CENTER OVERALL: PROGRAM SUMMARY / ABSTRACT While considerable evidence is available for screening and early treatment of breast and cervical cancers, huge gaps remain in equitable and sustainable translation of this knowledge into practice and policy, especially in sub-Saharan Africa. In Kenya, gaps in screening and linkage to treatment result in late-stage presentation of breast and cervical cancers, profound preventable morbidity and mortality, and disproportionate hindrance to women’s development. 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 Kenyatta National Hospital (KNH), Emory University, 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 seamlessly 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 women’s 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 women’s 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 equity in our institutions, research, and our impacts.

CENTER OVERALL: PROGRAM NARRATIVE Breast and cervical cancer kill many millions of women around the world, particularly in Sub-Saharan Africa, despite the fact that deaths and disability related to these cancers can be prevented by early detection and treatment. There are major gaps in the screening for and coordination of care to prevent women’s cancers in countries like Kenya; a profound inequity that threatens the health and well-being of women, their families, and communities. We propose to establish the Enhanced BReast and cErvical cAncer screening in Kenya THROUGH implementation science research and training (BREAKTHROUGH) Center, a partnership between institutions in Kenya, the US, and Canada to: 1/ promote research on how to improve women’s cancer control; 2/ to build the base of future researchers in Kenya that can continue and expand this work; and 3/ to inform policy makers on the best ways to engage women in breast and cervical cancer screenings and link them with appropriate care.