Community Research in Cancer:
“CORICA”
CPCRN – Los Angeles
Roshan Bastani, Antronette Yancey, Annette Maxwell, Beth Glenn,
William McCarthy, Ritesh Mistry, Barbara Berman, Weng Kee Wong,
Leo Morales, Jennifer Tsui
University of California, Los Angeles (UCLA)
CPCRN
Build Research
Infrastructure in
Community
Cancer
Early-Detection
DISCOVERY
Vaccine
Preventable
Cancers
Tobacco
Control
Obesity
Prevention
DISSEMINATION
Infrastructure
• UCLA Center of Excellence in the Elimination of Health Disparities
(CDC REACH US, 2007-2012)
• Asian American Network for Cancer Awareness Research &
Training (AANCART), NCI funded Community Networks Program,
2000-2010.
• Lance Armstrong Survivorship Center (2006-2010)
• Prevention Research Center, CDC (1999-2009)
WORKING Project
Working Out Regularly Keeps Individuals Nurtured and Going
WORKING I: 2005-08; WORKING II: 2008-13, PI: Yancey
NCMHD/NIH R24
Community Partner
Academic Partner
LA County Dept. of
Health Services
UCLA School of
Public Health
Community Investigator Team
Representatives from health & human
services organizations
WORKING I
Planning and Pilot
Phase 2005-08
WORKING II
Full Intervention
Trial Phase
WORKING III
Dissemination
Phase
WORKING II Study Design
Recruitment
60 sites, 25
workers/site
Health and Human Services
Agencies
Baseline
Assessment
Organizational
Change Intervention:
•Policy changes
•Program champions
•Photovoice
•PA Competition, etc.
Intervention
Control
30 sites, 750
workers
30 sites, 750
workers
Outcomes:
Follow up
6, 12, 18 months
•Objective biometrics, step test
•Self-reported practices, etc.
•Worksite environmental audits
Recent Success Story
• North East Valley Health Corporation (Debra
Rosen et al.) receives HRSA Grant:
Patient Navigator Outreach and Chronic Disease
Prevention Program
• Breast, Cervix, CRC screening and F/U
– 2 year project, $1 Million (Sept 2008)
– UCLA CPCRN role: navigator training and
project evaluation
Dissemination Grant
Submissions
• Community Dissemination of An Evidence-based CRC
screening Intervention (Maxwell)
– Among Filipino Americans, Test 4 dissemination strategies for a
CRC screening intervention proven effective in prior randomized
trial among
• Engaging Filipino American CBOs in Tobacco Control (Maxwell)
– Test 4 dissemination strategies to increase usage of the
California Smokers Helpline, an evidence-based cessation
approach
• Disseminating and Implementing Tobacco Prevention
Education or Deaf and Hard of Hearing Youth (Berman)
– Test 2 dissemination strategies for a first ever evidence-based
tobacco prevention curriculum, Hands Off Tobacco! An AntiTobacco Program for Deaf Youth
HPV Vaccine
Informed Decision-Making Pilot
• LA County Office of Women’s Health: Prevention
Matters! Program
1-800 Health Hotline (est. 2002):
• Health education and link callers to prevention services
• Seven languages: Spanish, English, Mandarin, Cantonese,
Korean, Vietnamese, Armenian
• 10,000 callers/year: low-income, limited English proficiency,
92% uninsured
• Capitalize on this infrastructure for
HPV Vaccine education, tracking of
access & uptake in county, including
predictors
HPV Vaccine
Informed Decision-Making Pilot
• Survey:
– Conduct at least 100 interviews per language:
English, Spanish, Cantonese, Mandarin,
Korean, Armenian
• Informed DecisionMaking Intervention:
– Pilot test brief telephone
and mail intervention
– link callers to services
Capacity Building
• Annual Symposia:
–
–
–
–
Cancer Disparities 2005
Obesity 2006
Vaccine Preventable Cancers 2007
Lessons Learned from Tobacco Control 2008
• Using What Works Trainings:
– Participants: CBOs, Health Depts., Funding
agency (Beach Cities Health Dept), grant
applicants
– Follow-up technical assistance
• Cancer 101 (Promotores)
• CBPR (African American 5-a-day)
• Using secondary data and GIS for needs
assessments (NBCCEDP)
UCLA School of Public
Health
Jonsson Comprehensive
Cancer Center
Division of Cancer Prevention
and Control Research
CORICA
UCLA CPCRN
Community-based Organizations
Examples
of Community Partners
Los Angeles County Department of Public Health
California Department of Public Health
NCI’s Cancer Information Service
American Cancer Society
California’s Comprehensive Cancer Control Plan
National Breast and Cervical Cancer Early
Detection Program (NBCCEDP)
CDC’s Prevention Research Program (PRC)
Multiple Community-based Organizations N=25+
Tri-Counties Cancer Detection Partnership
Partnered for Progress
Northeast Valley Health Corporation
Community Clinics Association of Los Angeles Cabrillo
Herald Cancer Association
Clinica Monsenor Oscar A. Romero
Clínicas Camino del Real
Cabrillo Village Cooperative Housing
Rancho Sespe Cooperative Housing
Asian Pacific Healthcare Venture
Filipino American Service Group, Inc.
