COmmunity Research In CAncer: “CORICA” CPCRN – Los Angeles

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)

UCLA CPCRN

Early-Detection & Cancer Vaccines Jonsson Comprehensive Cancer Center Division of Cancer Prevention and Control Research CORICA UCLA CPCRN Nutrition & Physical Activity Tobacco Control Training & Capacity Building DISCOVERY DISSEMINATION

Community Pilot Projects Publish Community Data

UCLA CPCRN

Conduct Intervention Research

RESEARCH PRACTICE

Disseminate Evidence- & Practice-based Programs Deliver Evidence-based Training Host Annual Cancer Symposia

Center of Excellence for the Elimination of Disparities (REACH US, 2007-2012, CDC) UCLA

Yancey, Bastani, McCarthy, Maxwell, Glenn, Mistry, Guinyard, Mojica

LA County Dept. of Public Health

Simon, Gonzalez, Harding, Gunzenhauser, Fielding

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.

• 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

WORKING Project

Working Out Regularly Keeps Individuals Nurtured and Going NCMHD/NIH R24 Community Partner

LA County Dept. of Health Services

Simon, Gonzales

Community Investigator Team

Representatives from health & human services organizations

Academic Partner

UCLA School of Public Health

Yancey, Bastani, McCarthy, Glenn, Mistry

WORKING I

Planning and Pilot Phase 2005-2008

WORKING II

Full Intervention Research Phase 2008-2013

WORKING III

Dissemination Phase

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 American Women in Low-Income Korean • Colorectal Cancer Screening among Filipino Americans • Breast Cancer Educational Programs in Deaf Women • Decision Making About Genetic Testing among minority women for Breast Cancer Risk

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 Project HPV Vaccine

Background 1) CPCRN Cross-Center HPV Vaccine Latino Survey

Mothers of girls, 11-17 years 24 Core Items (knowledge, barriers, receipt, etc.) Spanish and English 325 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 Interviews Spanish, Korean, Mandarin, Cantonese, Armenian and English Brief Pilot IDM Intervention: Telephone education, link to services

CPCRN Cross-Center Project HPV Vaccine

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)

Recruitment: LA OWH Hotline Baseline (eligibility) N=50

Brief IDM Intervention & Referral to Low-Cost Services

N=50

Usual Care Control

3-Month Follow-Up

Receipt of 1 st Dose of Vaccine

CPCRN Cross-Center Project HPV Vaccine

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.

Design of Cross-Center Pilot Study IDM Intervention

Recruitment at multiple CPCRN Network Sites Baseline/Screener*

n=30-50/site (N=200-350 total)

Brief IDM Intervention & Referral to Services*

n=15-25/site, N=100-175

Usual Care Control

n=15-25/site, N=100-175

3-Month Follow-Up

Receipt of 1 st Dose of Vaccine

75% response rate (N=150-225)

*Variations in delivery mode, language, setting

Design of Cross-Center Pilot Study IDM Intervention

• Pilot will provide data on feasibility, effect size, for full implementation trial • Cross-Center grant proposal to conduct trial

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

Sub-Project 1

Cross-Center Survey

Sub-Project 2 Sub-Project 2

Inventory of Existing Interventions Develop Pilot Intervention Test Pilot Intervention

Publish Manuscripts Write & Submit Research Grant Proposal project Begin to Conduct Full Research Project 0 Year 1 1 Year 2 2 Year 3 3 Year 4 4 Year 5 5

Published Data from CBO-Initiated Projects

• • • • 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 Con Leche Semi-descremada 1% – – Experience Adelante 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

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 & vegetables access 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 Partners

Los Angeles County Department of Public Health California Department of Public Health NCI’s Cancer Information Service American Cancer Society California’s Comprehensive Cancer Control Plan National Breast and Cervical Cancer Early Detection Program (NBCCEDP) CDC’s Prevention Research Program (PRC)

Community-Based Organizations

Tri-Counties Cancer Detection Partnership Partnered for Progress Northeast Valley Health Corporation Community Clinics Association of Los Angeles Cabrillo Herald Cancer Association Clinica Monsenor Oscar A. Romero Clínicas Camino del Real Cabrillo Village Cooperative Housing Rancho Sespe Cooperative Housing Asian Pacific Healthcare Venture Filipino American Service Group, Inc.

South Asian Network To Help Everyone Clinic California Food Policy Advocates Esperanza Community Housing Corporation Worksite Wellness Los Angeles