Institute for Clinical Research and Health Policy Studies

Program on Equity in Science and Health

The Program on Equity in Science and Health, directed by Dr. Karen Freund, addresses research disparities in health care, and diversity in the biomedical workforce.  Research on equity in science seeks to understand the factors associated with promoting and achieving diversity in biomedical careers.  This includes understanding the factors associated with the recruitment, promotion and retention of women and minority faculty in academic biomedical careers.  Research includes observations studies to understand the factors associated with promotion and advancement in biomedical careers, as well as intervention to address these issues.  The Program also addresses disparities in the delivery of health care, with major focus on care to women and minority communities.  Disparities in care are well documented in multiple racial and ethnic minority groups.  Conditions in common between women and men have also demonstrated gender disparities in outcomes.  Our recent research focuses on interventions to reduce and eliminate these disparities.

Massachusetts Cure Breast Cancer license plate

Boston hospitals working together

Karen Freund, MD, speaks about a collaboration between Boston academic medical centers to reduce the outcomes gap between white and African American breast cancer patients and improve outcomes for all breast cancer patients.

Learn how hospitals are closing the treatment gap

Active Projects

Evaluation of Hospital-at-Home in Response to Covid-19 Pandemic

During the COVID-19 pandemic, there is an increased need to rapidly develop new models of inpatient care to address the demand for hospital beds during surge episodes. Standing up freestanding inpatient units outside of hospitals has been met with limited success, and in general can only accommodate low acuity patients, with minimal mild disease and limited monitoring and assistance. Providing inpatient level care in one’s house (hospital-at-home) to a subset of patients has been a concept recently developed and demonstrated to be effective and safe in several small randomized trials, but has not had the necessary stakeholder buy in by patients, their families, or their providers to expand to broader use or for more high acuity cases. Given the current interest on the part of patients to receive as much care as possible locally, due to fears of COVID19, this is an ideal opportunity to evaluate the implementation of hospital-at-home for high acuity inpatient care. Tufts Medical Center has partnered with a company, Medically Home, to provide hospital at home high acuity (levels II and III) inpatient level care to qualifying patients from either the emergency department or the inpatient service. This program was launched on March 31, 2020 with a small but sustained transition of patients to this model of care. The COVID-19 pandemic offers the opportunity to conduct a formal implementation evaluation of a hospital-at-home program. This includes evaluation of outcomes of care and complications of care, and implementation facilitators and barriers. We propose a pilot analysis of the findings from patients at Tufts Medical Center to inform a larger multi-site analysis of this hospital-at-home program.

Disparities in Testing and Diagnosis of COVID-19 among Tufts Medical Center Employees

The COVID-19 pandemic is shining a powerful spotlight on pre-existing health disparities. Black and Latinx people in the United States are overrepresented in COVID-19 diagnoses and deaths. The increased mortality in minority communities is a result of decades of structural racism. Racist policies and practices have led to disinvestment in community infrastructure and public health for people of color. The long-term consequences have resulted in higher prevalence of chronic illnesses like obesity and diabetes, less access to healthcare, increased reliance on public transportation, and higher rates of employment at hourly-waged jobs. At the natural interface between the hospital and community, healthcare workers are particularly high risk for transmission of COVID-19 infection.  Tufts Medical Center represents a socioeconomic microcosm, with a hierarchical mapping of higher salaries for predominantly-white physicians, nurses and administrators, and lower salaries for a population of racially and socioeconomically diverse people who work in various jobs integral to the function of the hospital, including but not limited to technicians, administrative staff, food services, housekeeping and transportation. Tufts MC was one of the first hospitals in Boston to offer in house rapid COVID-19 testing, and one of the only hospitals in Boston to make testing available to all staff. There are still unanswered questions about the relative role that socioeconomic status plays in exposure to the disease. The cohort of Tufts MC and Tufts MC Physicians Organization (Tufts MC PO) employees thereby provides unique opportunity to interrogate the impact of sociodemographic impact on COVID-related care for front-line healthcare workers with access to COVID-19 testing.

Active Studies

Translating Research into Practice (TRIP)

African American women with breast cancer face disparities in time-to-treatment, quality of treatment, and delayed follow up to abnormal tests. According to the Centers for Disease Control and Prevention, African American women have a 40 percent higher chance of dying from breast cancer than white women. 

In partnership with the Boston Breast Cancer Equity Coalition, the TRIP researchers found three evidence-based strategies known to reduce delays in care that have failed to make it into practice as a result of persistent patient and health system barriers:

  • A navigator for every vulnerable patient to solve problems and provide support and guidance through the complex health care system
  • A regional registry to help providers and navigators track their patients
  • Resources to help navigators identify social determinants of health (e.g., food and housing insecurity)

Translating Research into Practice (TRIP) is being carried out at six clinical sites from the Boston area with the goal of assisting 1100 women who are seeking breast cancer care over the next five years. Investigators from Boston University Clinical and Translation Science Institute (CTSI), Tufts CTSI, Brigham and Women’s Hospital, Harvard Catalyst (the Harvard Clinical and Translational Science), and the University of Massachusetts Center for Clinical and Translational Science (CCTS) are testing a coordination of care approach for vulnerable populations experiencing breast cancer disparities.

