community research in cancer: “corica” roshan bastani, antronette yancey, beth glenn, ritesh...
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COmmunity Research In CAncer: “CORICA”
Roshan Bastani, Antronette Yancey, Beth Glenn, Ritesh Mistry,
Annette Maxwell, William McCarthy, Barbara Berman,Weng Kee Wong, Jennifer Tsui, Roena Vega
University of California, Los Angeles (UCLA)
CPCRN – Los Angeles
CORICAUCLA CPCRN
CORICAUCLA CPCRN
Division of Cancer Prevention and Control Research
Division of Cancer Prevention and Control Research
UCLA School of Public Health
UCLA School of Public Health
Jonsson Comprehensive Cancer Center
Jonsson Comprehensive Cancer Center
CORICAUCLA CPCRN
CORICAUCLA CPCRN
Division of Cancer Prevention and Control Research
Division of Cancer Prevention and Control Research
UCLA School of Public Health
UCLA School of Public Health
Jonsson Comprehensive Cancer Center
Jonsson Comprehensive Cancer Center
Division of Cancer Prevention and Control Research
Division of Cancer Prevention and Control Research
UCLA School of Public Health
UCLA School of Public Health
Jonsson Comprehensive Cancer Center
Jonsson Comprehensive Cancer Center
Early-Detection &
Cancer Vaccines
Nutrition &PhysicalActivity
Tobacco ControlTraining &CapacityBuilding
DISCOVERY DISSEMINATION
UCLA CPCRN
UCLA CPCRN
DeliverEvidence-based
Training
ConductIntervention
Research
Host AnnualCancer Symposia
CommunityPilot
Projects
RESEARCH
PRACTICE
Publish CommunityData Disseminate
Evidence- &Practice-based
Programs
Center of Excellence for the Elimination of Disparities (REACH US,
2007-2012, CDC)
• Dissemination:
– Evidence and practice-based strategies
– Initial focus on obesity prevention
– Future years: tobacco, cancer screening
– Promote organizational level change within: Worksites,
churches, schools, clinics
UCLAYancey, Bastani,
McCarthy, Maxwell,Glenn, Mistry,
Guinyard, Mojica
Community Organizations• LA Urban League
• Worksite Wellness LA• CA Black Women’s Health Project• Asian Pacific Health Care Venture
• Latino Health Access• Esperanza Housing Corp.
LA County Dept. of Public Health Simon, Gonzalez,
Harding, Gunzenhauser, Fielding
WORKING IIIDissemination
Phase
WORKING IIFull Intervention Research Phase
2008-2013
WORKING IPlanning and Pilot
Phase2005-2008
Community PartnerLA County Dept. of Health Services
Simon, Gonzales
Community PartnerLA County Dept. of Health Services
Simon, Gonzales
Academic PartnerUCLA School of Public Health
Yancey, Bastani, McCarthy, Glenn, Mistry
Academic PartnerUCLA School of Public Health
Yancey, Bastani, McCarthy, Glenn, Mistry
Community Investigator TeamRepresentatives from health & human
services organizations
Community Investigator TeamRepresentatives from health & human
services organizations
WORKING ProjectWorking Out Regularly Keeps Individuals Nurtured and Going
NCMHD/NIH R24
Promote Organizational Level Change
Recent Success Story
• North East Valley Health Corporation (Debra Rosen et al.) receives HRSA Grant:– Patient Navigator Outreach and Chronic
Disease Prevention Program• Breast, Cervix, CRC screening and F/U
– 2 year project, $1 Million– UCLA CPCRN role: navigator training and
project evaluation
Cancer Screening
• Latino Prostate Cancer screening: informed decision-making
• Hepatitis B screening among Korean Church Attendees (UW)
• Follow-up of Breast Abnormalities in Low-Income Korean American Women
• Colorectal Cancer Screening among Filipino Americans
• Breast Cancer Educational Programs in Deaf Women
• Decision Making About Genetic Testing for Breast Cancer Risk among minority women
Tobacco
• School-based Anti-Tobacco Programs for Deaf/HH Youth
• Secondary Analysis of California Tobacco Use Prevention Education Data
• California Tobacco Use Prevention Education
• Pathways of How Socioeconomic Context Affects Teen Smoking
CPCRN Cross-Center ProjectHPV Vaccine
Background
1) CPCRN Cross-Center HPV Vaccine Latino SurveyMothers of girls, 11-17 years24 Core Items (knowledge, barriers, receipt, etc.)Spanish and English325 Surveys completed (LA: 202, Houston: 44, Seattle:80)
2) LA-CPCRN – Office of Women’s Health (OWH) HPV Project (200% of poverty, uninsured)
Survey: N=500 Telephone InterviewsSpanish, Korean, Mandarin, Cantonese, Armenian and English
Brief Pilot IDM Intervention: Telephone education, link to services
1: Cross Center HPV Survey • Expand to other CPCRN Centers and
groups (African-American, Asian, rural, low income, etc.)
• Expand to other settings (community clinics, schools, 211)– UT Houston currently
implementing survey in local 211 (N=~200)
• Adapt existing core items • Mode of administration:
telephone, face-to-face, self-admin
CPCRN Cross-Center Project
HPV Vaccine
2: Pilot Informed Decision-Making (IDM) Intervention
• Adaptation of LA-CPCRN IDM intervention currently implemented in 6 languages (Spanish, Korean, Mandarin, Cantonese, Armenian, English)
CPCRN Cross-Center Project
HPV Vaccine
Recruitment: LA OWH Hotline
Baseline (eligibility)
3-Month Follow-UpReceipt of 1st Dose of Vaccine
N=50Brief IDM Intervention &
Referral to Low-Cost Services
N=50
Usual Care Control
Adapt LA-CPCRN OWH Project intervention
• Compile inventory of existing interventions
• Develop brief IDM intervention (5-8 mins)– Address major concerns (e.g. side effects, daughter
being too young, don’t know where to get vaccine, etc.)– Referral & appointments for free/low cost HPV
vaccination
• Potential intervention settings: 211, clinics, churches, schools, etc.
