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Cannon TY, Jefferson GD, Brenner MJ. Intersectionality of Social Determinants of Health in Head and Neck Cancer-From Analysis to Action. JAMA Otolaryngol Head Neck Surg 2024:2820034. [PMID: 38935396 DOI: 10.1001/jamaoto.2024.1181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Affiliation(s)
- Trinitia Y Cannon
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, North Carolina
| | - Gina D Jefferson
- Department of Otolaryngology-Head and Neck Surgery, The University of Mississippi Medical Center, Jackson
| | - Michael J Brenner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor
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2
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Kale S, Hirani S, Vardhan S, Mishra A, Ghode DB, Prasad R, Wanjari M. Addressing Cancer Disparities Through Community Engagement: Lessons and Best Practices. Cureus 2023; 15:e43445. [PMID: 37711952 PMCID: PMC10498131 DOI: 10.7759/cureus.43445] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/13/2023] [Indexed: 09/16/2023] Open
Abstract
Cancer disparities continue to be a significant public health challenge, disproportionately affecting certain communities in terms of incidence, mortality, and access to quality care. Addressing these disparities requires a multifaceted approach that involves not only healthcare professionals and researchers but also the active participation and collaboration of the affected communities themselves. Community engagement has emerged as a promising strategy to reduce cancer disparities and promote health equity. This review article synthesizes the existing literature and examines the role of community engagement in addressing cancer disparities. It explores various approaches and best practices utilized in community engagement initiatives to empower and involve diverse populations in the fight against cancer. The review discusses key lessons learned from successful programs and identifies challenges faced in implementing such initiatives. The article highlights the importance of cultural competence, trust-building, and meaningful collaboration between stakeholders, including community leaders, healthcare providers, researchers, and policymakers. It emphasizes the significance of tailoring interventions to specific community needs, acknowledging cultural differences, and fostering a two-way exchange of knowledge and resources. Moreover, this review investigates the impact of community engagement on cancer prevention, early detection, treatment adherence, and survivorship outcomes. It sheds light on the role of community-based participatory research and other innovative strategies in generating evidence and facilitating the translation of research findings into real-world interventions. In conclusion, this review underlines the potential of community engagement in addressing cancer disparities and promoting health equity. By involving communities as active partners in cancer control efforts, healthcare systems can design more effective and sustainable interventions. This approach not only contributes to reducing cancer disparities but also fosters a sense of ownership and empowerment within the communities affected, paving the way for a more equitable and inclusive healthcare landscape.
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Affiliation(s)
- Swarali Kale
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shoyeb Hirani
- Medicine, Mahatma Gandhi Mission (MGM) Medical College and Hospital, Aurangabad, IND
| | - Sauvik Vardhan
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditi Mishra
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Dewang B Ghode
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Roshan Prasad
- Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mayur Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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3
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Marzan-Rodríguez M, Muniz-Rodriguez K, Morales LM, Martínez IS, Torres-Borrero N, Castro-Figueroa EM. Epidemiological intelligence community network intervention: a community response for COVID-19 community transmission. BMC Public Health 2023; 23:1044. [PMID: 37264399 DOI: 10.1186/s12889-023-15727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 04/22/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Expanding and providing access to early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through testing community-based strategies among socially vulnerable communities (SVC) are critical to reducing health disparities. The Epidemiological Intelligence Community Network (EpI-Net) community-based intervention sought to increase coronavirus 2019 (COVID-19) testing uptake and prevention practices among SVC in Puerto Rico (PR). We evaluated EpI-Net's community leaders' capacity-building component by assessing pre-post COVID-19 public health workshops' tests' score changes and satisfaction among trained community leaders. METHODS A total of 24 community leaders from SVC in PR have completed four community workshops. Pre- and post-assessments were completed as part of the health promotors training program to evaluate participants' tests score changes and satisfaction outcomes. RESULTS Preliminary results showed: (1) high intervention retention levels of community leaders (85.7% acceptance rate); (2) change in post-test scores for community engagement strategies (p = 0.012); (3) change in post-test educational scores in COVID-19 prevention practices (p = 0.014); and (4) a change in scores in public health emergency management strategies (p < 0.001). CONCLUSIONS The overall workshop satisfaction was 99.6%. Community leaders have shown the importance of community capacity building as a key component for intervention feasibility and impact. TRIAL REGISTRATION Our study was retrospectively registered under the ClinicalTrial.gov ID NCT04910542.
