"Should I Prioritize My Cancer or My Diabetes?": Patient-Perceived Barriers to Co-Managing Cancer and Diabetes Mellitus

Among patients with cancer, diabetes mellitus (DM) is a prevalent comorbid condition. With an aging population and an increase in the prevalence of cancer and DM, the number of cancer patients with DM will rise. To date, studies have largely focused on understanding the context of cancer and DM co-management from the perspectives of oncology and primary care providers. To better understand the potential barriers to optimal cancer and DM co-management, we conducted 17 semi-structured interviews with DM patients receiving cancer care at New York-Presbyterian Weill Cornell Medical Center outpatient oncology clinics in New York, NY. In total, 53% patients were female, 35% were non-White, and the mean age was 64.75 (SD 11.10) years. We qualitatively analyzed our data and identified the following nine themes: (1) patients develop DM during or after cancer treatment; (2) patients do not know about the possible interactions between DM and cancer treatment; (3) cancer care is prioritized over DM management; (4) severity of DM symptoms drive patients' DM self-management during cancer care; (5) impact of cancer treatment on quality of life; (6) demands from cancer care make DM management more difficult; (7) patients want individualized treatment plans that integrate DM and cancer co-management; (8) need for greater patient activation; (9) lack of patient-centered educational resources on DM management during cancer care. Owing to these results, our findings highlight the need to increase patient engagement by developing and disseminating patient-centered educational resources on cancer and DM to improve self-management practices and patient outcomes.

Impact of Clinical Trial Design on Recruitment of Racial and Ethnic Minorities

Knowledge related to how oncology treatment trial design influences enrollment of racial and ethnic minorities is limited. Rigorous identification of clinical trial design parameters that associate favorably with minority accrual provides educational opportunities for individuals interested in designing more representative treatment trials. We identified oncology trials with a minimum of 10 patients at an NCI-Designated Comprehensive Cancer Center from 2010 to 2021. We defined a study endpoint of racial and ethnic minority accrual greater than zero. Multivariable logistic regression was used to determine whether co-variables predicted our study endpoint. P-values of less than 0.05 were considered significant. A total of 352 cancer trials met eligibility criteria. These studies enrolled a total of 7981 patients with a total of 926 racial and ethnic minorities leading to a median enrollment of 10%. Trials open in community sites (yes versus no) were more likely to have a minority patient (OR, 2.21; 95% CI, 1.02-4.96) as well as pilot/phase I studies compared to phase II/III (OR, 3.19; 95% CI, 1.34-8.26). Trials incorporating immunotherapy (yes versus no) were less likely to have a minority patient (OR, 0.47; 95% CI, 0.23-0.94). Trials open in community sites as well as early phase treatment studies were more likely to accrue minority patients. However, studies including immunotherapy were less likely to accrue racial and ethnic minorities. Knowledge gained from our analysis may help individuals design oncology treatment trials that are representative of more diverse populations.

Partnership in Cancer Research (PCAR) Program Increases Medical Student Knowledge and Confidence to Perform Cancer Research

Arkansas has a high cancer burden, and a pressing need exists for more medical students to pursue oncology as a career. The Partnership in Cancer Research (PCAR) program provides a summer research experience at the University of Arkansas for Medical Sciences for 12 medical students who have completed their first year of medical training. A majority of participants spend time pursuing cancer research in basic science, clinical, or community-based research. Students report on their research progress in an interactive "Live from the Lab!" series and assemble a final poster presentation describing their findings. Other activities include participation in a moderated, cancer-patient support group online, lecture series on cancer topics, medical simulations, palliative care clinic visit, "Death Over Dinner" event, and an entrepreneurship competition. Students completed surveys over PCAR's first 2 years in operation to evaluate all aspects of the program. Surveys reveal that students enthusiastically embraced the program in its entirety. This was especially true of the medical simulations which received the highest evaluations. Most significantly, surveys revealed that the program increased cancer knowledge and participant confidence to perform cancer research.

Implementing a cancer survivorship seminar course to non-healthcare professional undergraduate students

BACKGROUND

At University of California, Irvine (UCI), a seminar course focused on cancer survivorship was developed and offered to non-healthcare professional undergraduate students. Utilizing the knowledge, attitude, and perception (KAP) framework, this study was designed to examine the impact on students who have taken this course, and to clarify the value of this course for undergraduate students.

METHODS

This was a cross-sectional survey. Undergraduate students enrolled in the Life After Cancer Freshmen Seminar course (Uni Stu 3) at UCI between 2021 and 2023 were invited to participate. The survey consisted of 4 main sections: (1) demographics, (2) knowledge of cancer survivorship, (3) attitude towards cancer survivorship, and (4) perception and awareness of cancer survivorship. The survey was administered prior to the implementation of the course, and the same survey was administered at the end of the course.

RESULTS

A total of 33 students completed the pre-implementation survey and 30 students completed the post-implementation survey. Comparing pre- and post-course implementation, there was an increase of perception and awareness of (i) resources and guidelines for cancer survivors (pre, 9.1% vs. post, 36.7%), (ii) mental health complications among cancer survivors (pre, 36.4% vs. post, 56.7%), (iii) benefits of cancer survivorship care (pre, 15.2% vs. post, 40%), latest research in cancer survivorship (pre, 0% vs. post, 23.3%), and (iv) tailoring survivors' needs according to their age groups (pre, 24.2% vs. post, 66.7%). Knowledge and attitude towards caring of cancer survivors were similar comparing pre- and post-course implementation.

CONCLUSION

In an undergraduate seminar course focused on cancer survivorship, we observed an improvement of non-healthcare students' perception and awareness of cancer survivorship-related issues, advocating the value on introducing highly prevalent cancer survivorship topics early to both undergraduate STEM and non-STEM students.

An Exploration of the Pillars of Leadership in Cancer Education

Leadership plays a key role in cancer education (CE) and the success of its practices. Leaders in CE must effectively use their leadership skills to be able to communicate, collaborate, and educate their team members. There is a lack of formalized and standardized curriculums for institutions in developing leadership programs, including what themes to focus on in CE. In this article, the authors describe key pillars of leadership in CE that have presented themselves throughout their experience and within the literature. A search was conducted using the Ovid MEDLINE® database and articles were reviewed for eligibility. In this review, thirty articles were selected for their relevance to CE. With this literature search and the authors' reflections, four pillars of leadership in CE were identified: (1) leadership development, (2) collaboration, (3) diversity and equity, and (4) implementation. Within these themes, key areas of importance were discussed further, and barriers to CE leadership were identified. By reflecting upon pillars of leadership in CE, this article may be helpful for developing future leadership programs within CE. It is vital that initiatives continue to be held and barriers are addressed to increase leadership effectiveness within CE.

Assessing Disparities in Cervical Cancer Screening with Pap Test by Disability Types

Prior research has found that women with disabilities have often experienced disparities in receipt of cervical cancer screening. However, there is a research gap regarding receipt of cervical cancer screening by types of disability. This study examined the differences in receiving cervical cancer screening through self-reported Pap testing among women by disability type. This cross-sectional study analyzed data from the 2016, 2018, and 2020 Behavioral Risk Factor and Surveillance System (BRFSS). The relative risk of cervical cancer screening through self-reported Pap tests received within the past three years among women aged 21-65 by disability type was compared using modified Poisson regression with robust error variance. A total of 307,142 women from across the USA were sampled. In every disability group, older women were significantly less likely to receive Pap tests than their counterparts without disabilities. Women with multiple disabilities (aRR=0.91; 95% CI, 0.89-0.94) and those with ambulatory disabilities (aRR=0.93; 95% CI, 0.91-0.97) reported being less likely to receive Pap tests than women with no disability. Ambulatory disability and multiple disabilities are associated with a lower likelihood of cervical cancer screening with Pap test, increasing the need to eliminate disability-specific disparities in Pap testing. Future efforts should focus on improving cancer education programs tailored to the needs of women with disabilities, addressing barriers related to mobility and access to healthcare services, and ensuring equitable access to preventive screenings.