TRIP integrates these strategies into a cohesive package. If successful, TRIP will be able to be adapted to any disease in other communities impacted by disparities. 

Cancer Health Disparities Network (CDRN) Cohort

The aim of this study is to evaluate the feasibility of recruiting, collecting survey and biospecimen data, and following a cohort of 450 diverse individuals from underserved populations from various geographic areas of the United States.  This study proposes to establish the Cancer Disparity Research Network (CDRN) Cohort, a resource for studies of factors related to cancer incidence among underserved populations. The CDRN Cohort will pool data and initiate new studies not previously undertaken in underserved populations. Targeted underserved populations that will compose the CDRN cohort will be recruited by research teams from the following study sites:

  • The Ohio State University Comprehensive Cancer Center (100 residents of Appalachia)
  • University of Illinois at Chicago (100 Hispanics)
  • Fox Chase Cancer Center (Philadelphia, PA) (100 African Americans)
  • University of Pennsylvania (50 African Americans)
  • Tufts Medical Center (100 Asians)

The Ohio State University Comprehensive Cancer Center is the Coordinating Center for the CDRN cohort feasibility study. The goals of the Tufts study site are to:

  • Recruit 100 Asians to the CDRN cohort
  • Collaborate with the CDRN Coordinating Center to refine study procedures, forms, questionnaires, and process for collecting and mailing biospecimen data.
  • Interact with the other cohorts/study sites to conduct two pilot studies: 
  1. Determine the impact of the Affordable Care Act (ACA) on cancer prevention and screening behaviors; and
  2. Explore the response to chronic stress (telomere length and Tumor Necrosis Factor (TNF) and C-reactive protein (CRP) concentrations) with the characteristics of cancer risk profiles for each of the populations and the cohort as a whole.

Insurance Instability and Disparities in Chronic Disease Outcomes

Racial and ethnic health disparities in the processes and outcomes of chronic disease care are pervasive, well documented, and consistently linked to health insurance coverage.  Insurance instability (the frequency of switches in insurance coverage or gaps without coverage), may contribute to disparities in outcomes of chronic disease care.  With the explicit goal of reducing disparities, Massachusetts (MA) Health Insurance Reform has now extended comprehensive health insurance coverage to 98% of the state’s residents, with disproportionately greater gains in coverage among racial/ethnic minorities and the poor.  To examine if MA insurance reform has lessened health disparities through increased insurance stability, our specific aims are:

  • To examine changes in insurance instability pre- and post-reform, overall and comparing racial/ethnic specific minority populations to whites.  We hypothesize that (a) Insurance instability decreased in the post-reform period and (c) Insurance instability decreased more for racial/ethnic minorities.
  • To examine whether patients receiving care post-insurance reform had better processes of chronic disease management and improved health outcomes, compared with patients receiving care pre-insurance reform, and whether such patterns vary by race/ethnicity.  We hypothesize that improvements in processes and outcomes of chronic disease management were greater among racial/ethnic minorities who benefited the most from insurance reform, resulting in reduced disparities.
  • To assess whether patients with more favorable insurance stability had better processes of chronic disease care and improved health outcomes compared to patients with less favorable insurance stability, and whether racial/ethnic minority patients experienced disproportionately greater gains. We hypothesize that greater insurance stability will be associated with improved processes and outcomes of chronic disease management, resulting in reduced disparities.

We will assess the processes and outcomes of care for six highly prevalent, chronic conditions before and after the implementation of MA Health Insurance Reform: diabetes, hypertension, hyperlipidemia, congestive heart failure, asthma, and chronic obstructive pulmonary disease.  We will utilize existing electronic medical records on over 110,000 subjects from Boston Medical Center and eight of its affiliated federally qualified Community Health Centers, the largest safety net institution in New England that serves African American and Hispanic communities, and Tufts Medical Center, which serves a large Asian American community in Boston’s Chinatown.  When the study is completed, we will provide empiric data on the direct impact of insurance reform and insurance instability on health disparities in multiple populations.

Partners on this project include Multi- Principal Investigator Dr. Nancy Kressin (Boston Medical Center), Dr. Amresh Hanchate, co-Investigator (Boston University School of Medicine), Dr. Norma Terrin, co-Investigator (Tufts Research Design Center/Biostatistics Research Center), and Dr. Tracy Battaglia, co-Investigator (Boston Medical Center).  This work is supported by the National Institute on Minority Health and Health Disparities.