CPCRN Cross-Center Project
HPV Vaccine
Design of Cross-Center Pilot Study
IDM InterventionRecruitment at multiple CPCRN
Network Sites
Baseline/Screener* n=30-50/site (N=200-350 total)
3-Month Follow-UpReceipt of 1st Dose of Vaccine75% response rate (N=150-225)
Brief IDM Intervention & Referral to Services*
n=15-25/site, N=100-175
Usual Care Control
n=15-25/site, N=100-175
*Variations in delivery mode, language, setting
• Pilot will provide data on feasibility, effect size, for full implementation trial
• Cross-Center grant proposal to conduct trial
Design of Cross-Center Pilot Study
IDM Intervention
Cross-Center Products
• Inventory of available interventions and materials, surveys in multiple languages
• Cross-center publications– HPV Vaccine Survey – Pilot interventions (feasibility, effectiveness)
• Full research project/s to test intervention efficacy
• Research-tested intervention ready for dissemination (dissemination trial?)
Timeline
0 1 2 3 4 5
Begin to Conduct FullResearch Project
Sub-Project 2
Sub-Project 1
Cross-Center Survey
Inventory of Existing Interventions
Test Pilot Intervention
Develop Pilot Intervention
Sub-Project 2
Publish Manuscripts
Begin to conduct full research project
Write & Submit Research Grant Proposal
Year 1 Year 2 Year 3 Year 4 Year 5
• Pausa Para Tu Salud: Integration of exercise breaks into workplace organizational routine may reduce wight and waistlines:
– Lara A, Yancey AK, Tapi-Conyer R, Flores y, Kuri Morales P, Mistry R, Subirats E, McCarthy WJ. Preventing Chronic Disease, 2008 Jan; 5(1):A12.
– Mexican Ministry of Health
• Cancer Screening of Korean-Americans in Los Angeles County: Adding Pieces to the Puzzle
– Maxwell AE and Song H. Korean-American Studies Bulletin 13:59-70, 2003– Korean Health, Education, Information & Research Center
• Adapting a 1% or Less Milk Campaign for a Hispanic/Latino Population: The Adelante Con Leche Semi-descremada 1% Experience
– Hinkell AJ, Mistry R, McCarthy WJ, Yancey, AK. American Journal of Health Promotion, 2008 Nov-Dec; 23(2):108-111.
– CANFit
• Tobacco Use among South Asians: Results of a Community-University Collaboration
– Glenn B, Surani Z, Chawla N, Bastani R. Ethnicity & Health 14(2): 131-145– South Asian Network
Published Data from CBO-Initiated Projects
Community Projects Program
• LA County Department of Public Health Office of Women’s Health– Use Telephone Hotline to collect data about HPV vaccine and pilot test education
intervention.• Cabrillo Village Housing Cooperative
– Conduct health needs assessment in farm worker housing communities.• Clinicas del Camino Real
– Enhance outreach to promote cancer screenings in Spanish-speaking low-income families.• Cabrillo Economic Development Corporation
– Assess the impact and functioning of a no-smoking policy at affordable housing complexes.• H/LATEN: Hispanic/Latino American Tobacco Education Network and
NCI/CIS– Dissemination and Evaluation of the 5-A’s of Tobacco Cessation.
• Partnered for Progress: Los Angeles County Cancer Detection Partnership
– Assess cancer prevention activities within health and social service organization worksites.• Tri-County Cancer Detection Project
– Expand cancer prevention and control outreach to Mixteco population. • Clinica Romero
– Design a needs assessment tool and conduct data collection in surrounding neighborhoods.• South Asian Network
– Adapt and disseminate materials for colorectal cancer screening in South Asians. • Los Angeles Community Garden Council
– Design survey to assess how community gardens impact fruits & vegetablesaccess and consumption.
• ADD NATIVE AMERICAN DVD
LA-CPCRN Specific Aims
• Strengthen network relations with diverse organization that address cancer disparities.
• Develop capacity building activities to increase use of evidence-based approaches to reduce cancer risk; evaluate programs where gaps in evidence base exist.
• Conduct community-based participatory research in cancer screenings, vaccine preventable cancers, nutrition and physical activity, and tobacco use, emphasizing implementation and dissemination.
• Lead a cross-center project to develop interventions that accelerate population adoption of HPV vaccine.
• Serve as active member of the national CPCRN collaboration on multi-site research projects, scientific publications, training and capacity-building activities
Community Partners
Major PartnersLos Angeles County Department of Public Health California Department of Public Health NCI’s Cancer Information Service American Cancer SocietyCalifornia’s Comprehensive Cancer Control PlanNational Breast and Cervical Cancer Early Detection Program (NBCCEDP)CDC’s Prevention Research Program (PRC)
Community-Based OrganizationsTri-Counties Cancer Detection PartnershipPartnered for ProgressNortheast Valley Health CorporationCommunity Clinics Association of Los Angeles Cabrillo Herald Cancer AssociationClinica Monsenor Oscar A. RomeroClínicas Camino del RealCabrillo Village Cooperative Housing Rancho Sespe Cooperative HousingAsian Pacific Healthcare VentureFilipino American Service Group, Inc.South Asian NetworkTo Help Everyone ClinicCalifornia Food Policy AdvocatesEsperanza Community Housing CorporationWorksite Wellness Los Angeles