Effect of an Oncology Focused High School Outreach Event in Increasing Interest in Cancer Care and Healthcare Careers

Despite widely heralded efforts to improve diversity, equity, and inclusion in oncology, few outreach programs exist to inspire high school students to pursue a career in medicine. Doctors' Day is an event developed and organized by medical trainees that features both didactic and hands-on learning components to provide high school students with exposure to the healthcare field and knowledge about cancer and cancer screening. We investigated in the influence of Doctors' Day on students' interest in healthcare careers and oncology. On March 30, 2023, health professions students and residents organized and led Doctors' Day, a half-day educational program for eight public high schools in Nashville, TN. After the event, high school student participants were invited to complete a 21-item survey. The questionnaire collected demographic information, feedback regarding the session, and comfort with various activities related to the program. Among the 8 public high schools involved in Doctors' Day, 91 participants completed the survey. Few (9, 9.9%) participants were White or European American, and 30 (33.0%) and 23 (25.3%) were Black and Hispanic, respectively. There were 20 (22.0%) participants who identified as LGBTQI+ with 2 (2.2%) indicating they were unsure. Feedback regarding the program was positive across all domains, and students reported increased interest in healthcare careers and oncology along with an increased comfort level in describing the importance of cancer screening. Our community outreach program for high school students with backgrounds underrepresented in medicine was effective in increasing interest in healthcare careers and oncology.

Changes in Cancer Screening Knowledge Among a Prospective Cohort of Spanish-Speaking Hispanic Community Outreach Event Participants in Florida and Puerto Rico

The current study examined cancer prevention and early detection awareness (pre-workshop) and changes in knowledge (from pre- to post-workshop) among Hispanic/Latino (H/L) community members who participated in Spanish-language educational outreach events in Puerto Rico (PR) and Florida (FL). Spanish-language educational outreach events were comprised of an educational session lasting approximately 45-60 min and were delivered to groups in rural and urban community settings by a single trained community health educator (CHE). The research team assessed sociodemographic characteristics, personal and familial cancer health history, as well as awareness and knowledge (pre-test) of a range of cancer prevention and screening topics. Following the presentation, participants completed a post-test knowledge survey which also measured likelihood of engaging in cancer screening, cancer preventive behaviors, and cancer research as a result of information presented during the session. Change in the average knowledge score was evaluated using a paired samples t-test. Post-session likelihood of completing cancer screening and preventive behaviors and engaging in cancer research were examined using descriptive statistics and group/site comparisons. The percentage reporting awareness of screening procedures ranged from 33% (PSA test) to 79% (mammogram). H/L in PR reported higher percentage of stool blood test awareness when compared to H/L in FL (χ2(1)= 19.20, p<.001). The average knowledge score increased from 5.97 at pre-test to 7.09 at post-test (Cohen's d=0.69). The increase was significant across all participants (t(315)= 12.4, p<.001), as well as within the FL site (t(124)= 6.66, p<.001, d=0.59) and the PR site (t(190)=10.66, p<.001, d=0.77). Results from this study suggest that educational outreach events delivered to H/L community members by a CHE are valuable strategies to address challenges regarding cancer screening knowledge and engagement in multiple behaviors.

Identifying Frequently Endorsed Benefits and Barriers to Breast Cancer Screening for African-Born Women in the NYC Metropolitan Area: a Pilot Study

Most cancer screening data report on Black participants without distinguishing nativity, limiting our understanding of the needs of distinct groups within the African diaspora. The purpose of this pilot study was to assess demographic characteristics and perceptions of the benefits of and barriers to mammography among African immigrant women in New York City (NYC). Forty-two women who were 40 years or older, born in Africa, and English and/or French-speaking were recruited from African immigrant communities in NYC to complete a survey. Eighty percent of our sample aged 50 to 73 was adherent to the 2016 USPSTF mammography screening guideline. The most frequently endorsed benefits were that mammography will help find breast cancer early, could help find a breast lump before it is big enough to feel, and that if found early, breast cancer could be successfully treated. The most endorsed barriers were that having a mammogram is painful and that lack of insurance or being treated rudely at the mammogram center would keep participants from having a mammogram. Chi-square analyses assessed relationships between demographic characteristics and perceptions about mammography and revealed that endorsement of barriers to screening (e.g., health issues, transportation problems, pain, and time associated with mammography) varied by educational attainment. Findings suggest that future interventions should be multi-level and (1) support patients in accessing screening via resource sharing, (2) address other commonly cited barriers such as fear of pain during the procedure, and (3) support anti-racist healthcare environments especially in terms of treatment by providers.

Engaging the community served: a U.S. Cancer Center's Facebook live cancer awareness campaign for Spanish-speaking Latinos during COVID-19

Cancer is the leading cause of mortality in U.S. Latino adults, a group with limited access to screening, higher rates of advanced disease, and prone to online misinformation. Our project created a Facebook Live social media video campaign on general cancer prevention, screening, risk, information, and resources, targeting Spanish-monolingual Latinos during the COVID-19 pandemic. Content was delivered in Spanish by fluent, ethnically concordant topic experts and cancer center staff. Four prerecorded and three livestream interview videos were produced, amassing over 161 shares, 1,000 engagements, 12,000 views, 19,000 people reached, and 34,000 impressions in a span of four months. Strengths of this project included developing community partnerships and collaborations, providing evidence-based cancer information in a culturally responsive manner to often-excluded community members during COVID-19 pandemic, and presenting our cancer center as an accessible resource to the wider community. Future directions include formalizing evaluation strategies to capture medical engagement via cancer screening and detection rates, delivering focused cancer discussions by disease sites, and further expanding audience base through mixed media formats.

Impact of a Cancer Education Curriculum on Appalachian Kentucky Middle and High School Students

Appalachian Kentucky is disproportionately affected by elevated cancer incidence and mortality rates. This disparity is driven by inequities in health behaviors and social determinants of health including decreased education attainment levels that cause lower health literacy. To increase cancer literacy in the region, a three-part cancer education curriculum was designed for Appalachian Kentucky middle and high school students. This study was designed to evaluate the effect the curriculum had on students' cancer literacy. The curriculum lessons were disseminated to Appalachian Kentucky middle and high school teachers who engaged 223 students with the material. For each lesson, students filled out a 10-question pretest and an identical 10-question posttest. The average and median percent of correct responses from the pre- to posttests were analyzed. The average percentage of correct responses significantly increased from 40% to 70%, 52% to 69%, and 33% to 53% on lessons 1, 2, and 3, respectively. A significant increase in the average percentage of correct responses on each individual question was also observed. The results demonstrate that the three-part cancer education curriculum intervention can significantly increase Appalachian Kentucky middle and high school students' cancer literacy. Increased cancer knowledge has the potential to encourage behavioral modifications that could reduce cancer incidence and mortality rates over time. Future work will include further improving the content relative to the target age/grade level and implementing the material with a broader group of teachers and students.

Using Culturally Adapted Theater Outreach to Promote Cancer Screening Among Medically Underserved Minority Communities

Black, Hispanic, and Asian individuals, the three largest US racial/ethnic minorities, continue to suffer disproportionately from breast, cervical, and colon cancers largely because cancer screening continues to be underutilized even after decades of availability. This study examined the utility of theoretically grounded and culturally adapted in-person theater monologues aimed at promoting early detection screening among the three highest population racial/ethnic groups in Harris County, Houston, TX. Nine monologues were created to promote cancer screening and early detection for breast, cervical, and colorectal cancers in three different languages (English, Spanish, Vietnamese) and targeting underserved Black, Hispanic, and Vietnamese adult Harris County residents. From January 2014 to March 2020, 265 live monologue outreach events were held with 110 focused on prevention and screening for breast cancer, 75 for colorectal cancer, and 80 for cervical cancer. A total of 5989 individuals attended these outreach events and 86.3% completed the post-performance evaluation survey. Overall for all monologues, 6.6% of participants reported a positive change in their intent to screen from 75.7 to 82.3% after intervention (p < 0.001) and audience member scores on knowledge questions for all three cancers were mostly positive. Importantly, early detection questions for all three cancers were over 90% correct for all respondents, and well over 70% for the various groups. The findings revealed opportunities for improving monologue content to cultivate cancer early detection and screening knowledge. Results suggest that a theater-based approach may be an effective strategy to disseminate cancer screening education, improve knowledge, and increase intent to obtain screening among medically underserved communities.

