Lydia Pace, MD, MPH

Dr. Lydia Pace is a general internist and a health services and policy researcher. Her research focuses primarily on the delivery of and access to preventive health care services for women both in the United States and sub-Saharan Africa. She is particularly interested in screening and access for women’s cancers as well as family planning. Dr. Pace received her MD from UCSF and her MPH (concentration in quantitative methods) from the Harvard Chan School. After completing her residency in internal medicine at BWH, Dr. Pace completed a two-year Global Women’s Health Fellowship through the Connors Center, while based at Butaro Hospital in Rwanda with Partners in Health (PIH).

 

Dr. Pace currently practices clinically at the Jen Center, where she also precepts residents, as well as the BWH Breast Cancer Prevention, Risk Assessment and Education Program (B-PREP). She teaches residents on topics related to breast cancer risk assessment, screening, and contraception. In addition to her teaching and mentorship, Dr. Pace is active on several committees and was selected as the director of Women’s Health Policy and Advocacy for the Connors Center in 2017. She was honored with the Young Leader award from the Breast Health Global Initiative (BHGI) and was selected for the Women’s Leadership Program with the BWH Office for Women’s Careers. For her research efforts, she has previously received the Burke Global Health Fellowship from the Harvard Global Health Initiative and the Mary Ann Tynan Fellowship in Women’s Health from the Connors Center. She received the Society of General Internal Medicine New England Regional Award for Excellence in Clinical Investigation and more recently, the Resident Research Mentor Award from the BWH Internal Medicine Residency Program.

 

Dr. Pace’s research interests include breast cancer research in Rwanda – diagnosis delays, early detection, development of interventions and trainings and assessment of outcomes and care; family planning in the primary care setting; and women’s health policies in the United States. Her past work has included a cluster randomized controlled trial of a health worker training and system building intervention to promote earlier diagnosis of breast cancer among women with breast symptoms in Rwanda, as well as identifying strategies to measure and improve the quality of breast cancer care in Rwanda. Within the U.S., she has evaluated the impact of health policies such as the Affordable Care Act (ACA) on access to and utilization of women’s health services including mammography and family planning. Overall, her research aims to understanding health policies and health care delivery strategies to advance equity in women’s health outcomes and care for women in the U.S. and globally.

Brigham & Women’s Hospital
Associate Physician, Division of Women’s Health, Department of Medicine; Associate Physician, Division of General Internal Medicine and Primary Care, Department of Medicine; Director of Women’s Health Policy and Advocacy, Connors Center for Women’s Health and Gender Biology; Director of Global Women’s Health Fellowship, Connors Center for Women’s Health and Gender Biology
Harvard Medical School
Assistant Professor of Medicine

Areas of Expertise

Current Research

With her research efforts in Rwanda, Dr. Pace is examining the quality, effectiveness and cost of breast cancer treatment delivered at Rwanda’s first public cancer facility. She is also working with PIH, the Rwandan Ministry of Health, and the University of Pennsylvania to expand early detection breast cancer interventions and evaluate strategies to minimize loss to follow-up. In Nigeria, Dr. Pace is involved in a project that aims to develop a competency-based mHealth ultrasound-guided breast biopsy training program for low- and middle-income country radiologists, validate the assessment metrics, and train Nigerian radiologists using the program.

Domestically, Dr. Pace is examining the impact of preventive services coverage and Medicaid expansion on uptake of HPV vaccination and cancer screening services in three Northeastern states. She is also consulting on a project that provides technical assistance to Massachusetts maternity hospitals to improve quality and scope of contraceptive care.

 

 

Funding

 

  • Evaluating Breast Cancer Care in Rural Rwanda (NCI, PI)
  • Promoting Early Detection of Breast Cancer in Rural Rwanda: Impact of a Community Health Worker and Health Center Nurse Training Program (BCRF, Co-I)
  • Building a culture of care quality improvement at Butaro Cancer Center of Excellence in Rwanda (Celegene CareLinks, Co-PI)
  • Evidence-Based Policy for Maternal Health: A Quasi-Experimental Evaluation of the Impact of Innovative Medicaid Policies on Women’s Use of Effective Postpartum Contraception and Safe Birth Spacing (HSPH, Co-I)
  • Postpartum factors affecting birth spacing and health outcomes (NICHD, Co-I)
  • Tablet-based mobile health ultrasound for point-of-care breast cancer diagnosis in Nigeria (NCI, Co-I)

