1 / 35

Objectives

delu
Télécharger la présentation

Objectives

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Reducing Cancer Burden Through Community-Based ResearchSeptember 28, 2007Eugene J. Lengerich, VMD, MSAssociate ProfessorDepartment of Public Health Sciences Department of Health Policy and Administration The Pennsylvania State UniversityDirector, Community Outreach and Education Penn State Cancer Institute

  2. Objectives • Provide an update on ACCN research initiatives (today) • Provide an overview of ACCN and NACN • Review NACN community-based initiatives • Review recent surveillance information

  3. Appalachia Community Cancer Network (ACCN)

  4. The Appalachia Community Cancer NetworkSupported by the National Cancer Institute’sCenter to Reduce Cancer Health Disparities1 U01 CA114622 (2005-2010) Appalachian Areas of 7 States KY, MD, NY, OH, PA, VA, WV Principal Investigator Mark Dignan, PhD, MPH University of Kentucky Regional Principal Investigators KY – Nancy Schoenberg OH – Electra Paskett PA – Eugene Lengerich VA – Jim Bohland WV – Pamela Brown Cancer Sites Colorectal Cervical Lung/Tobacco Breast, especially late stage at diagnosis

  5. The Appalachia Community Cancer NetworkSupported by the NCI’s Center to Reduce Cancer Health Disparities1 U01 CA114622 (2005-2010)

  6. Northern Appalachia Cancer Network (NACN)

  7. The Northern Appalachia Cancer Network (NACN)A Region of the Appalachia Community Cancer Network • A community-academic partnership to develop, test and implement evidence-based interventions intended to reduce the burden of cancer in rural, medically underserved communities of PA and NY • Established in 1992 • Three primary strategies • Community-based participatory research with 10 cancer coalitions • Among the longest-running network of community cancer coalitions in the U.S. • Practice-based research with rural primary care providers, specialists, and hospitals • Surveillance research

  8. NACN Advisory Committee • Composed of Community Representatives (n=10) and State & Professional Representatives (n=13) • Role: • Advise NACN • Facilitate community-based participatory research • Represent coalitions • Expectations: • Meet face-to-face once each year of the five years of the cooperative agreement • Meet via teleconference in the other three quarters of each year

  9. Action Health Cancer Task Force (PA) Allison Clark – Community health education Nicole Hockenbrock – Community health education Chautauqua County (NY) Partners for Prevention Laurie Adams – Community health and education Coalition for People Against Cancer, Clearfield County (PA) Mary Day – Cancer education and outreach Crawford County Cancer Coalition (PA) Dawn Moshbacher, BA, BSN – Community health Delaware County (NY) Cancer Coalition Jeanne Darling – Rural community education Elk County Cancer Coalition (PA) Paulette Schreiber, CRNP – Health care and cancer screening Greene County Cancer Coalition (PA) Carolyn Wissenbach – Community education and training Indiana County Cancer Coalition (PA) Charlie Shoemaker – Health care administration Lawrence County Cancer Coalition (PA) Marcia S. Anderson -- Adult literacy Wyoming County Cancer/Tobacco Partnership (PA) Valerie Ann Bell, RN, BSN -- Cancer prevention, education, and screening Community Partnershipson the NACN Advisory Committee

  10. Cancer Education, Outreach, and Policy Julia Bucher, RN, PhD PA Cancer Control Consortium Statewide Education, Training, and OutreachMarilyn Corbin, PhD Associate Director, Penn State Coop. Extension Rural Health Disparities and Health Networks Lisa Davis, MHA Director, PA Office of Rural Health Clinical Trials Education and Training Linda Fleisher, MPH Program Director, NCI CIS (Fox Chase) Cancer Genetics, Tobacco, and Lung Cancer Philip Lazarus, PhD Associate Director, Penn State Cancer Institute Professor, PSU Health Communication Research Roxanne Parrot, PhD Professor, PSU Rural Hospitals and Networks Aileen Galley, ACSW, LSW Administrative Director, Mt. Nittany Medical Center Cancer screening outreach and recruitment Heather LeBlanc, BS NY Department of Health Continuing Education for Health Professionals Luanne Thorndyke, MD Associate Dean, PSU Cancer Screening Services and Rural Health Louann Weil, MPH Director, Cancer Screening, Family Health Services Health Services Research Carol Weisman, PhD Professor, PSU Social Marketing and Health Communication Christy Widman Partnership Program Director, NCI CIS (Roswell Park) Public Health Kathleen Zitka, MPH PA Department of Health Professional and State Representativeson the NACN Advisory Committee

  11. Topography: The Northern Appalachia Cancer Network and the Penn State Cancer Institute Susquehanna HS Wyoming Valley Mount Nittany and University Park Lehigh Valley Lewistown Pittsburgh Hershey Philadelphia

  12. NACN Update: RE-AIM

  13. RE-AIM Evaluation Glasgow RE, Vogt TM, Boles SM (1999) Evaluating the public health impact of health promotion interventions: The RE-AIM framework.American Journal of Public Health, 89:1323-1327. A systematic way for researchers, practitioners, and policy makers to evaluate health behavior interventions

  14. NACN 2002-2004Data from Kluhsman, et al, Prev Chronic Disease, 2006 * (Grant Total Cost)x(96 Screening Initiatives) / ((371 Education and Screening Initiatives)x1951 Screenings). Assumes 0 benefit for community changes and 0 cost for outreach and development initiatives.