Technology-Enhanced Learning in the Education of Oncology Medical Professionals: A Systematic Literature Review

As cancer continues to be a significant global health challenge, the education of oncology professionals plays a crucial role in providing quality cancer care and achieving optimal patient outcomes. In order to meet the growing need for flexible, accessible, and effective training, this study examines the role of technology-enhanced learning (TEL) in the education of oncology medical professionals. Following the PRISMA guidelines, this systematic review included 34 articles published between 2012 and 2022 in EBSCO and PubMed databases. Findings reveal a diverse range of digital tools being used in oncology training, despite a shortage of advanced educational technologies and limited functional improvement compared to traditional instruction. Since the training primarily targeted at multiple professions in the medical expert role, with radiation oncologists being overrepresented, other oncology domains should be examined more thoroughly in the future, taking into account distinct professional abilities, e.g. communication, collaboration, and leadership skills with reference to the CanMEDS framework. Although the training programmes generally resulted in positive outcomes according to the Kirkpatrick evaluation model, experimental research designs were rather limited. Therefore, the substantial contribution and limitations of TEL in oncology education need to be clarified. Precise reporting of digital tools and instructional processes, as well as challenges encountered, is highly recommended to increase transparency and replicability. Research methodology in digital oncology education remains a major concern and should be addressed accordingly in future research.

Preparing Patients to Communicate with Their Doctors About Clinical Trials as a Treatment Option: Impact of a Novel Video Intervention for Patients with a Blood Cancer and Their Caregivers

Cancer clinical trials (CCTs) are imperative for advancing cancer treatment and providing treatment options for patients; however, many barriers exist to offering and enrolling interested and eligible patients. It is crucial to equip patients and caregivers with communication skills that help them initiate and navigate conversations about the option of receiving treatment within a CCT. The aim was to assess the acceptability and impact of a novel video training for patients and caregivers that models strategies for patient-provider communication using the PACES method of healthcare communication and provides information about CCTs. The three-module training was implemented among blood cancer patients and caregivers. Using a single-arm pre-post study design, self-report surveys assessed changes in knowledge, confidence in using the PACES method, and perceived importance of, confidence in, and behavioral intention related to talking with doctors about CCTs. The Patient Report of Communication Behavior (PRCB) scale was administered. Among 192 participants, post-intervention knowledge gains were evident (p < 0.001). Confidence, importance, and likelihood to communicate about CCTs and confidence about using PACES also increased (p < 0.001); females who had never previously spoken to a provider about CCTs demonstrated greater impact (p = 0.045) than other genders. PRCB mean scores increased among patients 65+ who had never spoken to a provider about CCTs, with greater change than patients <65 (p = 0.001). This educational intervention for patients and caregivers increased knowledge about CCTs, skills in communicating with doctors about care and CCTs, and readiness to initiate conversations about CCTs as a potential treatment option.

Evaluation of the Spanish-Language Cancer Educational Webinar Series "Vamos a educarnos contra el cáncer" with the RE-AIM Framework

The COVID-19 pandemic disrupted healthcare for patients with chronic diseases, including cancer. Barriers to healthcare increased, especially for racial and ethnic minorities. While many institutions developed webinars to educate community members, few webinars used a community-based participatory approach, employed a theory-based engagement design, and were evaluated. This manuscript reports the outcomes of "Vamos a educarnos contra el cáncer," a 2021 webinar series. Monthly educational webinars were conducted in Spanish on cancer-related topics. The presentations were delivered by Spanish-speaking content experts from different organizations. Webinars were conducted using the video conferencing platform Zoom. Polls were launched during the webinar to collect data and evaluate each webinar. The RE-AIM model of reach, effectiveness, adoption, implementation, and maintenance was used to evaluate the series. The SAS Analytics Software was used for analysis and data management. Two hundred ninety-seven people participated with over 3000 views of the webinar recordings (Reach); 90% rated the sessions as good or excellent (Effectiveness); 86% agreed to adopt or improve a cancer-related behavior, and 90% reported willingness to adopt or improve a cancer-related action for someone else (Adoption); 92% reported feeling engaged (Implementation). The series has produced a resource library, manual of operations, and agreement of the Hispanic/Latino Cancer Community Advisory Board (CAB) to continue the webinar series in the future (Maintenance). Overall, these results highlight the impact of this webinar series and provide a standard approach to planning, delivering, and evaluating webinars as a strategy for cancer prevention and control in a culturally appropriate manner.

Impact of a Cancer Health Education Curriculum Among Milwaukee Public High School Students

In Milwaukee and nationwide, cancer incidence, late-stage diagnosis, and mortality are notably higher among some racial/ethnic populations. Cancer education has the potential to impact cancer burden and reduce cancer disparities. In particular, the addition of a service-learning component to academic curriculums has been shown to improve student learning as well as positively impact the surrounding community. This study implemented a cancer health education curriculum (CHEC) at a Milwaukee public high school with the goal of addressing cancer knowledge, fear and fatalism beliefs, and risk behaviors. The curriculum included interactive learning sessions and a service-learning final project. Five-hundred twenty-one students also completed pre- and post-surveys assessing cancer knowledge, fear and fatalism, risk behaviors, cancer-related communication, and a qualitative question asking what they hoped to gain (pre) or did gain (post) from the course. Results indicate (1) a significant improvement in cancer knowledge (p < 0.0001), (2) a decrease in cancer fear and fatalism (p < 0.0001), (3) an increase in fruit consumption (p < 0.0001), (4) a decrease in screen time (p = 0.0004), and (5) an increase in how often students spoke with their family about cancer (p < 0.0001). Qualitative data reflect important gains such as increased interest in sharing their knowledge about cancer with their community. Providing cancer education and leveraging a service-learning requirement led to notable changes in high school students' cancer knowledge, fear and fatalism, and risk behaviors. Students also communicated more with family/friends about cancer. Such efforts could have broader implications for student, family, and community cancer burden.

Registered Nurses' Perspectives of the Impact of a Post-registration Education Qualification on Patient Care and Clinical Practice in Cancer Care: a Qualitative Study

Student evaluation of teaching is routinely completed as modules and programmes of study at higher education institutions conclude. The evaluations are often focused on the educational value and experience. For programmes with healthcare professionals as students, the impact of the learning on patient care and clinical practice is not routinely captured in these student evaluations. These insights are crucial as the definitive impact of learning for many educational programmes of study for healthcare professionals is to enhance patient outcomes. The aim of this qualitative research study was to capture the impact of a post-registration Specialist Practice in cancer pathway for registered nurses in the context of Northern Ireland following completion of the programme. Eleven participants engaged in interviews in 2021 who had completed the education programme from 2013 to 2021. Two themes inductively emerged from the data which provided insights into the specific impact of the education programme on patient care and clinical practice. Theme one identified patient outcomes improved, and was related to five sub themes; development of nurse's clinical knowledge; enhanced awareness of the holistic impact of cancer; greater understanding of patient services available; development of clinical networks; and greater decision-making ability. Theme two related to the impact of the qualification on clinical practice through an increase in their professional credibility within the multidisciplinary team in cancer services. The debate on how to capture the impact of education on patient care and clinical practice in cancer care, should consider how to routinely capture this data.

Comprehensive evaluation of a cutaneous T-cell lymphoma education webinar

BACKGROUND

Effective and timely referral, treatment and care of people with cutaneous T-cell lymphoma (CTCL) depend on clinical staff possessing highly specialised knowledge and skills. Because of the fragmented nature of the CTCL workforce, specialist education was delivered via a webinar.

AIM

The study aimed to comprehensively evaluate the webinar and test the validity of using an evaluation model for a one-off education event.

METHODS

The webinar was evaluated using Moore et al's conceptual model for evaluation of education. Data were collected using polling questions and post-webinar questionnaires and analysed using descriptive summaries and content analysis.

