Cancer Care and Racial Equity Study (CCARES): An Innovative Community and Academic Model for Investigating Disparities in Systems of Breast Cancer Care

In this nation, the unequal burden of disease among People of Color has been well documented. One factor that is rarely explored with regard to disparities in health and healthcare is the role of institutional racism. Consistent findings of healthcare disparities have been explained by stereotyping, discrimination, and time pressure all by which occur in the context of institutional racism. In this presentation, we explore the integration of community-based participatory research (CBPR) principles with an Undoing Racism process to conceptualize, design, apply for and implement research to investigate disparities in healthcare. This process of integrating CBPR principles with anti-racist community organizing presents unique strengths and challenges that were negotiated by creating strong and transparent relationships that view conflict as necessary for true partnership. We will describe in detail the activities and necessary conflicts managed by our Health Disparities Collaborative to design and submit a successful application for NIH funding. Major challenges have included: assembling and mobilizing and maintaining a full collaborative; the difficulty of establishing a shared vision and purpose for the group; the issue of maintaining trust; and the willingness to address differences in institutional cultures. Expectation, acceptance and negotiation of conflict were essential. The presentation will end with a discussion of the concepts of cultural humility and cultural safety, which were central to the CBPR principles that guided CCARES partners through negotiating challenges and accommodating conflict.