Progress in the pipeline: replication of the minority training program in cancer control research

An innovative educational program for addressing health disparities in translational cancer research

North Carolina Central University (NCCU) and Duke Cancer Institute implemented an NCI-funded Translational Cancer Disparities Research Partnership to enhance translational cancer research, increase the pool of underrepresented racial and ethnic group (UREG) researchers in the translational and clinical research workforce, and equip UREG trainees with skills to increase diversity in clinical trials. The Cancer Research Education Program (C-REP) provided training for UREG graduate students and postdoctoral fellows at Duke and NCCU. An innovative component of C-REP is the Translational Immersion Experience (TIE), which enabled Scholars to gain knowledge across eight domains of clinical and translational research (clinical trials operations, data monitoring, regulatory affairs, UREG accrual, biobanking, community engagement, community outreach, and high-throughput drug screening). Program-specific evaluative metrics were created for three broad domains (clinical operations, basic science/lab research, and population-based science) and eight TIE domains. Two cohorts (n = 13) completed pre- and post-surveys to determine program impact and identify recommendations for program improvement. Scholars reported statistically significant gains in knowledge across three broad domains of biomedical research and seven distinct areas within TIE. Training in translational research incorporating immersions in clinical trials operation, biobanking, drug development, and community engagement adds value to career development of UREG researchers.

Éxito!: Making an Impact in Training Latinos for Doctorates and Cancer Research

Latinos lag behind other racial/ethnic groups in pursuit of master's and doctoral degrees in public health and the health sciences. Éxito! is modeled after the Minority Training Program in Cancer Control Research (MTPCCR), which found that Latino participants went on to doctoral programs at a lower rate (12%) than African American (36%) and Asian participants (33%). Éxito! Latino Cancer Research Leadership Training is designed to increase the number of Latinos who pursue doctoral degrees and careers in cancer health disparity (CHD) research. The program has three components: recruitment with partnering universities and associations, an ethnically tailored intensive 5-day summer institute (SI), and 6-month paid internships offered on a competitive basis. Up to 20 master's level students/master's level health professionals are selected annually to participate in the SI; faculty are leaders in Latino CHD research. Funded by the National Cancer Institute (NCI) from 2011 to 2015, Éxito! recruited 101 summer institute participants and awarded 21 internships. Analyses of pre- and post-institute surveys showed significant increases in confidence to apply to a doctoral program and academic self-efficacy among summer institute participants, and significantly increased research skills among interns. Forty-three percent of Éxito! program alumni applied to a doctoral program (our main outcome) and 29.7% were currently enrolled. This is nearly double the rate for MTPCCR Latino participants (17%) for the corresponding time period. Éxito! is a model pipeline program for encouragement of Latinos on to doctoral programs (e.g., PhD and DrPH) with the potential to increase the pool of cancer health disparity researchers.

Career Outcomes of Graduates of R25E Short-Term Cancer Research Training Programs

The efficacy of short-term cancer research educational programs in meeting its immediate goals and long-term cancer research career objectives has not been well studied. The purpose of this report is to describe the immediate impact on, and the long-term career outcomes of, 499 medical students and graduate students who completed the Cancer Research Experiences for Students (CaRES) program at the University of Alabama at Birmingham (UAB) from 1999 to 2013. In summer 2014, all 499 program alumni were located and 96.4 % (481 of 499) agreed to complete a longitudinal tracking survey. About 23 % of CaRES alumni (110 of 499) have published at least one cancer-related paper. Overall 238 cancer-related papers have been published by CaRES alumni, one third of this number being first-authored publications. Nearly 15 % (71 of 481 respondents) reported that their current professional activities include cancer research, primarily clinical research and outcomes research. Of these 71 individuals, 27 (38 %) have completed their training and 44 (62 %) remain in training. Of all respondents, 58 % reported that they administered care to cancer patients and 30 % reported other cancer-related professional responsibilities such as working with a health department or community group on cancer control activities. Of the 410 respondents not currently engaged in cancer research, 118 (29 %) stated intentions to conduct cancer research in the next few years. Nearly all respondents (99.6 %) recommended CaRES to today's students. Challenging short-term educational cancer research programs for medical students and graduate health professional students can help them refine and solidify their career plans, with many program alumni choosing cancer research careers.