FINDINGS

Respondents agreed or strongly agreed that the webinar was an effective way to learn, enjoyable, relevant to their role and interesting. Learners also reported improvements in awareness, knowledge and understanding of CTCL, its referral and treatment.

CONCLUSION

Evaluating one-off education events using a conceptual model of evaluation for continuous medical education is recommended, with some adaptations to overcome limitations.

A Cancer Education Framework for Australian Medical Schools: an Announcement of a New Educational Program

This framework draws upon national and international cancer curricula to identify the essential cancer-related learning outcomes for Australian medical students. The framework incorporates feedback from medical, radiation and surgical oncologists, haematologists, and palliative care physicians on what medical graduates need to know about cancer. The consensus view was that medical students require a basic understanding of the principles of cancer management and the opportunity to see cancer patients in a cancer service unit. The framework assumes that certain knowledge, skills, and attitudes are already embedded in current Australian medical school curricula, presenting instead only the core cancer content in order to provide a clear and concise framework designed to maximise integration within existing curricula.

Investigation of the Readability and Reliability of Online Health Information for Cancer Patients During the Coronavirus Pandemic

For cancer patients undergoing treatment who may be at higher risk of COVID-19, access to high-quality online health information (OHI) may be of particular importance amidst a plethora of harmful medical misinformation online. Therefore, we assessed the readability and quality of OHI available for various cancer types and treatment modalities. Search phrases included "cancer radiation COVID," "cancer surgery COVID," "cancer chemotherapy COVID," and "cancer type COVID," for the fourteen most common cancer types (e.g., "prostate cancer COVID" and "breast cancer COVID"), yielding a total of 17 search phrases. The first 20 sources were recorded and analyzed for each keyword, yielding a total of 340 unique sources. For each of these sources, the approximate grade level required to comprehend the text was calculated as a mean of five validated readability scores; subsequently, for the first ten results of each search, the DISCERN tool was manually used to assess quality. Search terms were translated into Spanish and French, and a quality assessment using the Health on the Net Code (HONcode) accreditation was conducted. The median grade level readability for all sources was 13 (IQR 11-14). Median DISCERN scores for the 170 sources assessed were 55 out of 75, suggesting good quality. OHI with quality scores below the median DISCERN score had a median readability of 12.5 (IQR 11-14) grade reading level vs 14 (IQR 12-17) for those above the median DISCERN score (T-test P < 0.0001). Percentages of HONcode-accredited websites were 34.9%, 39.9%, and 38.6% for English, Spanish, and French OHI, respectively. We conclude that efforts are needed to make high-quality OHI available at the appropriate reading level for patients with cancer; such efforts may contribute to the alleviation of disparities in access to healthcare information.

Standardizing Research Training: a Pilot Curriculum Within a Hematology/Oncology Fellowship Program

While scholarly activity is recognized as critical in cancer education, there is an outstanding need for methods to define research learning competencies and tools for formal research productivity and competency assessment. We piloted and studied a novel educational initiative within the University of Wisconsin Hematology/Oncology fellowship program, establishing a professional learning community (PLC) of research mentors and developing a formative evaluation tool, a research portfolio. We developed a PLC engaged in reflective conversations about intended learning outcomes and effective instructional strategies. Subsequently, a research portfolio was piloted with four first-year Hematology/Oncology fellows at the start of the 2020 academic year in which trainees document, critically evaluate, and reflect upon the knowledge, skills, confidence, and productivity acquired during research training. We employed surveys to evaluate the initiative. Seven Hematology/Oncology fellows (7/12, 58%) completed pre-intervention and six-month interim evaluation surveys, with 43% (3/7) identifying an increased confidence in quality of research training strategies following the pilot initiation. All four first-year fellows that piloted the research portfolio (4/4, 100%) completed interim evaluation surveys that demonstrated benefits of the research portfolio including self-reflection and goal setting. Research portfolio scoring correlated with other markers of academic success, suggesting its potential to predict research success. Our data suggest that bringing together a community of research mentors to generate shared learning goals and develop the framework for a formative evaluation portfolio may meet critical needs research training needs in cancer education. Given promising results, we aim to create a new educational tool for research training.

Leadership, Leading, and Influencing Change in Cancer Education: Development and Assessment of a Pilot Leadership Workshop in Cancer Education for Interdisciplinary Healthcare Staff

Effective leaders in healthcare settings create a motivating work environment, initiate changes in practice, and facilitate interdisciplinary collaboration to advance patient-centered care. Health professionals in cancer education need leadership development to meet the continued rise in cancer cases and to keep up with the rapid biomedical and technological advances in global cancer care. In addition, leadership development in cancer education supports interprofessional collaboration, optimizes patient engagement, and provides mentorship opportunities necessary for career advancement and skill development. The identified benefits from leadership development in cancer education led to the creation of an interactive pilot leadership workshop titled "Essential Skills in Cancer Education: Leadership, Leading, and Influencing Change in Cancer Education," held at the International Cancer Education Conference in October 2020. The workshop was led by global leaders in cancer education and utilized lectures, mentorship opportunities, interactive case studies, and individual learning projects to develop leadership skills in multidisciplinary oncology professionals. Fifteen attendees from diverse educational backgrounds and levels of experience participated in the virtual leadership workshop and mentorship program. Following the workshop, participants reported an increase in knowledge regarding how to use different leadership styles, initiate changes in practice, and apply leadership skills in their career development and at their institutions. The feedback received from participants through post-workshop evaluations was overall positive and demonstrated an interest for more leadership development opportunities in cancer education. This pilot workshop shows that leadership is a valuable and teachable skill that will benefit both healthcare professionals and patients in the field of cancer education.

Using Culturally Focused Storytelling to Empower Appalachian Kentucky Youth to Understand and Address Cancer Disparities in Their Communities

Kentucky has the highest cancer incidence and mortality rates in the nation with the Appalachian region of the state being most affected. These rates are driven by health behaviors and inequities in social determinants of health. Herein, Appalachian Kentucky students with the University of Kentucky's Appalachian Career Training in Oncology (ACTION) program were engaged in a storytelling exercise by writing culturally framed essays. Students discussed their personal experiences with cancer and their thoughts on the causes of and potential solutions to Appalachian Kentucky's cancer disparities. Content analysis was used to identify common themes, subthemes, and subtopics in the essays regarding cancer types, causes of cancer in Appalachia, and solutions to the high cancer rates. Common cancer types experienced by the students included breast, lung, and prostate. The most frequently identified themes that drive cancer rates in Appalachian Kentucky were identified as geography, environmental factors, tobacco use, education, poverty, prevention, and mistrust. Common proposed solutions to decrease cancer rates were to increase education and awareness, screening, and tobacco cessation. Overall, through storytelling, youth gained a better understanding of cancer in their communities and envisioned culturally tailored, community-based intervention strategies that can aid in reducing the cancer burden in Appalachian Kentucky.

Preferences for Breast and Cervical Cancer Screening Among Women and Men in Kenya: Key Considerations for Designing Implementation Strategies to Increase Screening Uptake

Breast and cervical cancer incidence rates and mortality rates in Kenya are high. Screening is globally accepted as a strategy for early detection and downstaging of these cancers for better outcomes, but despite the efforts established by the Kenyan government to provide these services to eligible populations, uptake has remained disproportionately low. Using data from a larger study aimed at understanding the implementation and scale-up of cervical cancer screening services, we analyzed data to compare the preferences for breast and cervical cancer screening services between men and women (25-49 years) in rural and urban communities in Kenya. Participants were recruited in concentric circles starting at the center of six subcounties. One woman and one man per household were enrolled for data collection on a continuous basis. More than 90% of both men and women had a monthly income of less than US $500. The top three preferred sources of information on screening for cancers affecting women were health care providers; community health volunteers; and media such as television, radio, newspapers, and magazines. More women (43.6%) than men (28.0%) trusted community health volunteers to provide health information on cancer screening. Printed materials and mobile phone messages were preferred by approximately 30% of both genders. Over 75% of both men and women preferred an integrated model of service delivery. These findings show that there are many similarities that can be leveraged when designing implementation strategies for population-wide breast and cervical cancer screening hence reducing the challenge of addressing diverse preferences of men and women which may not be easy to reconcile.

