern, I managed many of the day-to-day operations for the study, including collecting and managing data, running quality assurance tests, meeting with patients and providers recruited for the study, and transcribing audio recordings. One of my main responsibilities was to develop and analyze my own dataset, which allowed me to put to use many of the epidemiological concepts and statistics I learned in my academic curriculum and practicum site.

We conducted a pilot study of 50 women who underwent breast cancer risk assessment during mammography screening and were found to be eligible for chemoprevention based upon a 5-year risk of invasive breast cancer. Breast cancer risk assessment and chemoprevention with anti-estrogens are underutilized in the primary care setting, so we developed web-based decision support tools for our participants, called RealRisks, and their primary care providers, called BNAV, and integrated the tools into the clinic workflow.

Currently, there are 28 high-risk women enrolled in the study and of those, we analyzed data of 25 participants. Before and after interacting with RealRisks, we observed changes in breast cancer knowledge, chemoprevention knowledge, and risk perceptions of breast cancer. Enrollment and follow-up are currently ongoing to determine the effects of the tools on patient-provider communication during the clinical encounter. Overall, the study determined that women who are more aware of their risks may initiate discussions of preventive medicine. In addition, primary care can be enhanced with the use of health information technology to overcome barriers and increase uptake of chemoprevention.

This internship experience was valuable to me because the research I was conducting was relevant and useful to many women who continue dealing with the likelihood of developing breast cancer. It was also extremely personal for me as someone who had a father who died of lung cancer and has a mother that is a breast cancer survivor.

I learned about the complexities and challenges encountered in the research setting and delved deeper into a topic of personal interest that encouraged me to think critically. Although it was a challenging experience coordinating the efforts of the study, I enjoyed contributing to the larger picture of improving outcomes in population health. It was also enriching to collaborate with so many different departments (medicine, epidemiology, and bioinformatics) on one project, which facilitates diverse discussion and developing multi-pronged approaches to issues within research.

Through my experiences in this internship and my own personal relationship with cancer, I would like to continue working in the field of cancer epidemiology as a future public health professional.

For further reading, consider these related articles from the Journal of Public Health Management & Practice:

• Using Evidence-Based Interventions to Improve Cancer Screening in the National Breast and Cervical Cancer Early Detection Program
• The Role of Socioeconomic Status and Health Care Access in Breast Cancer Screening Compliance Among Hispanics
• Survival Benefits of Treatment Access Among Underserved Breast Cancer Patients Diagnosed Through the Texas Breast and Cervical Cancer Services Program

October is Breast Cancer Awareness Month, which is an annual campaign to increase awareness of the disease. For more resources on breast cancer, please visit the Centers for Disease Control and Prevention.

---

Jersen Telfort is a first generation Haitian American student from Miami, Florida, now living in New York City, New York. He is a second year student at the Mailman School of Public Health at Columbia University, pursing an MPH in Epidemiology with a certificate in Chronic Disease. His primary interests are in cancer and genetics.