South Asian Network
To Help Everyone Clinic
California Food Policy Advocates
Esperanza Community Housing Corporation
Worksite Wellness Los Angeles
Academic Institutions
Examples
of Activities
Pilot Projects
 Clinica Romero Community Needs Assessment Survey
 Farm Workers Health Survey
 Worksite and Employee Wellness Survey
 Colorectal Cancer Health Education Adaptation for
South Asians
 Using Telephone Health Hot-line for HPV Vaccine
Promotion
 Breast and Cervical Cancer Screening in Mixtecos
 Assess No Smoking Policy at Farm Worker Housing
 Dissemination of the 5-A’s of Smoking Cessation
Training and Capacity Building
 UCLA Center for Excellence in the Elimination of Health
Disparities (REACH US)
 Use of Evidence-based Strategies (Using What Works)
 Technical Assistance
 Annual Symposia
Research Projects
 Cancer screening (breast, cervix, CRC, hep B, HPV)
 Tobacco Control
 Obesity (nutrition, physical activity)
 Survivorship
 Policy, economics, outcomes
Center of Excellence for the Elimination of
Disparities (REACH US, 2007-2012, CDC)
UCLA:
LA County Dept. of Public Health:
Yancey, Bastani,
McCarthy, Maxwell,
Glenn, Mistry,
Guinyard, Mojica
Simon, Gonzalez,
Harding, Gunzenhauser, Fielding
Community Organizations:
• LA Urban League
• Worksite Wellness LA
• CA Black Women’s Health Project
• Asian Pacific Health Care Venture
• Latino Health Access
• Esperanza Housing Corp.
• Dissemination:
– evidence- and practice-based strategies
– initial focus on obesity prevention
– future years: tobacco, screening
– Promote organizational level change
• Worksites, churches, schools, clinics
Center of Excellence for the Elimination of
Disparities (REACH US, 2007-2012, CDC)
• Multiple ethnic groups
– Low-income Latinos, African Americans and Asians
• Build infrastructure and capacity
– strengthen relationships, provide training to primary
community partners
– Community partners train their partners and
implement strategies
Cancer Screening
• Latino Prostate Cancer screening: informed decision-making
• Hepatitis B screening among Korean Church Attendees (UW)
• Follow-up of Breast Abnormalities in Low-Income Korean
American Women
• Colorectal Cancer Screening among Filipino Americans
• Breast Cancer Educational Programs in Deaf Women
• Decision Making About Genetic Testing for Breast Cancer Risk
among minority women
Tobacco
• School-based Anti-Tobacco Programs for Deaf/HH Youth
• Secondary Analysis of California Tobacco Use Prevention
Education Data
• California Tobacco Use Prevention Education
• Pathways of How Socioeconomic Context Affects Teen
Smoking
Obesity
• Organizational Change for Obesity Prevention: The
WORKING (Working Out Regularly Keeps Individuals
Nurtured and Growing) Study
• Instant Recess in Stadiums and Schools with the
Professional Athletes Council
• Systematic Observation of Physical Activity in Worksite
Stairs (SOPAWS)
• Healthy Eating And Active Communities (HEAC) Project
• Comparison of Healthy and Unhealthy Weight-related
Ads in Communities of Differing Race/Ethnicity and SES
Publishing Data from CBO
Initiated Projects
• Pausa para tu salud: Integration of exercise breaks into workplace organizational
routine may reduce weight and waistlines
– Preventing Chronic Disease, 2008 Jan; 5 (1), A12
– Lara A, Yancey AK, Tapia-Conyer R, Flores Y, Kuri-Morales P, Mistry R, Subirats E,
McCarthy WJ.
• Adapting a 1% or Less Milk Campaign for a Hispanic/Latino Population: The
Adelante Con Leche Semi-descremada 1% Experience
– American Journal of Health Promotion, In Press
– Hinkell AJ, Mistry R, McCarthy WJ, Yancey AK
• Tobacco Use among South Asians: Results of a Community-University
Collaboration
– Ethnicity & Health, In Press
– Glenn B, Surani Z, Chawla N, Bastani R
• Rates and sociodemographic predictors of cancer screening among South Asians
– Journal of Community Health, In Press
– Glenn B, Bastani R, Surani Z, Chawla, N
Community Seed Projects
•
LA County Department of Public Health Office of Women’s
–
•
Cabrillo Village Housing Cooperative
–
•
Design a needs assessment tool and conduct data collection in surrounding neighborhoods.
South Asian Network
–
•
Expand cancer prevention and control outreach to Mixteco population.
Clinica Romero
–
•
Assess cancer prevention activities within health and social service organization worksites.
Tri-County Cancer Detection Project
–
•
Dissemination and Evaluation of the 5-A’s of Tobacco Cessation.
Partnered for Progress: Los Angeles County Cancer Detection Partnership
–
•
Assess the impact and functioning of a no-smoking policy at affordable housing complexes.
H/LATEN: Hispanic/Latino American Tobacco Education Network and NCI/CIS
–
•
Enhance outreach to promote cancer screenings in Spanish-speaking low-income families.
Cabrillo Economic Development Corporation
–
•
Conduct health needs assessment in farm worker housing communities.
Clinicas del Camino Real
–
•
Use Telephone Hotline to collect data about HPV vaccine and pilot test education intervention.
Adapt and disseminate materials for colorectal cancer screening in South Asians.
Los Angeles Community Garden Council
–
Design survey to assess how community gardens impact fruits & vegetables
access and consumption.