Learn more >

Dr. Amy LeClair’s Studies

30-Day Readmissions at Tufts Medical Center

This is a qualitative study to examine the medical and socioeconomic factors contributing to 30-day readmissions. The data collection for adults is currently complete. We are now piloting this study with the pediatric department to understand unique factors in the pediatric patient populations. 

CTSA Consortium SRC pilot study

This NCATS funded study assesses the implementation and use of in the recommended Scientific Review Committee (SRC) process developed by the SRC Working Group. Scientific review is distinct but complementary to IRB review. The goal of the SRC is to review studies for scientific merit and feasibility. This pilot study is attempting to implement this review process at 10 CTSA hubs and assess the barriers and facilitators to its implementation and use. 

Stakeholder and Community Engagement (SCE) in Early Stage (T1) Translational Science 

Four CTSA hubs have come together to develop a framework for stakeholder engagement in the early stages of translational science. 

Together for Child Wellness

With support from the Deborah Munroe Noonan Memorial Research Fund, this study aims to understand the barriers and facilitators to diagnosis and treatment of Autism Spectrum Disorder (ASD) in children from Chinese immigrant families. Chinese children with ASD tend to be diagnosed later than their non-Chinese peers and experience significant delays in linking to care. By understanding the perspectives of both parents and providers we hope to inform an intervention to address these delays in a culturally competent and relevant manner. 

Dr. Elena Byhoff’s Studies

Screening for Social Determinants of Health in Massachusetts 

Health Centers are nonprofit organizations that provide health and other related services to residents in medically underserved areas. Social Determinants of Health (SDH) are defined as the circumstances, in which people are born, grow up, live, and work. There is a well-documented relationship between SDH and health outcome. Despite the prevalence of unmet social needs that disproportionately impact health when compared to other aspects of medical care, we understand relatively little about how best to recognize and address such needs. Even less is known about the landscape of current SDH screening practices. Our proposed study will address this gap by characterizing SDH screening practices in health centers throughout Massachusetts. By understanding and comparing current practices across all health centers in the state, we can identify heterogeneity in screening, which can facilitate targeted improvement in practices across the state.
Learn more >

Completed Studies

Longitudinal Follow-up to the National Faculty Survey

In 1995, over 1,900 academic faculty from 24 medical school completed the National Faculty Survey (NFS).  Under the leadership of Phyllis Carr MD as PI, the NFS collected information about demographics, professional goals, academic environment, perceptions of bias, discrimination, and harassment, compensation, and work/life balance.  The original survey provided seminal data on recruitment, promotion and retention of women and underrepresented minority faculty in academic medicine.

In 2011- 2012, we invited 1,300 faculty members from the original survey to complete a follow up survey.  The data serves as the first longitudinal follow up of a nationally representative sample of faculty in medical schools.  The specific aims of the project are:

  • To measure longitudinal career outcomes for women compared with men, and under-represented minority women faculty compared with majority women, along the following domains:
    • Satisfaction with academic career
    • Compensation
    • Productivity, including grants and publications
    • Academic rank
    • Retention
  • Identify how individual (e.g., hours of work, family responsibilities), institutional environment (e.g., support, work environment) and factors that intersect the individual and institution (e.g., racial discrimination, sexual harassment) are associated with career advancement outcomes form women compared with me, and for under-represented minority women compared with majority women.

We also conducted key informant interviews with administrative faculty at the medical schools to collect information regarding institutional policies and practices that differentially facilitate or impede faculty advancement based on gender or under-represented racial/ethnic minority status.

Partners on this project include Multi- Principal Investigator Dr. Phyllis Carr (Massachusetts General Hospital), Dr. Norma Terrin, co-Investigator (Research Design Center/Biostatistics Research Center), Dr. Samantha Kaplan, co-Investigator (Boston University), and Dr. Anita Raj, co-Investigator (University of California, San Diego).  Dr. Carr was the Principal Investigator of the 1995 survey.  This work is supported by the National Institute of General Medical Sciences.

The National Patient Navigation Research Program

Dr. Freund serves as Chair of the Design and Analysis Committee of the National Patient Navigation Research Program (PNRP), an NCI funded cooperative group to conduct a controlled trial on the impact of patient navigation on timely cancer care in vulnerable populations.   The PNRP looks at the impact of patient navigation interventions to reduce or eliminate cancer health disparities. The Avon Foundation provides additional support for the secondary analyses of the Patient Navigation Research Program (PNRP). Current research questions addressed through this initiative include:

  • The impact of comorbidities on cancer care and patient navigation
  • The influence of household size and composition on delays in cancer care, and the ability of navigation to ameliorate their impact
  • Whether patient navigators with personal experience with cancer care are more effective in their position than navigators without cancer treatment experience
  • Understanding which tasks that navigators perform are associated with best practices and more timely care for their patients
  • The impact of patient navigation on the quality of breast cancer treatement
  • The impact of patient navigation for patients with abnormal Pap tests.
  • The impact of patient navigation in women with abnormal breast cancer screening