Reducing Disparities by way of a Cancer Disparities Research Training Program

BACKGROUND

For minority populations, there is a continuing disparity in the burden of death and illness from cancer. Research to address this disparity should be conducted by investigators who can best understand and address the needs of culturally diverse communities. However, minorities are under-represented in health-related research. The goal of this project was to develop and evaluate an approach to motivating and preparing master's degree students for careers dedicated to cancer disparities research.

METHOD

A Cancer Disparities Research Training Program (CDRTP) was initiated in 2010. The program consists of coursework, practicum experiences, and research opportunities. Assessment of the curriculum is based on monitoring achievement of evaluation indicators and included a mixed-method approach with included both quantitative and qualitative approach.

RESULTS

In its first three years, the program graduated 20 trainees, all of whom were minorities (18 African Americans and two Asians). When asked about career goals, two-thirds of the trainees indicated interest in pursuing careers in research in cancer prevention and control. The trainees expressed high satisfaction with the courses, instructor, materials, and curriculum. Although trainees had suggestions about course details, evaluations overall were positive. Across focus groups, three recurrent themes emerged regarding activities to enhance the trainee experience: having a wider variety of topics, more guest speakers, and field trips.

CONCLUSION

The CDRTP was intended to recruit students - primarily African Americans - into research on prevention and control of cancer disparities. Although final evaluation of the program's overall outcome will not be available for several years, this preliminary evaluation indicates early program success.

Evaluation of a Health Professionals' Training Program to Conduct Research in New York City's Asian American Community

BACKGROUND

Because health disparities among Asian Americans are understudied, a partnership program between the Charles B Wang Community Health Center and the Center for the Study of Asian American Health was created to increase awareness and interest in Asian American research.

PURPOSE

To evaluate the process, outcome, and impact of a health professionals' research training program.

METHODS

Mixed research methods were employed to collect data from online surveys administered to mentors and trainees of the program.

RESULTS

Although many trainees did not continue to pursue Asian American health disparities research, results indicate that the program has positive impacts on trainees in their preparedness to conduct CBPR, work within the Asian American community, and network with public health professionals and researchers.

DISCUSSION

This evaluation adds to the current literature of research training programs but more research on Asian American health disparities is needed.

TRANSLATION TO HEALTH EDUCATION PRACTICE

Although the program has helped raise awareness in Asian American health disparities research, more Asian American specific research training programs are needed to stimulate a true generation of researchers.

What are successful recruitment and retention strategies for underserved populations? Examining physical activity interventions in primary care and community settings

The purposes of this review are to (1) describe recruitment and retention strategies for physical activity interventions focusing on underserved populations and (2) identify successful strategies which show the most promise for "best practices" recommendations to guide future research. The method used was systematic review. Data on recruitment and retention strategies were abstracted and analyzed according to participant characteristics, types of strategies used, and effectiveness using an ecological framework. Thirty-eight studies were identified. Populations included African American (n = 25), Hispanic (n = 8), or Asian (n = 3) groups. Successful recruitment strategies consisted of partnering with respected community stakeholders and organizations, well-trained study staff ethnically, linguistically, and culturally matched to the population of interest, and use of multiple advertising channels. Successful retention strategies included efficient administrative tracking of participants, persistence, skillful teamwork, and demonstrating a positive, caring attitude towards participants. Promising recruitment and retention strategies correspond to all levels of ecological influence: individual, interpersonal, organizational, and societal.

The Minority Training Program in Cancer Control Research: impact and outcome over 12 years

The Minority Training Program in Cancer Control Research (MTPCCR) encourages underrepresented master's level students and professionals in the social, behavioral, and public health sciences to pursue doctoral training and careers in cancer disparities research. This paper reports new data on the program outcome after 12 years. A web-based survey was sent to all 462 program alumni. The questions addressed current academic status and plans, job status and plans, research focus, and influence of the MTPCCR. The survey response rate was 79 %. Overall, 30 % of alumni are enrolled in or have completed doctoral programs; 88 % of whom report involvement in research related to cancer. Scaled and open-ended responses indicate a strong influence of the program on doctoral program enrollment and cancer focus. The MTPCCR model is successful because it targets underrepresented minorities who are capable of doctoral studies but have not yet chosen that path.

