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

Early-Detection & Cancer Vaccines Nutrition & Physical Activity Tobacco Control Training & Capacity Building DISCOVERYDISSEMINATION UCLA CPCRN

Deliver Evidence-based Training Conduct Intervention Research Host Annual Cancer Symposia Community Pilot Projects RESEARCH PRACTICE Publish Community Data Disseminate Evidence- & Practice-based Programs

Center of Excellence for the Elimination of Disparities (REACH US, , 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 UCLA Yancey, 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 III Dissemination Phase WORKING II Full Intervention Research Phase WORKING I Planning and Pilot Phase Community Partner LA County Dept. of Health Services Simon, Gonzales Community Partner LA County Dept. of Health Services Simon, Gonzales Academic Partner UCLA School of Public Health Yancey, Bastani, McCarthy, Glenn, Mistry Academic Partner UCLA School of Public Health Yancey, Bastani, McCarthy, Glenn, Mistry Community Investigator Team Representatives from health & human services organizations Community Investigator Team Representatives from health & human services organizations WORKING Project Working 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 Project HPV Vaccine Background 1) CPCRN Cross-Center HPV Vaccine Latino Survey Mothers of girls, 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

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-Up Receipt of 1 st Dose of Vaccine N=50 Brief 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 Intervention Recruitment at multiple CPCRN Network Sites Baseline/Screener* n=30-50/site (N= total) 3-Month Follow-Up Receipt of 1 st Dose of Vaccine 75% response rate (N= ) Brief IDM Intervention & Referral to Services* n=15-25/site, N= Usual Care Control n=15-25/site, N= *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 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 2Year 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): –CANFit Tobacco Use among South Asians: Results of a Community-University Collaboration –Glenn B, Surani Z, Chawla N, Bastani R. Ethnicity & Health 14(2): –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 & 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