Patient Navigation Research Program Database

The national Patient Navigation Research Program recruited nearly 10,000 subjects with abnormal cancer screening, and over 2000 subjects with incident cancer and precancerous lesions into a controlled trial of patient navigation compared with the control of usual care.  Subjects were predominantly from under-insured and minority populations.  Subjects were recruited from nine centers (comprised of 21 local community health centers or ambulatory care sites).  We collected clinical and patient navigation information for eligible participants 18 years and older who had an abnormal breast, cervical, colorectal, or prostate concerning screening result.  Clinical information included type of screening abnormality, type and stage of cancer, dates and types of clinical services, and clinical outcomes.  Patient navigation information barriers identified as part of the care delivery process, activities to address the barriers, and services provided are also in the database.  Other information included race/ethnicity, gender, primary language, and health insurance coverage. 

Program Director

Karen Freund, MD in 2020Karen Freund, MD, MPH

Karen M. Freund, MD, MPH is Physician-in-Chief and Chair of the Department of Medicine and Sara Murray Jordan Professor of Medicine at Tufts University School of Medicine. She is trained and board certified as a general internist and primary care physician and is also board certified in preventive medicine. She joined Tufts Medical Center in 2012 and maintains an active practice in general medicine. Dr. Freund is a national expert in women’s health and health care to minority and low-income populations. She has an active research program with over 120 publications. She is recognized for her skills in mentorship and oversees mentorship programs within the department for medical educators and clinician scientists. 




Elena ByhoffElena Byhoff, MD, MSc

Elena Byhoff, MD, MSc is an Assistant Professor in the Department of Medicine at Tufts Medical Center and Tufts University School of Medicine. Her primary research focuses on how social determinants of health impact health and health care across the life course. She is interested in identifying primary care-based interventions to reduce health disparities in vulnerable populations. Dr. Byhoff received her MD from the University of Pennsylvania School of Medicine. She trained in primary care internal medicine at the Hospital of the University of Pennsylvania and completed the Robert Wood Johnson Clinical Scholars Program at the University of Michigan. Read an article about social determinants of health >




Dr. Alysse Wurcel is an infectious disease specialist in Boston at Tufts Medical Center. Alysse Wurcel, MD, MS
Assistant Professor and Attending Physician, Geographic Medicine and Infectious Disease, Tufts Medical Center

Alysse Wurcel, MD is an attending physician in the Division of Infectious Diseases and Geographic Medicine at Tufts Medical Center and Assistant Professor of Medicine at Tufts University School of Medicine. She is board certified in Internal Medicine and Infectious Diseases. A graduate of University of Pennsylvania School of Medicine, she completed her Internal Medicine training at Massachusetts General Hospital, Infectious Disease fellowship at Columbia-Presbyterian Hospital and Tufts Medical Center, and received a Masters in Clinical Research from the School of Graduate Biomedical Sciences at Tufts University School of Medicine.

Dr. Wurcel  provides HIV and HCV care at Tufts Medical Center as well as six local county jails. She is the Infectious Diseases consultant to the Massachusetts Sheriffs Association for COVID19 prevention and mitigation strategies. She is currently funded through a K08 grant from AHRQ to work with stakeholders in the jails to improve access to HCV testing and treatment.


Amy LeClair, PhD, MPhilAmy LeClair, PhD, MPhil

Amy LeClair, PhD, MPhil is an Assistant Professor in the Department of Medicine at Tufts Medical Center and Tufts University School of Medicine. She is a medical sociologist who employs qualitative and mixed methods to conduct health services research with disadvantaged populations. She joined Tufts Medical Center in 2015 after earning her PhD in Sociology from New York University and completing a NIMHD post-doctoral training fellowship in mental health services research at Rutgers University’s Institute for Health, Healthcare Policy and Aging Research. Dr. LeClair is the course director for Health Services Research in the Clinical and Translation Sciences graduate program She collaborates with several interdisciplinary teams on topics including racial and economic disparities in breast cancer care, addressing health related social needs in medical settings, and improving pathways for Hepatitis C testing and treatment among incarcerated populations. Dr. LeClair is currently developing an implementation study to increase the collection of sexual orientation and gender identity (SOGI) data in health care settings to optimize patient-centered care.