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Affiliation(s)
- Melissa Marzan-Rodríguez
- Public Health Program, Ponce Health Sciences University, Ponce, PR, Puerto Rico
- Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, Puerto Rico
| | | | - Luisa M Morales
- Public Health Program, Ponce Health Sciences University, Ponce, PR, Puerto Rico
- Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, Puerto Rico
| | - Iris S Martínez
- Public Health Program, Ponce Health Sciences University, Ponce, PR, Puerto Rico
- Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, Puerto Rico
| | | | - Eida M Castro-Figueroa
- Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, Puerto Rico
- School of Behavioral Sciences, Ponce Health Sciences University, Ponce, PR, Puerto Rico
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4
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Dee EC, Robredo JPG, Eala MAB, Suanes PN, Bhoo-Pathy N. The ripple effect: Cancer-related financial toxicity for family members and caregivers. Psychooncology 2023; 32:155-159. [PMID: 36383435 DOI: 10.1002/pon.6067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Janine Patricia G Robredo
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines.,Blavatnik Institute of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Michelle Ann B Eala
- College of Medicine, University of the Philippines, Manila, Philippines.,Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California, USA
| | - Patricia N Suanes
- Blavatnik Institute of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence-Based Practice, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Doykos PM, Chen MS, Watson K, Henderson V, Baskin ML, Downer S, Smith LA, Bhavaraju N, Dina S, Lathan CS. Special Convening and Listening Session on Health Equity and Community Outreach and Engagement at National Cancer Institute-Designated Comprehensive Cancer Centers. Health Equity 2021; 5:84-90. [PMID: 33681694 PMCID: PMC7929917 DOI: 10.1089/heq.2020.0155] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 01/11/2023] Open
Abstract
In recent years, the cancer research and care community has been more attuned to health equity, increasingly pursuing coordinated and comprehensive action to achieve equitable health outcomes. In addition to its support of a joint research agenda for health disparities in 2017, the National Cancer Institute (NCI) has demonstrated its commitment to addressing health inequities with its 2012 requirement for cancer centers to define and address the needs of a local "catchment area" and the 2016 mandate for Community Outreach and Engagement (COE). With several years of experience with the COE requirements, there is an opportunity to reflect on the experience to-date and identify opportunities to bolster the impact of COE on equitable cancer outcomes for the future. To do so, the Bristol Myers Squibb Foundation (BMSF) hosted a special convening and listening session in April 2019. The session agenda was cocreated by BMSF and NCI leaders and staff. It brought together 41 individuals, including representatives from the NCI Cancer Centers Program, Division of Cancer Control and Population Health and Center to Reduce Cancer Health Disparities, 22 NCI-designated, emerging or affiliated comprehensive cancer centers, and the broader cancer community. This article captures key themes from that meeting, including an overview of current COE efforts, with a deeper look at how four cancer centers are embedding health equity and COE efforts into their institutions and work, and the successes and challenges they have encountered.
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Affiliation(s)
| | - Moon S Chen
- UC Davis Comprehensive Cancer Center, Sacramento, California, USA
| | - Karriem Watson
- University of Illinois Cancer Center, Chicago, Illinois, USA
| | - Vida Henderson
- University of Illinois Cancer Center, Chicago, Illinois, USA
| | - Monica L Baskin
- O'Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sarah Downer
- The Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, Massachusetts, USA
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Preston MA, Ross L, Chukmaitov A, Smith SA, Odlum ML, Dahman B, Sheppard VB. Health Insurance Coverage Mandates: Colorectal Cancer Screening in the Post-ACA Era. Cancer Prev Res (Phila) 2020; 14:123-130. [PMID: 32917646 DOI: 10.1158/1940-6207.capr-20-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/30/2020] [Accepted: 09/02/2020] [Indexed: 11/16/2022]
Abstract
Building a culture of precision public health requires research that includes health delivery model with innovative systems, health policies, and programs that support this vision. Health insurance mandates are effective mechanisms that many state policymakers use to increase the utilization of preventive health services, such as colorectal cancer screening. This study estimated the effects of health insurance mandate variations on colorectal cancer screening post Affordable Care Act (ACA) era. The study analyzed secondary data from the Behavioral Risk Factor Surveillance System (BRFSS) and the NCI State Cancer Legislative Database (SCLD) from 1997 to 2014. BRFSS data were merged with SCLD data by state ID. The target population was U.S. adults, age 50 to 74, who lived in states where health insurance was mandated or nonmandated before and after the implementation of ACA. Using a difference-in-differences (DD) approach with a time-series analysis, we evaluated the effects of health insurance mandates on colorectal cancer screening status based on U.S. Preventive Services Task Force guidelines. The adjusted average marginal effects from the DD model indicate that health insurance mandates increased the probability of up-to-date screenings versus noncompliance by 2.8% points, suggesting that an estimated 2.37 million additional age-eligible persons would receive a screening with such health insurance mandates. Compliant participants' mean age was 65 years and 57% were women (n = 32,569). Our findings are robust for various model specifications. Health insurance mandates that lower out-of-pocket expenses constitute an effective approach to increase colorectal cancer screenings for the population, as a whole. PREVENTION RELEVANCE: The value added includes future health care reforms that increase access to preventive services, such as CRC screening, are likely with lower out-of-pocket costs and will increase the number of people who are considered "up-to-date". Such policies have been used historically to improve health outcomes, and they are currently being used as public health strategies to increase access to preventive health services in an effort to improve the nation's health.