Pot Song as a Novel Cancer Communication Intervention: Lessons Learned from Developing, Implementing, and Evaluating a Culturally Grounded Intervention for Breast Cancer Education in Rural Bangladesh

Targeted public education may offer an approach to achieving more effective treatment in countries like Bangladesh, where breast cancer is a leading cause of cancer death in women. Effective cancer education interventions address the target population's cultural and contextual needs. However, there is little published literature to guide the development of educational cancer interventions in a region where lack of resources combined with cultural stigma about cancer contribute to poor breast health outcomes for women. The goal of the current study was to design, test, and evaluate a culturally grounded intervention to promote breast problem care among women in rural Bangladesh. The current manuscript first describes the process of formative evaluation that led to the development of the intervention, including decisions about the audience, message construction, and mode of intervention delivery. Second, we describe the testing process, including process and outcome evaluation. Finally, we describe the lessons learned from the process. We conclude with recommendations related to cultural grounding for message development, questionnaire design, data collection procedures, and analysis.

Exploring Youth Perceptions About Cancer Prevention and Preferences for Education: a Qualitative Study

This study aimed to characterize adolescents' perspectives on cancer and cancer prevention and to explore their preferences for cancer education. A total of 188 middle and high school students participated in 25 focus groups. Focus groups were led by study team members and included five to ten participants each. Adolescents were asked to discuss their cancer and cancer prevention knowledge, sources of cancer education, and preferences for cancer prevention education. Focus groups were audio-recorded, and professionally transcribed. Transcripts were content and thematically analyzed by two study team members using NVivo qualitative data software. Six themes were identified in focus groups: knowledge about cancer, negative perceptions of cancer, awareness of cancer prevention, engagement in cancer prevention, facilitators and barriers for action, and preferences for cancer education. Adolescents described a wide range of cancer education sources, including friends, family, healthcare professionals, school, technology, and pamphlets. Participants associated cancer with negative emotions, such as sadness and fear. Participants expressed interest in learning about cancer and cancer prevention, but also identified barriers to engaging in preventative behaviors, such as discomfort, lack of knowledge, and lack of personal connection to cancer. Adolescents preferred learning through personal presentations, online videos, school, educational games, and social situations. Adolescence is a critical period for learning and developing healthy behaviors. Awareness of cancer and cancer prevention is crucial to lowering cancer risk in the future. To be effective, cancer education for adolescents should target specific areas of cancer prevention and address barriers to engagement in preventative behaviors.

The Impact of Receipt of Information on Prostate-Specific Antigen Testing on Screening with the Prostate-Specific Antigen Test

There is controversy on prostate cancer screening with the prostate-specific antigen (PSA) test in the USA, and as a result, there has been an increased push for physicians to have a thorough discussion with patients on the advantages and disadvantages of prostate cancer screening with the PSA blood test. Prior studies showed that pre-screening discussions increased the likelihood of PSA testing. This study is aimed at examining the impact of discussions of the advantages and disadvantages of the PSA test among men that fit the prostate cancer screening guidelines determined by the American Urological Association (AUA). This cross-sectional study used secondary data from the 2018 Behavior Risk Factor Surveillance System (BRFSS) in the USA. The analytic sample was determined based on the American Urological Association (AUA) guidelines for prostate cancer screening (n = 54,607). Approximately, 89.5% of men underwent PSA testing. The odds of PSA testing were higher for men who received information on only the advantages of PSA testing (OR = 3.40, 95% CI = 2.80, 4.13), only the disadvantages of PSA testing (OR = 1.52, 95% CI = 1.02, 2.28), and both advantages and disadvantages of PSA testing (OR = 2.99, 95% CI = 2.46, 3.63) compared to men who received no information. Discussions with men, that meet the requirements for prostate cancer screening, about the advantages and disadvantages of PSA testing increased the likelihood that men would undergo PSA testing.

An adolescent and young adult (AYA) cancer education initiative aimed at healthcare students in Japan

BACKGROUND

The focus on cancer in adolescents and young adults (AYA) has increased in recent years. We participated in an event called AYA week 2021 as part of a research project of the Ministry of Health, Labour and Welfare (MHLW) and conducted a fact-finding survey to collect information for raising public awareness of AYA-generation cancers and to improve support for AYA-generation cancer patients.

METHODS

A 25-item questionnaire survey was conducted through requests sent to the deans of medical schools and presidents of related universities across Japan and by advertising on social networking sites and friendship networks. Furthermore, the effects of a lecture given by three cancer survivors on their cancer experience were examined.

RESULTS

A total of 1288 healthcare students participated. The most common age group was between 20 and 24 years, with the majority being medical students (83%). The AYA cancer-educated population had more knowledge about AYA-generation cancers than the overall group. At present, very few people are familiar with AYA-generation cancers (30.5%), which highlights the importance of school education. There were 163 participants who attended the lecture given by the cancer survivors, of whom 108 completed the questionnaire. The results showed high participant satisfaction related to the lecture given by cancer survivors, suggesting that such lectures could help educate and raise awareness about AYA-generation cancers.

CONCLUSIONS

The knowledge survey and lecture given by cancer survivors had educational effects. Many healthcare students responded positively, suggesting the efficacy of these types of initiatives.

Argentina's National Program for Control of Breast Cancer: Time 1, Patient Navigation, and Patient Cancer Education Experience

Argentina has the second highest mortality rate for breast cancer (BC) in South America. The age-standardized incidence of BC in Argentina is 73 per 100,000. Despite the availability of early detection services, 30% of BCs are diagnosed at advanced disease stages. The National Cancer Institute (NCI) of Argentina and the National Program for Control of Breast Cancer (NPCBC) focus on two main objectives: guaranteeing adequate and timely BC treatment and reducing BC mortality in Argentina. These objectives are addressed by maintaining three core concepts: quality control, disease monitoring, and wide coverage of available early detection and treatment services. The NPCBC is currently implementing the "Time 1 Survey Study." Time 1 is defined as the time from the first appearance of BC signs or symptoms to the first consult within the public healthcare system. This timeframe is important in Argentina because it is outside of the health timeframes and data parameters monitored by the national cancer data registry system. The Time 1 Survey study has the potential to serve as an informational tool for BC patient navigation efforts in Argentina because it can be used to identify and characterize the barriers and delays that women face during Time 1. Lessons and experiences included in this study could be translated to other Latin American and middle-income countries for developing cancer control programs that can lead to improving treatment and reducing mortality through patient navigation and cancer education efforts for the public, health professionals, and patients.

Video education about side effects of chemotherapy and immunotherapy and its impact on the anxiety, depression, and distress level of cancer patients

BACKGROUND

Patients diagnosed with cancer are at higher risk of anxiety, depression, and overall distress. These mood disturbances are risk factors for non-adherence to cancer treatment, increased length of stay during hospital admissions, increased number of visits to the emergency department, and also impact survival. Although paper handouts about the potential side effects are widely used in the oncology practice studies have shown that digital educational material is known to work better when compared to traditional methods. However, the impact of video education on anxiety, depression, and distress have not been previously evaluated. Our study aimed to assess whether video education about potential chemotherapy and immunotherapy can reduce anxiety, depression, and distress levels.

METHODS

After IRB approval, we enrolled patients who were fluent in English, younger than 80 years of age, and who were able to provide informed consent. The Hospital Anxiety and Depression Scale and Distress Thermometer were used to assess distress, as well as depression and anxiety before and after watching video educational material. Paired t-test was used to compare the differences between the scores before and after watching educational videos. The statistical software GraphPad Prism 9, San Diego, California, was used to perform the statistical analysis.