  15. NACN Update: CRC Survivorship

  16. Percent Who Ever Had a Sigmoidoscopy or Colonoscopy, PA Adults 50 Years and Older,1995-2006 + 1.8% / year

  17. Design • Design: • Pre-post, multi-level, community intervention study • CBPR approach • Outcomes: • Individual-level:Knowledge and beliefs in public health and CRC-survivorship among individual members of coalitions and partnerships • Community-level:Presence and content of community plans and resource directories for CRC survivorship • Analysis • Change in knowledge and beliefs – McNemar’s test (p<0.05) • Content analysis by multiple reviewers (n=3)

  18. Study Schema Technical Assistance from NACN / PSCI / ACS Recruit and Prepare (Proposed 6 coalitions) Train on Colorectal Cancer Survivorship and Process for Plan Development (Conference 1: May 2006) Present CRC Survivorship Plans and Resource Directory (Conference 2: October 2006) Disseminate, Implement, and Research Assess Barriers & Needs; Develop Plan ASSESSMENT Public health and survivorship knowledge and beliefs ASSESSMENT Knowledge and beliefs; Survivorship Plans and Resource Directories Revised 5/11/06

  19. Participation Recruited • 11 coalitions (8 in PA; 3 in NY) and 4 hospitals (all in PA) • 32 individuals at initial conference (range 1-4 per coalition/hospital) • MD’s; RN’s; Health Educators • Hospital Administrators • Survivors Completed • 11 coalitions and 3 hospitals (93.3%) • 16 of 32 individuals at initial conference returned to second conference (50.0%)

  20. CRC Survivorship Assessments and Plans Appalachian Counties n = 14

  21. Barriers, Assets and Plans

  22. NACN Update: Recruitment to Mammography through Food Pantries, Indiana County, PA Design: Community- and evidence-based intervention in food pantries with pre-post assessment of screening mammography in Healthy Woman Program Result: Of the 302 age-eligible women, 158 (52.4%) were in need of scheduling a mammogram. Of the 158 women, 138 (87.3%) received a mammogram as a result of the adapted Tell A Friend® Program. Three (2.2%) women were diagnosed with breast cancer and received treatment. The number of breast cancer screenings provided to underserved residents increased by 46 (28.2%) during 2005. Geography: Indiana County Status: Manuscript accepted for publication, Journal of Rural Health Collaborators: Marcy Bencivenga, BA Susan DeRubis, MS, RN Patricia Leach, MS, MEd Lisa Lotito, BA Charles Shoemaker, ARRT(R), (N), CNMT, MBA Eugene J. Lengerich, VMD, MS

  23. NACN Update: Integrated Colorectal Cancer Program (ICCaP) Approach: Integrate community partnerships and evidence-based program education with health care training and delivery Objective: Increase colorectal cancer screening and survivorship in the target area Components: Community partnerships Evidence-based programs South Central Pennsylvania Cancer Education Network Cancer Information Service Primary care practice improvement Surgical and medical care delivery Geography: Central Pennsylvania – Seven rural or urban counties from Lebanon to Centre County Elevated ascending colorectal cancer rates Status: Begin January 1, 2008 for two years

  24. NACN Update: Obesity Reduction in Rural, Low-income Families through Food Selection and Physical Activity Design: Family-based randomized intervention trial with pre- and post-behavioral and biomarker measurement Population: Low-income, rural families Home-based intervention Geography: Central Pennsylvania – Centre and Snyder Counties Status: Completed focus groups Tionni Weinrich, MS, and J. Lynne Brown, PhD Currently recruiting for intervention study Tionni Weinrich, MS, and J. Lynne Brown, PhD Collecting baseline anthropometrics, blood pressure screening, questionnaire and biomarker assessment Robin Taylor Wilson, PhD Eugene J. Lengerich, VMD, MS

  25. NACN Update: Mapping of Cancer Data: Geocoded1997-2005 colorectal and prostate cancer cases in PA Software and Tools: Model cancer atlas Star Plots GIS analysis Principal components Status: Geocoded prostate cancer data Developed model atlas Developing GeoViz toolkit Collaborators: Gene Lengerich, VMD, MSFrank Hardisty, PhD Mark Gahegan, PhD Brenda Kluhsman, MSS Alan MacEachren, PhD Robin Taylor Wilson, PhD

  26. Surveillance Update: Appalachia

  27. Population Density Rates, 2000 Population Change in Appalachia, 1990–2000

  28. 2000 1990 Poverty Rates Poverty Rates

  29. Cluster Analysis of Hispanic Settlement Barcus H. The emergence of new Hispanic settlement patterns in Appalachia. Professional Geographer 2007:59(3);298-315.

  30. General Health Disparities in Appalachia

  31. Basic Sociodemographic Characteristics of the ‘Eight Americas’ Murray CJL, Kulkarni SC, Michaud C, Tomijima N, Bulzacchelli MT, Iandiorio TJ, Ezzati M. Eight Americas: Investigating mortality disparities across race, counties, and race-counties. PLoS Med 3(90)e260. DOI: 10.1371/journal.pmed.0030260.

  32. Life Expectancy at Birth in the Eight Americas (1982-2001) Males Females Appalachia Appalachia Murray CJL, Kulkarni SC, Michaud C, Tomijima N, Bulzacchelli MT, Iandiorio TJ, Ezzati M. Eight Americas: Investigating mortality disparities across race, counties, and race-counties. PLoS Med 3(90)e260. DOI: 10.1371/journal.pmed.0030260.

  33. Review • Provide an update on ACCN research initiatives (today) • Provide an overview of ACCN and NACN • Review NACN community-based initiatives • Review recent surveillance information

More Related