Dr. Jana LearyJana Leary, MD, MS

Dr. Leary is an Assistant Clinical Professor at Tufts University School of Medicine and a pediatric hospitalist at the Tufts Children's Hospital at Tufts Medical Center. She completed her medical training at Johns Hopkins Hospital and is board-certified in general pediatrics and pediatric hospital medicine. In 2016, she was awarded a TL1 research fellowship with the Tufts CTSI, during which she obtained her Masters degree in clinical and translational science. Her primary research aims to improve hospital experiences and health outcomes for vulnerable pediatric populations such as the medically and socially complex. In 2020, Dr. Leary was awarded a KL2 career development grant, to gather stakeholder perspectives on screening for social determinants of health during pediatric hospitalizations, informing the development of an inpatient screening strategy that she will subsequently pilot. Dr. Leary’s long-term research goal is to implement social screening and intervention across various pediatric inpatient settings to reduce healthcare disparities and hospital utilization. Her full list of publications can be found here >


Rubeen GuardadoRubeen Guardado, MPH 
Research Assistant 

Rubeen has an MPH with a concentration in Epidemiology and Biostatistics from Tufts University, and BA in Global Health form University of California San Diego. Previously Rubeen has worked abroad conducting small research projects investigating PrEP interest among MSM in Mexico and Anthropometric outcomes among indigenous communities in Guatemala. His current research interest include addressing gaps in healthcare access and other health disparities among marginalized populations, particularly people with substance use disorder and/or history of incarceration. In the future Rubeen hopes to continue doing research and applying what he’s learned into clinical practice as a clinical health provider. Outside of work, Rubeen enjoys singing, dancing, watching movies, and learning how to cook.


Dolma Tsering, BSDolma Tsering, BS 
Research Assistant 

Dolma received her BS in Psychology with a focus on Neuroscience and a minor in Women, Gender & Sexuality Studies from the University of Massachusetts Amherst. Her research interests include addressing and reducing health disparities within vulnerable populations through community-partnered research and improving health care services. In the future Dolma hopes to pursue an MPH as a means to improve health outcomes and efficiency in health systems that address disparities in health and healthcare. Outside of work she loves reading, baking, hiking and camping. 

Leena Rijhwani, BSLeena Rijhwani, BS
Research Assistant

Leena graduated from Boston College in 2020 with a BS in Biology and International Studies, with a concentration in Ethics & Social Justice. She is passionate about cultural competence in healthcare delivery and reducing barriers to care for vulnerable populations. Currently, Leena’s research with Dr. Leary focuses on screening for social determinants of health during pediatric hospitalizations. In the future, Leena hopes to attend medical school, and studying social determinants and broader health disparities will provide the foundation for the equitable, patient-centered approach to medicine she hopes to practice. Outside of work, Leena enjoys singing, dancing, and exploring Boston.



Julia Zubiago, MPHJulia Zubiago, MPH
Research Assistant

Julia received her Master’s in Public Health with a concentration in Health Services, Management, and Policy. Her research interests include addressing and reducing health disparities in vulnerable populations, particularly people with substance use disorder and/or history of incarceration. She is interested in identifying opportunities for systematic change towards health equity. Outside of work, Julia loves to read, run, hike, and listen to musicals.  




Former Staff


Danielle K.Danielle Krzyszczyk, BS
Research Assistant 

Danielle Krzyszczyk joined the research team in August 2018 after graduating from Harvard University with a BS in psychology. Her interests include retail therapy, memes, and Canadian candy. Danielle is currently pursuing her PsyD in clinical psychology at William James College with a focus in Forensic Psychology.





Carolyn Luk, BA, MPHCarolyn Luk, BA, MPH
Research Assistant

After leaving Tufts MC, Carolyn Luk went to pursue her MPH in Epidemiology from Columbia University Mailman School of Public Health. At Columbia, she was an Epi Scholar at the NYC Department of Health and Mental Hygiene and wrote her master's thesis on social determinants of childhood asthma outcomes. After receiving her MPH in 2018, she was selected as a Presidential Management Fellow based in Washington DC, where she conducted research and evaluation studies on federal nutrition assistance programs at the USDA Food and Nutrition Service and implemented healthcare service delivery models at the Center for Medicare & Medicaid Innovation. Since finishing the PMF program, Carolyn works on developing healthcare payment policy at the Centers for Medicare & Medicaid Services.    


Allison BrownAlison Brown, BS, MS, PhD 

Alison Brown, MS, PhD graduated from Spelman College with a BS in Chemistry and Columbia University with a MS in Applied Physiology and Nutrition before earning her PhD in Food Policy and Applied Nutrition at Tufts University’s Friedman School of Nutrition Science and Policy. She was a TL1 fellow and completed the certificate program in Clinical and Translational Sciences at Tufts Graduate School of Biomedical Sciences. Dr. Brown served as a AAAS Science and Technology Policy Fellow and is now at the NIH’s National Heart Lung and Blood Institute and works on stimulating research around social determinants of health, nutrition science, and health disparities.  In her free time, she likes to go running with her dog Onyx and spend time with family. 

