Development and pilot evaluation of a cancer-focused summer research education program for [corrected] Navajo undergraduate students

Online Oncology Careers Events to Attract the Future Oncology Medical Workforce: An Exemplar Event and Review of the Literature

AIMS

There are too few oncologists to meet the increasing burden imposed by the rising incidence of cancer. This results from issues with the retention of established oncologists and longstanding challenges to the recruitment of adequate numbers of trainees. To counter this, the British Oncology Network for Undergraduate Societies (BONUS) devised an online oncology careers event for medical students and junior doctors who are yet to select a specialty.

MATERIALS AND METHODS

An online careers event was devised with a focus on oncology practice and related subspecialties, as well as research. Event attendees were asked to respond to piloted pre- and post-event surveys. Knowledge and attitudes towards a career in oncology were evaluated using Likert scale and multiple-choice questions. A systematic literature search was carried out to contextualise these data.

RESULTS

Of the 73 attendees, 44 (60%) participants completed both the pre- and post-event surveys; 79.5% of attendees believed that information on a career in oncology is lacking in medical training. This viewpoint was supported by the systematic review, which highlighted a need for relevant focussed interventions targeted at medical students and fledgling doctors. The education event led to an increase in the median reported understanding of the oncology career pathway from 6.0 to 8.0 (P < 0.05 and P < 0.001), as well as the likelihood of pursuing a career in oncology (8.0-9.0; P < 0.05). It was also associated with a proportional increase in medical and surgical oncology interest, albeit with a fall in interest in clinical and interventional oncology as well as academia.

CONCLUSION

A targeted online careers event increases knowledge of and interest in a career in oncology, albeit predominantly for medical and surgical subspecialties. Broader initiatives based on our model should be developed and careers in academia as well as clinical and interventional oncology emphasised.

Utilizing Digital Storytelling to Develop a Public Health Professions Pathway for Native American High School Students

Digital storytelling is a decentering methodology in health promotion that positions the storyteller as an expert to create a narrative of their lived experiences. This article describes using a two-phase digital storytelling process within the Diné (Navajo) Educational Philosophy framework to guide the development of a culturally grounded curriculum plan that actively engages Diné youth in exploring health professions pathways in their community. The first phase consisted of developing a high school digital storytelling team by training three Diné youth attending high school on the Navajo Nation located in southwest United States, in digital storytelling. In the second phase, the high school digital storytelling team worked collaboratively with seven Diné students enrolled at the local tribal college to develop digital stories about navigating from high school to college. Data from seven completed digital stories were analyzed with assistance from a community advisory board to identify asset-based themes that contributed to positively transitioning from high school to a tribal college. The results revealed several strategies for successful transitions from high school to a public health college major. The culturally relevant strategies and stories were incorporated into a school-based health professions pathway curriculum plan for Diné youth.

Impact of the Appalachian Career Training in Oncology (ACTION) Program on Undergraduate Participants

Kentucky ranks first in the nation in cancer incidence and mortality. The Appalachian region of the state experiences the highest cancer disparities due to inequities in many social determinants of health. As a strategy for addressing cancer and education disparities in the region, the Appalachian Career Training in Oncology (ACTION) Program at the University of Kentucky Markey Cancer Center engaged 16 Appalachian-native undergraduate student participants annually in cancer-related activities. Students were recruited on an annual basis for the 2-year ACTION program. Entry, mid-point, and exit surveys were administered to participants. Classical test theory and exploratory factor analysis were used to examine the instruments used for program evaluation, whereas repeated measures ANOVA, paired t-tests, chi-squared, and post hoc analyses were used to analyze 6 years of survey data. There was a significant increase in participants' understanding of cancer-related topics among the entry, midpoint, and exit surveys (p < .001) and a significant increase in comfort with research, clinical, and outreach activities between entry and midpoint and entry and exit (p < .001), but not between midpoint and exit. With respect to research skills and perceptions of the program, increases in mean scores were observed between midpoint and exit, but these increases were not statistically significant (p = .167, p = 223, respectively). ACTION increased participants' understanding of cancer-related topics; comfort with research, clinical, and outreach activities; and research skills. These data suggest that ACTION has a significant impact on participants.

Engaging Native American High School Students in Public Health Career Preparation Through the Indigenous Summer Enhancement Program

Native American¹ populations are systematically marginalized in the healthcare and public health workforce. One effective approach to reduce health disparities and improve health care delivery among Indigenous populations is to train more Native American health professionals who integrate academic and cultural knowledge to understand and influence health behaviors and perspectives. Diné College partnered with Northern Arizona University to develop the Navajo Native American Research Center for Health (NARCH) Partnership, funded by the National Institutes of Health. The high school component of the Navajo NARCH Partnership created the Indigenous Summer Enhancement Program (ISEP), a 1-week summer training program providing exposure to health careers and mentorship in pursuing public health careers for Native American high school students. ISEP utilizes the Diné Educational Philosophy (DEP), a Navajo conceptual framework to serve as the foundation of the program. In 2020–2021, due to COVID-19 restrictions, the DEP model had to be incorporated in the Navajo NARCH high school virtual program activities. ISEP used 2018 and 2019 past program evaluation data to inform the virtual programming. Students' perception of the program was collected using an online Qualtrics evaluation questionnaire. Students stated appreciation for program staff, fellow students, peer mentors and culturally relevant learning experiences in both virtual and in-person environments. Recommendations included: expanding the length of ISEP and continuing the hands-on activities and Public Health Leadership series.

Development and Evaluation of a Cancer Literacy Intervention to Promote Mammography Screening Among Navajo Women: A Pilot Study

PURPOSE

Develop and evaluate a mammography intervention that provides hope about cancer prevention and treatment.

DESIGN

Pilot randomized controlled trial.