Select Past Research

  • Promoting Early Detection Of Breast Cancer in Rural Rwanda: Impact Of a Community Health Worker and Health Center Nurse Training Program (BCRF, Co-I / Site-PI)
    With PIH, the Rwandan Ministry of Health, and the DFCI, launched a pilot project to design and evaluate a curriculum for rural Rwandan community health workers and health center nurses to promote early presentation for breast symptoms and facilitate early diagnosis of breast cancer.
  • Early Impact of the ACA on Contraceptive Cost-Sharing and Use Among Privately Insured Women in the United States (Eleanor And Miles Shore 50th Anniversary Fellowship Program for Scholars in Medicine)
    Evaluated the impact of the ACA on contraceptive cost-sharing, method selection, and adherence among privately insured women.
  • Increasing Access to Long-Acting Reversible Contraception (LARC) Through Development of an Innovative Clinical Pathway (NIRH, PI)
    Investigated facilitators and barriers to high-quality LARC referrals at BWH and BWH-affiliated practices in order to improve clinical and administrative processes and patient access.
  • Engaging Primary Care Providers in BRCA1/2 Testing (ACS, PI)
    Project to study a strategy to engage primary care providers in disclosing BRCA1/2 results to a population of Ashkenazi Jewish patients being screened for BRCA founder mutations.

Select Publications

Pace LE, Keating NL. Medications to Reduce Breast Cancer Risk: Promise and Limitations. JAMA. 2019 Sep 3;322(9):821-823.


Schleimer LE, Dusengimana JMV, Butonzi J, Kigonya C, Natarajan A, Umwizerwa A, O’Neil DS, Costas-Chavarri A, Majyambere JP, Shulman LN, Keating NL, Shyirambere C, Mpunga T, Pace LE. Barriers to Timely Surgery for Breast Cancer in Rwanda. Surgery. 2019 Dec;166(6):1188-1195.


Steenland MW, Pace LE, Sinaiko AD, Cohen JL. Association Between South Carolina Medicaid’s Change in Payment for Immediate Postpartum Long-Acting Reversible Contraception and Birth Intervals. JAMA. 2019 Jul 2;322(1):76-78.


Pace LE, Dusetzina SB, Murray Horwitz ME, Keating NL. Utilization of Long-Acting Reversible Contraceptives in the United States After vs Before the 2016 US Presidential Election. JAMA Intern Med. 2019 Mar 1;179(3):444-446.


Pace LE, Dusengimana JMV, Keating NL, Hategekimana V, Rugema V, Bigirimana JB, Umwizera A, Park PH, Shulman LN, Mpunga T. Impact of breast cancer early detection training on Rwandan health workers’ knowledge and skills. J Glob Oncol. 2018 Sep;(4):1-10.


O’Neil DS, Keating NL, Dusengimana JMV, Hategekimana V, Umwizera A, Mpunga T, Shulman LN, Pace LE. Quality of breast cancer treatment at a rural cancer center in Rwanda. J Glob Oncol. 2018 Sep;(4):1-11. Epub 2017 May 12.


Dusengimana JMV, Hategekimana V, Borg R, Hedt-Gauthier B, Gupta N, Troyan S, Shulman LN, Nzayisenga I, Fadelu T, Mpunga T, Pace LE. Pregnancy-associated breast cancer in rural Rwanda: the experience of the Butaro Cancer Center of Excellence. BMC Cancer. 2018 Jun 5;18(1):634.


Pace LE, Dusetzina SB, Keating NL. Early impact of the Affordable Care Act on oral contraceptive cost sharing, discontinuation, and nonadherence. Health Aff (Millwood). 2016 Sep 1;35(9):1616-24.


Pace LE, Dusetzina SB, Keating NL. Early impact of the Affordable Care Act on uptake of long-acting reversible contraceptive methods. Med Care. 2016 Sep;54(9):811-7.


Pace LE, Keating NL. A systematic assessment of benefits and risks to guide breast cancer screening decisions. JAMA. 2014 Apr 2;311(13):1327-35