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Affiliation(s)
- Michael A Preston
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia. .,Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Levi Ross
- Department of Health Science, The University of Alabama, Tuscaloosa, Alabama
| | - Askar Chukmaitov
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Sharla A Smith
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, Kansas
| | | | - Bassam Dahman
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Vanessa B Sheppard
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia.,Department of Health Behavior and Policy, Office of Health Equity & Disparities Research, VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
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Moore A, Villalobos A, Gardner AL, Staples C, Shafir S. Leveraging the strength of comprehensive cancer control coalitions to support policy, systems, and environmental change. Cancer Causes Control 2019; 30:1033-1044. [PMID: 31435874 DOI: 10.1007/s10552-019-01215-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/03/2018] [Indexed: 12/17/2022]
Abstract
Strategies that facilitate change to policy, systems, and environmental (PSE) changes can enable behaviors and practices that lead to cancer risk reduction, early detection, treatment access, and improved quality of life among survivors. Comprehensive cancer control is a coordinated collaborative approach to reduce cancer burden and operationalizes PSE change strategies for this purpose. Efforts to support these actions occur at the national, state, and local levels. Resources integral to bolstering strategies for sustainable cancer control include coordination and support from national organizations committed to addressing the burden of cancer, strong partnerships at the state and local levels, funding and resources, an evidence-based framework and program guidance, and technical assistance and training opportunities to build capacity. The purpose of this paper is to describe the impact of public policy, public health programming, and technical assistance and training on the use of PSE change interventions in cancer control. It also describes the foundations for and examples of successes achieved by comprehensive cancer control programs and coalitions using PSE strategies.
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Affiliation(s)
- Angela Moore
- Division of Cancer Prevention and Control, Comprehensive Cancer Control Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Annette L Gardner
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA
| | - Citseko Staples
- Cancer Action Network, American Cancer Society, Washington, DC, USA
| | - Sarah Shafir
- State and National Systems, American Cancer Society, Atlanta, GA, USA
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Rempusheski VF, Klemm PR, Adams MC. Community Engagement Model to Match Psychosocial Health Needs. Res Gerontol Nurs 2018; 11:293-305. [PMID: 30452062 DOI: 10.3928/19404921-20181003-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/16/2018] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to develop a model from community engagement (CE) process data to guide future CE for a focused health problem. Community-based participatory research was used to engage older adults affected by cancer and their family caregivers in eight cancer clusters in one northeastern U.S. state. CE was focused on informing participants about a national telephone helpline offering psychosocial cancer services. A purposeful sample by settings in the cancer clusters yielded an estimated 200,500 individuals who participated in information sessions, health fairs, sporting events, and the media (i.e., print, radio, or television). A general inductive approach was used to analyze CE data and resulted in a four-phase model that health professionals consider in initiating CE. Strategies are discussed for resolving two roadblocks that were identified. This model serves as a guide to standardize CE that informs a community about available services to address a focused health problem. [Res Gerontol Nurs. 2018; 11(6):293-305.].
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Preston MA, Mays GP, Bursac Z, Thomas BR, Laryea J, Tilford JM, Odlum M, Smith SA, Henry-Tillman RS. Insurance coverage mandates: Impact of physician utilization in moderating colorectal cancer screening rates. Am J Surg 2018; 215:1004-1010. [PMID: 29555083 DOI: 10.1016/j.amjsurg.2018.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 02/27/2018] [Indexed: 12/26/2022]
Abstract
Precision public health requires research that supports innovative systems and health delivery approaches, programs, and policies that are part of this vision. This study estimated the effects of health insurance mandate (HiM) variations and the effects of physician utilization on moderating colorectal cancer (CRC) screening rates. A time-series analysis using a difference-in-difference-in-differences (DDD) approach was conducted on CRC screenings (1997-2014) using a multivariate logistic framework. Key variables of interest were HiM, CRC screening status, and physician utilization. The adjusted average marginal effects from the DDD model indicate that physician utilization increased the probability of being "up-to-date" vs. non-compliance by 9.9% points (p = 0.007), suggesting that an estimated 8.85 million additional age-eligible persons would receive a CRC screening with HiM and routine physician visits. Routine physician visits and mandates that lower out-of-pocket expenses constitute an effective approach to increasing CRC screenings for persons ready to take advantage of such policies.