The program highly values collaborative research partnerships.  Current collaborations include the following:

Collaborations within Tufts Medical Center

  • The Center for Health Solutions – Susan Parsons, MD, MRP, Laurel Leslie, MD, and Carolyn Leung Rubin, EdD
  • The Research Design Center/Biostatistics Research Center – Norma Terrin, PhD
  • Lahey Clinic Medical Center – Zoher Ghoghawala, MD
  • Center for the Evaluation of Value and Risk in Health -  Pei-Jung Lin, PhD
  • Sasha Fleary

Community Partnerships

  • Addressing Disparities in Asian Populations through Translational Research (ADAPT)
  • Asian Women for Health and the Asian Breast Cancer Project – Chien Chi Huang, MS
  • Greater Boston Chinese Golden Age Center

Academic Partnerships

  • Boston University/ Boston Medical Center, Women’s Health Unit – Tracy Battaglia, MD, MPH, Bonnie Sherman, PhD, Sharon Bak, MPH, Ann Han, MPH
  • Boston University/ Boston Medical Center, Health Disparities/Equity Unit – Nancy Kressin, PhD, Amresh Hanchate, PhD
  • Boston University/ Boston Medical Center, Obstetrics and Gynecology – Samantha Kaplan, MD, Rebecca Perkins, MD, MSc
  • Boston University/ Boston Medical Center, Pediatrics – Natalie Pierre Joseph, MD, Arvin Garg, MD, MPH
  • Texas A&M University – Carrie Byington, MD
  • Massachusetts General Hospital – Phyllis Carr, MD
  • University of California, San Diego – Anita Raj, PhD
  • Ohio State University – Electra Paskett, PhD
  • University of Arizona – Elizabeth Calhoun, PhD
  • University of Illinois, Chicago – Julie Darnell, PhD

Boston Breast Cancer Equity Coalition logo.In the City of Boston, inequities in breast cancer mortality have persisted among Black, non-Hispanic women compared to women of other racial/ethnic groups. The inequity is especially striking given that Black women in Boston receive mammography screening at the same rates as Boston White women and had a lower incidence of breast cancer than other women during this time period. Building on past efforts to address these cancer mortality inequities, the Dana-Farber Cancer Institute and the Boston Public Health Commission convened a meeting of a group of stakeholders in early 2014. From this stakeholder group, the Boston Breast Cancer Equity Coalition was formed. The coalition is comprised of a diverse group of multidisciplinary stakeholders. Members include oncology and primary care clinicians, patient navigators, public health policy makers, advocates, researchers and patients. The coalition members have determined that the immediate next steps are additional data collection and analyses (a “deep dive” of the data) to more fully understand causes of these inequities. For mor information, please visit

Tufts Breast Cancer Training Program to Reduce Health Disparities

Led by Drs. Karen Freund and Susan Parsons and supported by the Komen for the Cure Foundation, this training program provides a cadre of master’s and doctoral students with a broad understanding of Asian, specifically Chinese, breast cancer health disparities to conduct clinical and translational research to address the needs of Chinese American breast cancer patients and survivors. Asian Americans are the only racial/ethnic group in which cancer is the leading cause of death, and breast cancer is the most common type of cancer in Asian women. Tufts University School of Medicine and Tufts Medical Center (Tufts MC) sits within Boston Chinatown and provides care for this vibrant community, and for the surrounding Chinese immigrant communities in Quincy and Malden, MA, who use Chinatown as their cultural hub. This training program is in partnership with Tufts Cancer Center, Tufts Clinical Translational Science Institute (CTSI) and the Graduate School of Biomedical Sciences at Tufts University.


  • Zahna Bigham, BA, MD/PhD Candidate
    Zahna Bigham, BA MD/PhD Candidate
    Zahna is a current MD/PhD candidate in the Tufts University MSTP. She received her BA in Biology from Wesleyan College in 2018. Her primary research interest is reducing heath care disparities, particularly those that disproportionately impact communities of color. Currently, she is working to identify the risk factors that contribute to the disproportionate burden of breast cancer in Black women and exploring the sociodemographic factors that impact medical student mental health. Zahna plans to become a physician scientist that conducts translational research. For her, becoming a physician scientist is not simply a career goal, but a necessity for the impact she intends to make in science and her community. Outside of work, Zahna enjoys traveling, reading, watching movies and HGTV, and shopping.

  • Maria Rodriguez Berrios, ND, Postdoctoral Research Fellow
    Maria Rodriguez Berrios, ND Postdoctoral Research Fellow
    Dr. Rodriguez Berrios is a licensed Naturopathic physician with broad experience in public health and clinical research. She received her medical training at the Southwest College of Naturopathic Medicine in Arizona, after graduating from her Bachelor’s degree in Biology at the University of Puerto Rico, Rio Piedras. Her lifelong goal as a clinician has been to educate and empower diverse communities, and to offer culturally-appropriate interventions for optimal health and wellness. 

    During her fellowship, she is also pursuing a Certification in Clinical Research & Translational Sciences at Tufts University. She supports the research team on a number of projects. Her main research project studies the association of sociocultural factors with cancer screening adherence among medically-underserved populations. Her research interests include Integrative Medicine, Health Promotion and Disease Prevention, and collaborating with multidisciplinary sectors to reduce Health Disparities. 

