1. Appalachian Center for Cancer Education, Screening, and Support (ACCESS) Robin Vanderpool, DrPH, CHES University of Kentucky College of Public Health October 21, 2014 This presentation was supported by Cooperative Agreement Number 1U48DP005014-01 from the Centers for Disease Control and Prevention. The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

2. UK Rural Cancer Prevention Center The Rural Cancer Prevention Center (RCPC) is a planned collaboration of community members, public health professionals, and researchers designed to reduce cancer disparities among residents of the Kentucky River Health District in Appalachian Kentucky.

3. ACCESS Investigators & Partners

4. ACCESS Investigators InvestigatorRoleExpertise Dr. Robin Vanderpool Principal Investigator Cancer disparities among rural, Appalachian populations Cancer prevention & control across the continuum (prevention through survivorship Dr. Angela Carman Co-InvestigatorStrategic organization of public health services Community engagement Quality improvement Dr. Bin HuangBiostatisticianInnovative statistical/epidemiological methodologies and study designs for population-based cancer research Survival analyses; Complex data linkages

5. ACCESS Specific Aims 1) Contribute to the overall impact and success of national CPCRN initiatives through the strategic use of cancer prevention and control resources and partnerships, study personnel, and scientific expertise. 2) Conduct formative research with White House Clinics to understand perceived and real barriers and facilitators to implementing a Proactive Office Encounter (POE) intervention from the perspective of healthcare system leadership, practicing clinicians, and patients. 3) Implement a feasibility study within White House Clinic-Irvine to systematically develop, implement, and evaluate a pilot POE intervention for subsequent dissemination and implementation throughout the entire White House Clinics organization. 4) Disseminate the POE intervention to other Appalachian Kentucky healthcare delivery systems and CPCRN public health and clinical partners. In sum, the mission of ACCESS is to improve community-clinical linkages and to use existing primary care resources more efficiently and effectively to promote cancer preventive services to achieve gains in population health.

6. ACCESS Research Project  Allows RCPC to expand outreach to other parts of Appalachian Kentucky  Partner with White House Clinics, a healthcare system with 8 community clinics  Designed FQHC and licensed primary care provider  Proactive Office Encounter (POE) intervention: breast, cervix, colorectal, lung cancers

7. Proactive Office Encounters  Developed by Kaiser Permanente, implemented in their Southern California Region  A method for ensuring that a patient’s comprehensive needs are met (i.e., acute, chronic, screening/preventive, wellness)  Enlists the entire healthcare team [and patients] to identify and address gaps in care

8. Proactive Office Encounters White House Clinics: Irvine Clinic White House Clinics: all 8 clinics KPCA KAN CPCRN

9. Proposed Cross-Center Projects Developing cancer prevention and control projects with public health practice-based research networks (PBRNs) Further dissemination of RCPC “1-2-3 Pap” intervention Expansion of Dr. Huang’s research regarding survival analyses through linkage of National Death Index & cancer registry data Lung cancer screening, lung cancer survivorship Prepopulating survivorship care plans with cancer registry data Further dissemination of RCPC colorectal cancer screening intervention with FIT testing (future) Further dissemination of ACCESS POE intervention (future)