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Affiliation(s)
- Michael A Preston
- University of Arkansas for Medical Sciences, Department of Surgery, Health Initiatives and Disparities Research, 4301 West Markham Street #827, Little Rock, AR 72205-7199, USA.
| | - Glen P Mays
- University of Kentucky, Department of Health Management & Policy, College of Public Health, 111 Washington Avenue #201, Lexington, KY 40536-003, USA.
| | - Zoran Bursac
- University of TN Health Science Center, Center for Population Sciences, Department of Preventive Medicine, 66 N Pauline St., Suite 307, Memphis, TN 38163, USA.
| | - Billy R Thomas
- University of Arkansas for Medical Sciences, Department of Pediatrics Neonatology, College of Medicine, 4301 West Markham Street, Little Rock, AR 72205-7199, USA.
| | - Jonathan Laryea
- University of Arkansas for Medical Sciences, Department of Surgery, Health Initiatives and Disparities Research, 4301 West Markham Street #827, Little Rock, AR 72205-7199, USA.
| | - J Mick Tilford
- University of Arkansas for Medical Sciences, Department of Health Policy & Management, College of Public Health, 4301 West Markham Street, Little Rock, AR 72205-7199, USA.
| | - Michelle Odlum
- Columbia University, School of Nursing, 617 West 168th Street, Rm 225, New York, NY 10032, USA.
| | - Sharla A Smith
- University of Kansas School of Medicine-Wichita, Department of Preventive Medicine & Public Health, 1010 N. Kansas Street, Wichita, KS 67214, USA.
| | - Ronda S Henry-Tillman
- University of Arkansas for Medical Sciences, Department of Surgery, Health Initiatives and Disparities Research, 4301 West Markham Street #827, Little Rock, AR 72205-7199, USA.
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Hawley ST, Morris AM. Cultural challenges to engaging patients in shared decision making. PATIENT EDUCATION AND COUNSELING 2017; 100:18-24. [PMID: 27461943 PMCID: PMC5164843 DOI: 10.1016/j.pec.2016.07.008] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/02/2016] [Indexed: 05/08/2023]
Abstract
OBJECTIVE Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. DISCUSSION The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. CONCLUSION While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care.
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Affiliation(s)
- Sarah T Hawley
- Professor of Medicine and Health Management and Policy, University of Michigan & Research Investigator, Ann Arbor VA Center for Clinical Management Research, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI 48109, United States.
| | - Arden M Morris
- Associate Professor of Surgery and Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, United States
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Braun KL, Stewart S, Baquet C, Berry-Bobovski L, Blumenthal D, Brandt HM, Buchwald DS, Campbell JE, Coe K, Cooper LC, Espinoza P, Henry-Tillman R, Hargreaves M, James A, Salmon Kaur J, Viswanath K, Ma GX, Mandelblatt J, Meade C, Ramirez A, Scarinci I, Park Tanjasiri S, Thompson B, Vines AI, Dignan M. The National Cancer Institute's Community Networks Program Initiative to Reduce Cancer Health Disparities: Outcomes and Lessons Learned. Prog Community Health Partnersh 2015; 9 Suppl:21-32. [PMID: 26213401 PMCID: PMC4698458 DOI: 10.1353/cpr.2015.0017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND We describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities. METHODS Quantitative and qualitative data were abstracted from CNP final reports. Qualitative data were grouped by theme. RESULTS Together, the 25 CNPs worked with more than 2,000 academic, clinical, community, government, faith-based, and other partners. They completed 211 needs assessments, leveraged funds for 328 research and service projects, trained 719 new investigators, educated almost 55,000 community members, and published 991 articles. Qualitative data illustrated how use of CBPR improved research methods and participation; improved knowledge, interventions, and outcomes; and built community capacity. Lessons learned related to the need for time to nurture partnerships and the need to attend to community demand for sustained improvements in cancer services. IMPLICATIONS Findings demonstrate the value of government-supported, community-academic, CBPR partnerships in cancer prevention and control research.
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