Lessons learned from a decade of focused recruitment and training to develop minority public health professionals

From 1999 to 2009, the Eliminating Health Disparities Pre-doctoral Fellowship Program provided specialized education and mentoring to African American graduate students in public health. Fellows received a public health degree, coursework in understanding and eliminating health disparities, experiential learning, mentored research, and professional network building with African American role models. We describe successful strategies for recruiting and training fellows and make 5 recommendations for those seeking to increase workforce diversity in public health: (1) build a community of minority students, not a string of individual recruits; (2) reward mentoring; (3) provide a diverse set of role models and mentors; (4) dedicate staffing to assure a student-centered approach; and, (5) commit to training students with varying levels of academic refinement.

Approaches for longitudinally tracking graduates of NCI-funded short-term cancer research training programs

Short-term cancer research programs for health professions students typically state goals of encouraging and fostering interest in pursuing cancer research-based careers. Evaluating career choices and professional achievements of these trainees has been problematic. Well-designed program evaluation is a key element in determining successful training experiences, and program-specific outcome measures are typically used to assess the effectiveness of each short-term cancer research experience. We describe evaluation approaches for longitudinal tracking of participants of our National Cancer Institute-sponsored Cancer Research Experiences for Students program at the University of Alabama at Birmingham, emphasizing those approaches that demonstrated greatest effectiveness. We also evaluate the various methods we used in terms of cost, efficiency, and effectiveness. Recommendations are provided to assist comparable training programs facing the challenges of longitudinal tracking and program evaluation.

Theorizing social context: rethinking behavioral theory

Major behavioral theories focus on proximal influences on behavior that are considered to be predominantly cognitive characteristics of the individual largely uninfluenced by social context. Social ecological models integrate multiple levels of influence on health behavior and are noted for emphasizing the interdependence of environmental settings and life domains. This theory-based article explains how social context is conceptualized in the social sciences and how the social science conceptualization differs from and can broaden the analytic approach to health behavior. The authors use qualitative data from the Behavioral Constructs and Culture in Cancer Screening study to illustrate our conceptualization of social context. We conclude that the incorporation into health behavior theory of a multidimensional socioculturally oriented, theoretical approach to social context is critical to understand and redress health disparities in multicultural societies like the United States.

Developing competencies for training practitioners in evidence-based cancer control

BACKGROUND

Competency-based education allows public health departments to better develop a workforce aimed at conducting evidence-based control cancer.

METHODS

A 2-phased competency development process was conducted that systematically obtained input from practitioners in health departments and trainers in academe and community agencies (n = 60).

RESULTS

Among the 26 competencies developed, 10 were rated at the beginner level, 12 were intermediate, and 4 were advanced. Community-level input competencies were seen as beginner level, whereas policy-related competencies were rated as advanced.

CONCLUSION

Although adaptation to various audiences is needed, these competencies provide a foundation on which to build practitioner-focused training programs.

Development, implementation, and assessment of a lecture course on cancer for undergraduates

The war on cancer has been waged for nearly 40 years, yet the cancer burden remains high, especially among minority and underserved populations. One strategy to make strides in the war on cancer and its disparate impacts is to increase the diversity of the cancer research workforce. We describe an approach to recruit a diverse population of future cancer researchers from an undergraduate student population at a minority-serving land-grant institution. Specifically, we have addressed the following questions: Given the dearth of published reports of undergraduate cancer courses, is it possible for undergraduates at a land-grant institution (rather than a research or medical institution) to successfully learn cancer biology from a lecture-based course? Can we develop a template that has the potential to be used by others to develop and implement an undergraduate cancer course? Can such a course stimulate interest in careers in cancer research? Based on a learning gains analysis, students were able to learn cancer content and related skills, and based on student surveys, students' interest in cancer research was stimulated by course participation. We have identified aspects of our course development process that were critical for the successful development, implementation, and assessment of the course.

Physical activity as primary prevention to address cancer disparities

OBJECTIVE

To review the research literature on physical activity (PA) intervention trials, with an emphasis on underserved populations.

DATA SOURCE

Research studies, review articles, and books.

CONCLUSION

PA intervention studies have generally shown statistically significant but modest outcomes. Comprehensive intervention designs combining individual-level and physical environmental changes have posted the largest effect sizes, and emerging models are incorporating sociocultural and organizational environmental changes with promising results. Research including or targeting underserved populations poses unique challenges at each stage of the intervention process: design, recruitment, implementation, and evaluation. Synthesis of evidence-based approaches to address these challenges is presented.

IMPLICATIONS FOR NURSING PRACTICE

Promoting PA in underserved communities is essential in improving population-level cancer outcomes. Additional resources are becoming available to nursing researchers and practitioners to aid in the conduct of PA intervention in understudied groups.