The Deep South Network for Cancer Control: Eliminating Cancer Disparities Through Community/Academic Collaboration University of Alabama at Birmingham University of Southern Mississippi University of Alabama

Demographics Per Capita Income% Poverty% AA Black Belt$12,61234%64% Delta$12,65031%60%

Established an Academic - Community based Organizational Structure 883 CHARP’s trained (volunteer) 883 CHARP’s trained (volunteer) County coordinators (part-time paid) County coordinators (part-time paid) Regional coordinators (full-time paid) Regional coordinators (full-time paid) Program managers Program managers Claudia Hardy Freddie White-Johnson Investigators Investigators Links UAB / USM / UA to the community

Established Relationships with National, State, and Local Partners National Partnership  American Cancer Society State Partnerships  Alabama and Mississippi Department of Public Health Breast and Cervical Cancer Early Detection Programs  Alabama Quality Assurance Foundation, Mississippi Information and Quality Healthcare (IQH)

To Do What! Promote cancer awareness Promote cancer awareness Clinical trial recruitment Clinical trial recruitment Assist with community based research Assist with community based research

Results from Alabama Breast and Cervical Cancer Early Detection Program 72,670 Screened 72,670 Screened  820 Breast Cancer Detected  1/89 Mammograms Detected Cancer

Reduction in Disparity of Mammography Screening (98-06) 17% 5% 11% 14%

Disparities in Mammography Utilization Between African American and White Women In Black Belt Counties Counties( ) (1999 – 2001) ( ) (4/1/04 – 3/31/06) Choctaw11%10%8% - 7% - 7% Dallas20%17%14%0% Lowndes19%18%14%11% Macon15%7%8%1% Marengo20%18%7%1% Sumter17%14%12%11% Montgomery17%18%15%10% Tuscaloosa16%13%9%2% Average % Disparity17%14%11%5% Based on Alabama Medicare Data

Deep South Network for Cancer Control as Community Network Partnership Goals Improve access to and utilization of proven beneficial cancer interventions Improve access to and utilization of proven beneficial cancer interventions Develop a cadre of well-trained investigators who will continue to address elimination of cancer health disparities Develop a cadre of well-trained investigators who will continue to address elimination of cancer health disparities

Guided by the Concepts/Principles of Community-based Participatory Research, Education, and Training

Stage 1 Network Expansion (3 months)

Community Network Partners 12 Counties in Alabama Business02 Education15 Faith-Based23 Government19 Healthcare34 Local Non-profit19 Media08 No Category05 Other Agencies34 Total159

Community Network Partners 10 Counties in Mississippi Education 03 Civil Organizations 04 Government City Government07 County Government01 State Government01 Business11 Faith-Based15 Healthcare18 Local Non-profit11 Media02 Other Agencies04 Total77

Stage 2 Capacity Building (3 months) Retrain Staff (CBPR) Retrain Staff (CBPR) Retrain CHA’s (add colorectal Retrain CHA’s (add colorectal cancer) cancer) 551 Recommitted to DSN II 551 Recommitted to DSN II

Stage 3 Needs/Assets Assessment (6 months) Discussion Groups (like Focus Groups) Discussion Groups (like Focus Groups) CHARP’s CHARP’s Community Network Partners Community Network Partners One group in each county One group in each county

Perceptions From Discussion Groups Top five disparities in cancer Top five disparities in cancer breast, colorectal, cervical, prostate, lung Health disparities Health disparities hypertension, heart disease, obesity, diabetes and cancer Problems in community Problems in community physical activity, obesity/overweight, tobacco, substance abuse, risky sexual behavior, mental health/stress, environment, access to care

Perceptions From Discussion Groups Problems and solutions seen at individual, provider, and systems level Problems and solutions seen at individual, provider, and systems level Greatest success Greatest success increase in screening More needs to be done More needs to be done diet, exercise, smoking

Stage 4 Community Action Plan Development (6 months)

Working Groups to Recommend Component of CAP Individual Individual Provider Provider Systems Systems Advocacy/Policy Advocacy/Policy Nutrition/ physical activity Screening for breast, cervix and colorectal No direct activity with tobacco control or prostate screening

Working Groups Charge Review literature for effective programs Review literature for effective programs Review current programs/activities of DSN Review current programs/activities of DSN Review existing programs/resources in the community Review existing programs/resources in the community Make Make Primary recommendations Primary recommendations Secondary recommendations Secondary recommendations for inclusion in CAP

Community Action Plan (CAP) Nutrition – Body and Soul Nutrition – Body and Soul Physical Activity – Walk Campaign Physical Activity – Walk Campaign Advocacy – Direct Action Organizing Advocacy – Direct Action Organizing Cancer Awareness – continue current awareness programs, add colorectal cancer screening Cancer Awareness – continue current awareness programs, add colorectal cancer screening

CAP Approved by all County CNPs (in principle)

Training (Train the Trainers) (2 days training) Body and Soul – Cancer Information Service Body and Soul – Cancer Information Service Walk Campaign – UAB Minority Health and Research Center Walk Campaign – UAB Minority Health and Research Center Advocacy – Direct Action Organizing Advocacy – Direct Action Organizing Cancer Awareness Cancer Awareness Continue current activity Continue current activity Target Body and Soal and Walk Teams Target Body and Soal and Walk Teams Target low compliance areas Target low compliance areas

CAP Implementation (30 months) Overview of implementation requirements to each CNP group Overview of implementation requirements to each CNP group Select team leaders Select team leaders In depth training of team leaders In depth training of team leaders Implement CAP incrementally Implement CAP incrementally

Metrics of Successs Baseline Wellness Questionnaire Baseline Wellness Questionnaire (repeat at 12 and 24 months) All Body and Soul churches and Walk teams All Body and Soul churches and Walk teams County level Medicare utilization data County level Medicare utilization data County level BCCEDP utilization data County level BCCEDP utilization data