SETTING

Two communities on the Navajo Nation.

PARTICIPANTS

Navajo women and support persons.

INTERVENTION

Both groups received standard care: one home visit discussing mammography pros/cons and barriers. The treatment group received an intervention based on Navajo language via an additional home visit with health education materials (written and oral) in English and Navajo, including a Navajo Cancer Glossary with a new descriptive phrase for cancer.

ANALYSIS

Between control and intervention conditions, we compared baseline sociodemographics; changes from baseline to 3 months on mammography completion and breast cancer literacy scores.

MEASURES

(1) intervention feasibility; (2) self- and clinic-reported mammography screening completion; (3) breast cancer literacy.

RESULTS

A total of 25 participants were randomly assigned (13 treatment, 12 control), with 7 support persons in each arm. Mean age was 53 years, 90% had a high school degree or higher, 86% spoke Navajo and English. At 3 months, 44% had a clinically verified mammogram. Mammography completion was 57% among those with a support person and 27% among those without (P = .14). Intervention women reported more breast cancer beliefs consistent with mammography (P = .015).

CONCLUSIONS

Increases in breast cancer beliefs consistent with mammography show promise. Findings highlight a need to tailor education materials to Navajo culture/language and focus on enhancing support.

Journal clubs: an educational approach to advance understanding among community partners and academic researchers about CBPR and cancer health disparities

Journal clubs may enhance the knowledge and skills necessary to engage in community-based participatory research (CBPR) that will ultimately impact cancer health disparities. This article (1) describes an innovative approach to adapting the traditional journal club format to meet community and academic participants' needs, (2) presents evaluation data, and (3) explores whether responses differed between academic and community members. Five journal clubs occurred between February 2011 and May 2012 as a training activity of a regional cancer health disparities initiative. Each journal club was jointly planned and facilitated by an academic member in collaboration with a community partner. Attendees were recruited from academic programs across the Moffitt Cancer Center/University and community partners. Responses to a 13-item evaluation of each journal club session were compared to assess whether certain topics were evaluated more favorably, and explore differences between academic and community participants' assessment of the topic relevance. Evaluations were positive (mean ratings >4 out of 5) on most items and overall. No statistically significant differences were observed between academic and community members' ratings. Key overlapping interests by community partners and academic researchers/trainees for future journal club topics included discussing real-world CBPR examples and methods for involving the community in research. Although the initial goal was to use journal clubs as an educational tool to increase CBPR knowledge and skills of junior faculty trainees, results suggest mutual academic-community benefit and interest in learning more about CBPR as a way to reduce cancer health disparities.

Developing future clinician scientists while supporting a research infrastructure

BACKGROUND

Supporting clinical research is a national priority. Clinician scientists are rare and clinical trials in academic medical centers (AMC) often fail to meet enrollment goals. Undergraduate students interested in biomedical careers often lack opportunities to perform clinical research.

OBJECTIVE

Describe an innovative undergraduate course that supports clinical research in an AMC.

METHODS

The course, Clinical Research Methods and Practice, offers undergraduate students the opportunity to learn clinical research through didactic and practical experiences. The students in turn support clinician scientists' conduct of clinical studies in an AMC. Clinician scientists receive research support and participate in mentoring sessions for students.

RESULTS

Over seven semesters, 128 students have assisted in 21 clinical studies located in outpatient and inpatient units of two hospitals. Students identified and screened eligible patients, collected clinical data, assisted in obtaining informed consent, and transported specimens. Many of the clinician scientists have met their enrollment goals and several have been top-enrollers in multicenter clinical trials as a result of student support.

CONCLUSIONS

The Clinical Research Methods and Practice class addresses barriers to clinical research in AMC. This may be a model for institutions committed to mentoring students early in their career and to developing infrastructures for clinical research.

Development and pilot evaluation of Native CREST-a Cancer Research Experience and Student Training program for Navajo undergraduate students

The Mayo Clinic Cancer Center and Diné College received funding for a 4-year collaborative P20 planning grant from the National Cancer Institute in 2006. The goal of the partnership was to increase Navajo undergraduates' interest in and commitment to biomedical coursework and careers, especially in cancer research. This paper describes the development, pilot testing, and evaluation of Native CREST (Cancer Research Experience and Student Training), a 10-week cancer research training program providing mentorship in a Mayo Clinic basic science or behavioral cancer research lab for Navajo undergraduate students. Seven Native American undergraduate students (five females, two males) were enrolled during the summers of 2008-2011. Students reported the program influenced their career goals and was valuable to their education and development. These efforts may increase the number of Native American career scientists developing and implementing cancer research, which will ultimately benefit the health of Native American people.

Introducing students to cancer prevention careers through programmed summer research experiences

Training programs in cancer prevention research play an important role in addressing impending shortages in the cancer prevention workforce. Published reports on the effectiveness of these programs, however, often focus on a program's success in recruiting and retaining a demographically diverse trainee population or on academic successes of the trainees, in general. Little has been reported about programs' success in stimulating long-term interest in cancer prevention per se, whether in research or in other choATsen applications. We set out to examine the success of our National Cancer Institute (NCI) R25E American Recovery and Reinvestment Act (ARRA)-funded summer research experiences program for undergraduates at fostering awareness of and career interest in cancer prevention. Fourteen summer research undergraduates participated in a 12-week structured training program which featured a variety of experiences designed to create awareness of and interest in cancer prevention and cancer prevention research as career tracks. Experiences included career talks by faculty, informational interviewing of role model faculty, career exploration workshops, and structured interactions with graduate students, postdoctoral fellows, and junior faculty. Students were surveyed about the effectiveness of the program via SurveyMonkey 8 months after completing the program. This article reports on the results of the survey and analyzes the relative effectiveness of the various types of programming strategies used. Implications for use in training program development are discussed.