List of Trainees – Tufts Breast Cancer Training Program

  • Angie Mae Rodday, PhD, MS (2015)
  • Research Project: Assessing the Relationship between Self-Efficacy and Socio-economic Status Using the Communication and Attitudinal Self-Efficacy General Scale

  • Jinghui Dong, PhD (2015-)
  • Research Project: Impact of Patient Navigation of Patient Acceptance of Recommended Breast Cancer Treatment

  • Kimberly Esham, MD
  • Research Project: Uncharted Waters: Course and Correlates of Migratory Newly Diagnosed Breast Cancer Patients

Former Trainees – Program on Equity in Health and Science

  • Aysha Almas, MBBS, FACP
  • Anthony Kulukulualani, MD candidate
  • Andre Vogel, Brown University undergraduate student

2018 ACS Pulling for Hope

On September 23, 2018, Dr. Freund and Dr. LeClair formed a team called “Pulling for Research” with other members of the ICRHPS and Tufts Medical Center. They were able to pull a plane at Boston Logan Airport 24 feet in 11.75 seconds.


Karen Freund and other members at the ACS Walk in OctoberAmerican Cancer Society (ACS) Walk

On October 1, 2017, Dr. Karen Freund attended and spoke at the American Cancer Society (ACS) Walk about breast cancer disparities in Black women and her current work in this field.




Komen Graduate Training Program

Under Dr. Karen Freund, scholars presented their research at the Annual Komen Graduate Trainee meeting in Atlanta, GA.


Kimberly Esham presenting her posterKimberly Esham, MD




Dong standing in front of her posterJinghui Dong




Anita standing in front of her posterAnita Kumar

Karen Freund, MD, MPH

  1. American Cancer Society – “What Does the End of Cancer Look Like?
  2. The Week – “Is your doctor a woman? She’s probably being paid less.
  3. Science 2.0 – “Why Do Women Lag in Academic Medicine Leadership Positions?” 


  • 2018.11.17 Massachusetts Chapter, American College of Physicians, Boston, MA - Primary Care Physician versus Hospitalist Panel
  • 2018.09.13 Medical Grand Rounds, Beth Israel Deaconess Medical Center – “Strategies for Building and Advancing the Careers of Women”
  • 2018.09.07 Medical Grand Rounds, Tufts Medical Center – “Growing and Sustaining a Diverse Department of Medicine”
  • 2016.11.16 Boston Chinese Evangelical Church – Community Cancer Talk: “How to Keep Healthy”
  • 2016.12.09 Tufts MC Cancer Center Grand Rounds – “Addressing Cancer Disparities”
  • 2016. 9.30 American Cancer Society – “Patient Navigation to Eliminate Cancer Disparities”
  • 2016.8.3 Academic Partnership webinar – “Solutions to Gender Disparities in Research and Academic Careers in Medicine and Science”
  • 2016.7.10 QuantiaMD webinar – “Patient Navigation”
  • 2017.4.20 SGIM Special Symposium – “Maintaining Resilience and Grit in a General Medicine Research Career”
  • 2017.4.21 SGIM Oral presentation – “Racial Differences in Insurance Stability after Health Insurance Reform”
  • 2017.9.27 AACR Poster presentation – “The Impact of Insurance and Insurance Stability on Cancer Screening Behaviors”

Elena Byhoff, MD, MSc

  1. – “New study explores why cost of dying higher for African Americans and Hispanics
  2. Science Daily – “Two kinds of Medicare, two kinds of patients? Findings may mean a lot for health policy
  3. Consumer Reports – “Can You Rely on Your State’s Medical Board?


  • 2.28.2020 - State Health and Value Strategies [VideoWebinar] – “Patient Perspectives on Social Risk Screening”
  • 10.2019 - The Root Cause Coalition National Summit on the Social Determinants of Health – “Patient acceptability of health care-based social risk screening and screening tool validity.”
  • 09.24.2019 - Social Interventions Research and Evaluation Network (SIREN) [Video webinar] – “Opportunities and Tensions in Community Based Organization-Health Care Collaborations to Address Patients’ Social Needs.”
  • 09.2019 - New England Area Medicaid Research Symposium – “Case Management as a Bridge Between Health Care and Social Services.”
  • 06.20.2019 - Social Interventions Research and Evaluation Network (SIREN) [Video webinar] – “Patient Acceptability of Social Risk Screening”
  • 06.2019 – Academy Health Annual Research Meeting – “Screening for Immigration-Related Health Concerns in a Federally Qualified Health Center: A mixed methods study.”
  • 06.2019 – Academy Health Annual Research Meeting – “Case Management As a Solution to Addressing Health Related Social Needs: Competing Rationales and Unintended Consequences”
  • 05.2019 - Society for General Internal Medicine Annual Meeting – “If you can’t talk to your doctor about it, who can you tell? A qualitative study of patient acceptability and preferences for social risk screening in health settings.”
  • 06.2018 – Academy Health Annual Research Meeting – “You Can’t Scale Unicorns: Exploring Community Based Organizations’ Perspectives on Health Care’s Entry into Social Determinants of Health Programming.”
  • 06.2018 – Academy Health Annual Research Meeting – “Gender Differences in the Prevalence and Probability of Social Determinants of Health Across the Life Course in the United States”
  • 04.2017 SGIM Poster presentation – “Patient Characteristics Associated with Leaving a Usual Source of Care Despite Improved Insurance Coverage After Massachusetts Health Reform”
  • 12.2016 CCHERS presentation – “Michigan to MA: Screening for Social Determinants of Health in Community Health Centers”
  • 12.2016 ICRHPS Grand Rounds – “Michigan to MA: Screening for Social Determinants of Health in Community Health Centers”