RESULTS

We enrolled 29 patients, of whom 20 completed the study, six withdrew, two were lost to follow-up, and one did not complete the initial questionnaire. Of all patients that completed the study 85% of the patient found videos helpful, and they were 7/10 likely to recommend them to other patients who may experience symptoms. The mean depression score changed from 4.75 before to 4.9 after watching the videos (p 0.77), distress score from 2.3 to 2.65 (p 0.52), and anxiety scores changed from 4.85 to 6.15 (p 0.03). The feedback provided by the patients indicated that they were more willing to watch the videos related to the side effects they experienced at their free time and convenience.

CONCLUSIONS

Our study suggests that patients were open to video education and found it helpful and worth watching. However, the exposure of the patients to the videos about potential side effects of cancer treatment, including those patients do not experience, may lead to increased anxiety.

PEARL: A Guide for Developing Community-Engaging and Culturally-Sensitive Education Materials

Community outreach and engagement has been a regular activity of the National Cancer Institute at its designated Cancer Centers. However, in 2016, community outreach and engagement became a required activity for all cancer centers. Yet there is a gap in the literature that provides guidelines for developing materials that resonate with communities. We developed the PEARL rubric to fulfill that gap from our work developing culturally sensitive breast cancer education materials for African American and Immigrant African women. We conducted a targeted literature review to understand the approaches that have been used for developing education materials for communities. We reviewed the literature and distilled key elements into our PEARL guide for creating culturally appropriate education materials. PEARL consists of five elements: Plain language and understandability, Explicit data, statistics, and graphs, Affirmative framing, Representative content, and Local connection. PEARL is a modern comprehensive guide that researchers can use for creating culturally sensitive materials. It is designed to guide researchers develop educational materials who have little to no experience in community engagement.

Using The Cancer Genome Atlas as a Tool to Improve Undergraduate Student Understanding of Cancer Genetics and the Hallmarks of Cancer Progression

Undergraduate students harbor a number of misconceptions about the complexity of cancer. Though educational interventions have been shown to promote student learning of various aspects of this ubiquitous disease, to date no studies have evaluated undergraduate student understanding of the Hallmarks of Cancer, a set of core properties that have emerged as the defining characteristics that drive cancer development and progression. This study documents poor baseline knowledge of many fundamental aspects of cancer biology and genetics by 2nd- and 3rd-year undergraduate students, and it evaluates the efficacy of a student-centered project as a pedagogical strategy for improving student understanding of both the hallmarks of cancer and the genetic influences that drive their acquisition by cancer cells. Using genomic and transcriptomic datasets from The Cancer Genome Atlas, students investigated the most common genetic aberrations associated with specific cancer types of interest and then researched the functions of these altered genes in order to link their aberrations with specific hallmark properties of cancer. A pre-/post-project assessment of student understanding of topics related to the hallmarks of cancer demonstrated the efficacy of this approach as a means of educating undergraduate students about core cancer concepts.

Nursing Students' Knowledge and Attitude Toward Cancer Survivorship

The number of cancer survivors is expected to rise to up to 20 million by 2026. It is of utmost importance that nurses who provide survivorship care enhance their knowledge and skills to meet the needs of cancer survivors. The purpose of this project is to propose a pilot evidence-based educational project to incorporate the concept and framework of the survivorship care plan for nursing students. We evaluated feedback from nursing students for their knowledge and attitude on cancer survivorship care. A pilot educational project was given to 38 undergraduate students and 17 graduate students. Pre- and post-test feedback were collected from these students. Content analysis was used to analyze the data. At least 60% of both undergraduate and graduate nursing students had experience in either adult or pediatric oncology units. Only 11% of undergraduate and 18% of graduate students reported awareness of survivorship care plans. However, all of the students believed the survivorship care plan will be helpful for cancer patients. We recommend that it is imperative to incorporate the concept of cancer survivorship in the early stage of nursing education.

The Summer School Oncology Groningen: Improving a Successful International Course by Refining the Old, Maintaining What's Good

For more than two decades, the International Summer School Oncology for Medical Students (ISOMS) has organized a biennial 2-week international summer school program in Groningen, the Netherlands. The summer school aims to increase knowledge about general cancer care, reduce fear of talking to cancer patients, and expose students to cancer-related problems. After 22 years, there was a need to improve the summer school format, the application procedure, and the intensity of the course. Here, we describe and evaluate these and additional changes that were made to the program. Several changes were made to the summer school format. The course was shortened from 10 days to a more intensive 7 days. The scientific program was integrated with the clinical program and students were taught scientific writing and presentation skills. The application process involved a personal video pitch. Importantly, the new summer school format was organized by a committee in which medical students had the lead. To evaluate the changes to the summer school, we conducted knowledge tests and regularly obtained feedback. There was a high overall student satisfaction, with a median score of a 9 out of 10. Students appreciated the interactive sessions and practicals and the scientific program, and were satisfied with the course level. All students had improved test scores. Improvement points highlighted the need for a less packed schedule and more lectures on basic oncology principles, or were related to specific lectures. The student-led innovation and adaptation of the ISOMS has been successful.

Evaluation of cancer awareness, cancer education, and prevention intervention techniques among university-level students in the United States and India

BACKGROUND

Cancer is one of the leading causes of death globally. A considerable number of different cancer types may be preventable, using primary intervention techniques, such as health education, cancer awareness, behaviors and lifestyle modifications. The present study conducted a comparative assessment of cancer awareness among undergraduate students of the United States and India.

MATERIALS AND METHODS

Students from an Institution in India (KC) (55 females, 33 males), and an Institution in the United States of America (SHU) (226 female, 58 male) during 2019-2020 participated in this study. Participants (n = 372) across all majors and all years (first through fourth year) completed an online questionnaire and answered the questions on their demographic characteristics (e.g., gender, age, and location), academic status (e.g., year of study, major), multiple-choice questions about cancer knowledge, and opinion questions (e.g., "where would you find info," "should therapies be free"). Student responses were collected using Qualtrics Survey Software. Excel was used to analyze responses. We conducted statistical Χ² tests for independence to determine whether there is a statistically significant difference between the expected frequencies and the observed frequencies in one or more categories of a contingency table, with a significance of ɑ = 0.01. While small sizes due to the small institutions and the response pool, we note that we achieved the necessary "n" for all tests reported.

RESULTS

Our research shows a few important statistically significant differences, including knowledge of cancer and breast lumps is dependent on location, ranking of global cancer deaths is dependent on location, and that cancer knowledge is dependent on the information source. All for Χ² tests with P < 0.001.

CONCLUSIONS

Further encouragement of education for young people in various aspects of cancer and cancer prevention, as well as information facility and sources of reliable data, could be helpful for improving the overall health and primary prevention. A thorough assessment is needed to understand the responsible factors for the observed cancer knowledge variations among students of two different places.

The cancer epidemic in the Caribbean region: Further opportunities to reverse the disease trend

Cancer incidence has been rising in the Caribbean and is expected to have significant adverse implications for the health of people in the region and health systems in this decade. While developed countries, for the most part, enjoy the benefits of advanced technologies and adaptive systems in cancer control and management, a different experience confronts a large segment of the Caribbean population. The region has experienced some success in enhancing cancer services, however, there is a need to address gaps in several areas through nationally and regionally tailored initiatives. This Review complements previous publications on the challenges, actions, and progress towards cancer prevention and care in Caribbean countries but also further outlines potential positive impacts that can be derived from addressing gaps pertaining to cancer education, data management, screening and risk assessment, navigation services, gender factors, and resource development. The proposed approaches encapsulate concepts of health theories that are applicable across the ecological domains. When implemented in combination, the proposals may effectively contribute to reducing the cancer burden in the region.

