community research in cancer: “corica” roshan bastani, antronette yancey, beth glenn, ritesh...

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


UCLA School of Public Health


Jonsson Comprehensive Cancer Center


CORICAUCLA CPCRN

CORICAUCLA CPCRN













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)


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.


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

community research in cancer: “corica” roshan bastani, antronette yancey, beth glenn, ritesh...

Documents

health services simon

community research

public health simon

community data

project evaluation slide

fielding slide

breast cancer risk

tobacco school