Alison Brown, MS, PhD

Tufts Nutrition – “Former FDA Commissioner Kessler Headlines 2017 Commencement"
Tufts Nutrition –“Could community-based “Change Clubs” improve heart health in black women?”
Tufts Nutrition – “Friedman Student Alison Brown Wins the 2014 Tufts University's Presidential Award”

Amy LeClair, PhD, MPhil


  • 2019 – Centers for Medicare and Medicaid Services Webinar – “Improving Readmission Through a Comprehensive Approach to Discharge Planning and Care Transitions”
  • 2017.4.19 SGIM Poster presentation – “Patients’ Perspectives on Reasons for Readmission”
  • 2017.4.19-20 ACTS Poster presentation – “Stakeholder and Community Engagement in Early Stage Translational Science”
  • 2017.4.21 ACTS Poster presentation – “Documenting ADAPT: The growth of a community-research collaborative”

    Jana Leary, MD


    • 12.2018 – Division CME Lecture - “Escaping the Island: Mentorship Challenges and Rules for Success in PHM.”
    • 12.2018 – Tufts Medical Center Pediatric Grand Rounds - “Readmissions for Children with Medical Complexity: What We Predict and What Parents Perceive.”  
    • 11.2018 – Tuft Medical Center Department of Pediatrics Research Seminar Series - “How Can I Change the World?  Formulating and Planning a Research Project.”   
    • 09.2017 – Intern Noon Conference Series – “Introduction to Systems Improvement.”
    • 04.19-2017 ACTS Poster presentation – “Patients’ Perspectives on Reasons for Readmission"

    1U01TR002070-01, NIH/NCATS 09/01/2017-05/31/2022

    Translating Research into Practice: A Regional Collaborative to Reduce Disparities in Breast Cancer Care
    To implement scientific evidence and systems interventions in order to promote utilization of guideline concordant therapies, and ultimately reduce disparities in breast cancer care in Boston, MA and beyond.

    1K12HD092535-01, NIH/NIDCR 09/11/2017-08/31/2022
    Tufts BIRCWH Program (K12)
    The program seeks to support investigators through a mentored research and career development experience leading to an independent scientific career that will 1) benefit the health of women or advance research on sex/gender influences on health, and 2) encourage interdisciplinary research methodology. 

    R01 MD007735, NIMHD 2014/09/25-2018/05/31
    Insurance Instability and Disparities in Chronic Disease Outcomes
    To address the impact of insurance instability on continuity of care for chronic disease management focusing on racial and ethnic health disparities. 

    R01 MD007735-02S1, NIMHD
    Gender Disparities in Stability of Insurance Coverage and Chronic Disease Management 
    To address the impact of insurance instability on continuity of care for chronic disease management focusing on gender health disparities.

    CRP-17-112-06-COUN, American Cancer Society 
    Clinical Research Professorship
    This award recognizes Dr. Freund’s national leadership in cancer health disparities research, and supports her mentorship and research activities in cancer health disparities.

    GTDR15333918, Susan G. Komen Foundation
    Tufts Breast Cancer Training Program to Reduce Health Disparities 
    To train students to conduct breast cancer health disparities research, focusing on Asian Americans.

    UL1TR00064, NCATS 2013/09/26-2018/04/30
    Tufts Clinical and Translational Science Institute (CTSI)
    To accelerate translational and interdisciplinary research across Tufts University and Tufts CTSI members.
    Role: Research Lead, ADAPT (Addressing Disparities in Asian Populations)

    KL2TR00063, NCATS
    Tufts Clinical and Translational Science Institute (CTSI) Mentored Career Development
    To support junior investigators in developing their careers as clinical translational investigators.

    CE-1304-6173, PCORI 2013/10/01-2017/09/30
    Cervical Spondylotic Myelopathy Surgical Trial (CSM-S Trial)
    The goal of this study is to conduct a comparative effectiveness randomized clinical trial of two methods of neurosurgical intervention for cervical spondylotic myelopathy.

    Program on Equity in Science and Health
    800 Washington St., Box #63
    Boston, MA 02111

    35 Kneeland St., 11th Floor
    Boston, MA 02111

    Fax: 617-636-8023