Enhancing International Cancer Organization Collaborations: King Hussein Cancer Center and Princess Margaret Cancer Centre Model for Collaboration

Collaborative partnerships, which link two health organizations with shared characteristics to achieve common goals and to improve healthcare quality, are becoming increasingly common in oncology. The purpose of this study is to review the collaboration between King Hussein Cancer Center (KHCC) and Princess Margaret Cancer Centre (PM). The context, input, process, and product (CIPP) model, a quasi-experimental form of program evaluation, has been applied to the KHCC-PM collaboration. This model is well suited to evaluate complex collaborations as it does not assume linear relationships. Data sources include stakeholders' judgements of the collaboration, assessment of achievements, and informal interviews with key participants involved in the program. KHCC and PM are recognized as high-caliber comprehensive cancer centers, with a common goal of delivering high-quality care to patients. Through personal relationships among faculty in the centers and the perceived opportunities for mutual benefit, KHCC and PM signed a memorandum of understanding in 2013 to enter into a formal partnership. This partnership has been an evolving process that started with collaboration on education and grew to include clinical care. Research is an area for potential future collaboration. Enabling factors in the collaboration include dedication of individuals involved, trusting relationships amongst faculty, and the reciprocal nature of the relationship. Challenges have been financial, competing interests, and the absence of a successful collaborative model to follow. The KHCC and PM collaboration has been successful. A strategic plan is being developed and followed to guide areas of expansion.

Lack of Knowledge, the main Stumbling Block of Fertility Preservation Promotion in China

The aim of this study is to evaluate fertility preservation (FP) popularization in China among female cancer patients in terms of awareness of fertility, knowledge about FP, and attitudes toward FP. A questionnaire-based survey was conducted among female cancer patients in Tongji Hospital in China from March 2019 to July 2019. The 29 fertility-related issues, which were presented in either five-point Likert scales or "yes or no", in this questionnaire consisted of demographic characteristic and disease-related situation, awareness of fertility, knowledge about FP, and attitudes toward FP. Participants were required to finish the questionnaire, and data were gathered and analyzed by SPSS. Forty-five valid questionnaires without missing data remained in the final analysis. The survey discovered that a regional imbalanced limitation in knowledge of infertility risk and FP in young cancer patients acted as a major obstacle in FP promotion nationwide and FP decision-making in patients. Compared with rural patients, patients from urban areas were more eager to give birth and more likely to have a better understanding of FP with a more positive attitude. Moreover, most of the participants (62.2%) had a low level of understanding of FP, although they remained positive toward it. "Cancer treatment as the priority", "Cancer relapse caused by FP", and "Health of the next generation" were the top three factors affecting decisions on FP. The findings revealed a general FP actuality in China and specifically offered some intervention targets in the near future to improve FP service and networks, benefiting more female patients of childbearing age who are at risk of infertility.

Robust Institutional Support and Collaboration Between Summer Training Programs in Cancer and Biomedicine Drive the Pivot to a Virtual Format in Response to the COVID Pandemic

Summer internships serve important roles in training the next generation of biomedical researchers and healthcare providers through laboratory and clinical experiences that excite trainees about these fields and help them make informed decisions about career paths. The SARS-CoV-2 (COVID) pandemic and associated physical distancing restrictions precluded implementation of traditional in-person summer curricula and led to the cancellation of many internships across the USA. COVID-related disruptions also created opportunities for trainees to engage in remote research, become proficient in online learning platforms, and explore multidisciplinary topics. These skills are highly relevant to trainees as virtual interfaces occupy an increasingly mainstream role in their professional paths. The response to the COVID pandemic required real-time adaptations at all levels for major biomedical institutions including the University of Maryland Baltimore (UMB). Pivoting summer programs to a virtual format as part of this response provided a "teachable moment" to expose trainees to the innovation and resilience that are essential components of the biomedical profession. UMB summer programs, which span diverse biomedical disciplines from cancer research to diabetes, consolidated resources and identified mentors with online research projects to develop a robust virtual curriculum. Herein, data from a cancer-focused internship illustrate the collaborative adaptations to established components and creation of new learning modules in the transition to, and implementation of, online training. Outcomes are presented in the context of the COVID pandemic and significant societal issues that arose in the summer of 2020. The utility of virtual components and their impact on future programs is discussed.

The Cancer Clear & Simple Story: Developing a Cancer Prevention Curriculum for Rural Wisconsin Through a Community Partnership

To address rural cancer disparities, the University of Wisconsin Carbone Cancer Center launched a rural cancer project through its Cancer Health Disparities Initiative (CHDI) in 2010. With support from the National Cancer Institute's (NCI) National Outreach Network, CHDI conducted an assessment of rural counties and partnered with Adams County to implement a collaborative cancer education project. Together CHDI and Adams County partners selected an evidence-based educational curriculum, Understanding Cancer, as a basis for local adaptation for use with rural Wisconsin communities. The new curriculum, titled Cancer Clear & Simple (CC&S), consists of three modules: (1) cancer basics, (2) cancer prevention, and (3) cancer screening. CC&S has also been culturally tailored for African American and Latino populations. The adaptation utilized community involvement throughout a multi-step process to ensure cultural appropriateness. The process included materials selection, translation, conceptual adaptation, visual adaptation, and validation with target audiences. All adaptations of the curriculum incorporate health literacy principles and is designed to build knowledge and improve health-related decision-making around lung, colorectal, skin, breast, cervical, and prostate cancer. Current efforts seek to (1) increase the evidence of CC&S's effectiveness through additional research, (2) expand its use by new audiences, and (3) adapt it into a web-based platform featuring a cancer prevention serious game.

Colorectal cancer community engagement: a qualitative exploration of American Indian voices from North Dakota

Background

American Indians (AI) in North Dakota present with higher rates of advanced-stage disease for screening detectable colorectal cancers and have lower overall baseline colorectal cancer screening rates than non-AIs. We sought to identify the perceived barriers and facilitators for the engagement with colorectal cancer prevention within North Dakota tribal communities.

Methods

Twelve semi-structured interviews were carried out across four tribal reservation communities in the state of North Dakota with American Indian adults between the ages of 30 and 75 years. We utilized purposive sampling to ensure maximum variation in age, sex, and tribal community until data saturation was achieved. The interviews were transcribed, and thematic analysis was carried out to identify consistent themes rooted within the data. Ethical approval was gained for this project from all relevant institutional review boards.

Results

Four main themes were identified as barriers for the engagement with colorectal cancer prevention, including: colorectal cancer screening barriers, focused on other health problems, lack of colorectal cancer tailored health promotion, and socio-cultural factors affecting colorectal cancer prevention. Three main themes were identified as facilitators for the engagement with colorectal cancer prevention, including: reasons for getting colorectal cancer screening, role of culture, and getting out into the community.

Conclusion

There is need for more community-rooted, strengths-based approaches to colorectal cancer prevention activities in AI communities in North Dakota. Socio-cultural factors, such as the use of storytelling, and the use of traditional knowledge have been demonstrated to be an important element of consideration for colorectal cancer tribal community engagement and prevention planning in the state.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12885-021-09119-2.

The Contribution of the European School Of Oncology Education to the Central Asian and Caucasian Regions

The European School of Oncology (ESO) organizes educational activities within Europe, the Mediterranean region, Central Asia, and the Caucasus. In this paper, we report on the participation of oncologists from Uzbekistan, Kazakhstan, Kirgizstan, Tajikistan, Azerbaijan, Georgia, and Armenia in various ESO activities including the masterclass, courses, refresher courses, conventions, conferences, consensus conferences, clinical training centers fellowship program, and the medical students' courses in oncology. Over the last 15 years, 428 oncologists and medical students have successfully attended one or more of the above activities organized in various European countries. This article details the implementation and coordination of the ESO educational events in the Central Asian and the Caucasian regions.

ESO's career development program (2002-2021): Presentation and evaluation

Over the last two decades, the European School of Oncology (ESO) provided a career development program to young oncologists by offering extensive learning programs. In 2020, the College of ESO was established to provide a fully comprehensive educational pathway that covers the different needs of medical students, oncology fellows and specialists. The following educational activities were organized worldwide: i) the masterclass in clinical oncology, ii) fellowships in clinical training centers, iii) the certificate of competence and advanced studies, iv) the medical student courses in oncology, v) the live e-sessions, vi) the refresher courses and vii) the Visiting Professor Program; and have reached areas where education is most needed and offered a variety of educational events in Europe, Eurasia, Middle East and Latin America. In this article, we present and evaluate the ESO educational programs devoted to young oncologists over the last 20 years.

Using Key Informants to Evaluate Barriers to Education and Acceptability of the HPV Vaccine in Tanzania: Implications for Cancer Education

Cervical cancer is the third most common cancer globally, with high mortality when left untreated. In sub-Saharan Africa, Tanzania shows higher incidence rates of cervical cancer at 59.1 per 100,000 compared with the global average of 13.1 per 100,000. The HPV vaccine has been shown to successfully reduce HPV infection and is recommended for school-age girls and boys in the USA. Understanding the acceptability of the HPV vaccine and the barriers to vaccination is important for ensuring that HPV vaccination programs are successful. In 2016, Tanzania began school-based HPV vaccination programs in cities and towns surrounding Dar es Salaam, the largest city in Tanzania. Successful implementation of HPV vaccination programs in Dar es Salaam relies on overcoming barriers to vaccination. This study focused on primary school teachers as key informants to assess these barriers. Participants were given a short survey and then asked to participate in focus group sessions. Overall, knowledge of HPV was low, with only 37% of participants having heard of the HPV and only 28.6% having heard of the HPV vaccine. Teachers had a very positive response to the HPV educational sessions. Of the teachers who completed the questionnaires, 100% of them were willing to speak with their school parents about the HPV vaccine and 99% would recommend this vaccine to parents. This study has significant implications for national cancer prevention vaccination programs, not only in Tanzania, but also in other countries starting HPV vaccination as teachers are potentially important advocates for immunization and other childhood health initiatives.

Clinical Case Presentation and Discussion During ESO-ESMO Masterclass: a 10-Year Interactive Educational Experience

In this article, we report on the clinical case presentations that have been delivered during the ESO or ESO-ESMO Masterclasses in Clinical Oncology in the last 10 years. Masterclasses have been held in three different geographical continents including Europe, Middle East, and Latin America, in which participants had to submit a clinical case and present it either in front of a tumor board (multidisciplinary-like sessions) or in small groups. Clinical case presentation is a unique part of the educational program preparing young oncologists to present and discuss their own patients with distinguished experts. In each Masterclass, between 40 and 55 clinical cases-depending on the number of participants-are presented. All presentations are assessed and evaluated by faculty members as well as by the rest of the participants.

A Brief Educational Intervention Enhances Basic Cancer Literacy Among Kentucky Middle and High School Students

Kentucky experiences the highest overall cancer incidence and mortality rates in the USA with the greatest burden in the eastern, Appalachian region of the state. Cancer disparities in Kentucky are driven in part by poor health behaviors, poverty, lack of health care access, low education levels, and low health literacy. Individuals with inadequate health literacy are less likely to participate in preventive measures such as obtaining screenings and making healthy lifestyle choices, thus increasing their chances of developing and dying from cancer. By increasing cancer literacy among youth and adults, it may be possible to decrease cancer disparities across Kentucky. This study aimed to establish connections with middle and high schools in Kentucky that would facilitate pilot implementation of a brief cancer education intervention and assessment of cancer health literacy among these student populations. A baseline pretest cancer literacy survey consisting of 10 items was given to 349 participants, followed by the delivery of a cancer education presentation. Immediately following the presentation, participants were given a posttest with identical items to the pretest. Participants were primarily Caucasian (89.4%), female (68.7%), and in 10th through 12th grade (80.5%). Significant (p < 0.0001) increases in both average and median percent of correctly marked items were observed between the pretest and posttest (average, pretest = 56% versus posttest = 85%; median, pretest = 60% versus posttest = 90%). The scores for all individual items increased after the brief intervention. The results demonstrated a significant increase in cancer literacy levels immediately after the pilot educational intervention. We suggest that it may be possible to improve cancer literacy rates in Kentucky by integrating cancer education into middle and high school science and/or health education curricula. This could ultimately drive changes in behaviors that may help lower cancer incidence and mortality rates. Plans for future interventional studies measuring long-term cancer knowledge retention and resultant behavioral changes among middle and high school students as well as the feasibility of integrating cancer education into middle and high school curricula are also discussed.

Exploring Glocalization in the Construction and Implementation of Global Curricula

Despite proposed advantages of global curricular harmonization including physician mobility and improving the quality of care, the challenges and unintended consequences require greater study. The aim of this study was to problematize the concept and implementation of global oncology curricula and their relationship to local contexts of power and culture. Fourteen international participants involved in the development and implementation of global oncology curricula completed in-depth, one-on-one semi-structured interviews lasting 40-60 min. Snowball sampling was employed. Through iterative analyses, using an abductive approach, the study team discussed and reviewed the data and made revisions through collaborative analysis to enhance comprehensiveness and to improve credibility. In the final analysis the meaning and implication of the themes were discussed yielding a conceptual analysis. Our data have articulated 5 key challenges for global curricula including 1) Ambiguous or conflicting perspectives on the purpose and scope of Global Oncology Curricula 2) Insufficient representation of diverse perspectives and realities in the creation of the final curricula 3) A rigid conceptualization of competency requirements 4) A mismatch between the curricular requirements and local context and 5) The influence of power relationships and decision makers. Leveraging the strengths of diversity including fostering representation, addressing power differentials and factoring local contexts may be an approach to mitigating these challenges. Global oncology curricula may serve important advocacy roles within the healthcare system. Leveraging diversity may positively impact the common challenges in the construction and implementation of global oncology curricula.

Experiential Learning in Career Development

This manuscript demonstrates the learning experiences of graduate public health students through mentored field research in cancer epidemiology and cancer prevention over the past 13 years. The program has been funded through an R25 grant from the National Cancer Institute (NCI) since 2006 and has supported nearly 200 students from different universities in the USA. Included are data on student recruitment, selection, mentorship, and evaluation of research training in US minority settings as well as foreign countries. Examples of students' learning experiences and life-long skills that shaped students' careers are presented. The insights that fostered the experiential learning idea among key leaders at the NCI Cancer training branch have proven to be sound.

YouTube as a source of information on breast cancer in the Arab world

BACKGROUND

The general population is increasingly using YouTube as a source of information on breast cancer, the most frequent cancer among women. Arabs are the most interested population in breast cancer on YouTube. The transmission of accurate information is important to reduce mortality rates. This cross-sectional study aims to evaluate breast cancer videos on YouTube in the Arab world.

METHODS

A YouTube search for "breast cancer" in Arabic was performed. The most viewed 60 videos included were evaluated for global quality (GQS score), reliability (modified DISCERN score), content (content score), and misleading claims. Recorded and calculated data included views, duration, videos power index, and viewers' interaction. Sources from legal persons (governments, universities, TV channels, physicians' groups), and blogs (online health channels, individuals) were categorized.

RESULTS

The median global quality (3/5), reliability (2/5), and content scores (4/11) were overall low. Misleading information was found in 42% of the videos. Although videos uploaded by legal persons were less popular (163,454 vs 327,488 views), they hosted more physicians (52% vs 15%), were less misleading (15% vs 64%), covered more content, and were of higher global quality and reliability than videos uploaded by blogs [p < 0.05]. While the topic of symptoms (55%) was discussed the most, genetic counseling (13%) and prevention (20%) were the least mentioned.

CONCLUSIONS

YouTube is poorly informational and inaccurate on breast cancer in the Arab World where it is highly used. Although videos uploaded by legal persons tend to be more adequate, they are of lower popularity. Governments and physicians are encouraged to upload more intelligibly informational videos, guide the population to reliable sources, and support regulations.

Mentoring in Global Cancer Research Training

This manuscript illustrates general concepts of mentoring in low- and middle-income countries (LMICs). The focus of this manuscript is on public health research based on our experiences with the Cancer Epidemiology Education in Special Populations (CEESP) Program which is further illustrated in this Supplement. While the CEESP Program provides research training in global and US minority settings, this manuscript is focused on the global aspects of the program. We describe the process of selecting students into the CEESP Program, the process of mentoring them, and the preparation of the mentoring sites. We emphasize the review of the CEESP mentors in LMICs and put forward recommendations for enhancing their mentoring skills and disseminating the experience to other US and global institutions interested in global cancer education.