Cancer Prevention Research Research Articles

Abstract A23: Using Internet-platform technology to train community-based researchers in developing countries: Lessons Learned from a Caribbean study

Abstract As cancer increases as a global health challenge, the use of available technological platforms for communication is required. To develop a collaborative program of cancer prevention research between the U.S. and the Caribbean, we relied on several mobile phone and Internet-based communication platforms. In 2016-2017, a two-phase advocacy-engaged research study was initiated to determine 1) women’s perceptions of breast and cervical cancer screening and 2) gatekeepers’ perceptions of the quality and availability of breast and cervical cancer screening and treatment services in the four countries of the English-speaking Windward Islands. Our results revealed that mobile communication and Internet-platform technologies successfully trained Caribbean community researchers on qualitative data collection and analysis methods as well as dissemination strategies. In particular, mobile platforms including GoToTraining, WhatsApp, YouTube, Dedoose, Google Drive, and email were used to deliver interactive training modules to community researchers in the Caribbean. The Internet-based technology enhanced training, communication, and social interactions. Additionally, it facilitated the collaborative development of recruitment materials and data collection instruments, data management, reports, manuscripts, and results dissemination. Community and academic researchers agreed that use of technology fostered a cost-effective and efficient collaborative process. The availability and use of communication technology are especially critical for researchers addressing the raising global cancer burden, particularly in resource-poor countries. Advocacy-engaged, technology-facilitated cancer research has the potential to cultivate and sustain community capacity and infrastructure for international research partnerships by building bridges via the use of mobile and Internet-based technology. Citation Format: Kamilah B. Thomas-Purcell, Marva Primus-Joseph, Christine Richards, Ann Marie McBurnie James, Julie Blaze, Lydia Atkins, Patsy Wiley, Kimlin Tam Ashing. Using Internet-platform technology to train community-based researchers in developing countries: Lessons Learned from a Caribbean study [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr A23.

Interventions to increase breast and cervical cancer screening uptake among rural women: a scoping review.

Despite widespread promotion of breast and cervical cancer (BCC) screening, uptake remains low in rural communities. Barriers to healthcare, which often result in poorer health outcomes, differentially impact residents of rural communities. Effective interventions addressing the unique needs of rural women may target these barriers and increase BCC screening participation. Our objective is to review and assess the published literature on interventions to increase BCC screening in rural communities. A systematic scoping review of PubMed/Medline was performed to identify BCC screening interventions conducted in rural settings. English language articles from peer-reviewed journals published from January 2006 to October 2019 were included if they reported results for BCC screening interventions in rural communities in the United States. We reviewed 228 articles and identified eight articles consistent with our inclusion criteria. Studies varied in sample population characteristics, geographic location, design, and mode of intervention delivery. Interventions included patient navigation strategies, educational outreach programs, peer counseling, and small media initiatives. Interventions focused on promoting uptake of initial or one-time screening rather than targeted repeat screening, and few studies detailed the cost-effectiveness of the interventions. This review may inform efforts to develop strategies to increase BCC screening among rural women. Additional cancer prevention and control research gaps in rural communities include the examination of the theoretical foundations, design, delivery, and cost-effectiveness of BCC screening interventions for rural communities. Future research might focus on methods to promote repeat BCC screening and effective translation of these interventions for other rural populations.

Diet and Transgenerational Epigenetic Inheritance of Breast Cancer: The Role of the Paternal Germline.

The past decade has made evident that in addition to passing their genetic material at conception, parents also transmit a molecular memory of past environmental experiences, including nutritional status, to their progeny through epigenetic mechanisms. In the 1990s, it was proposed that breast cancer originates in utero. Since then, an overwhelming number of studies in human cohorts and animal models have provided support for that hypothesis. It is becoming clear, however, that exposure in the parent generation can lead to multigenerational and transgenerational inheritance of breast cancer. Importantly, recent data from our lab and others show that pre-conception paternal diets reprogram the male germline and modulate breast cancer development in offspring. This review explores the emerging evidence for transgenerational epigenetic inheritance of breast cancer focusing on studies associated with ancestral nutritional factors or related markers such as birth weight. We also explore paternal factors and the epigenetic mechanisms of inheritance through the male germline while also reviewing the existing literature on maternal exposures in pregnancy and its effects on subsequent generations. Finally, we discuss the importance of this mode of inheritance in the context of breast cancer prevention, the challenges, and outstanding research questions in the field.

Abstract IA21: A systems approach to cancer prevention

Abstract Cancer prevention research and practice largely focus on three overlapping areas: precision prevention (e.g., genetic, social, and other factors specific to an individual patient), genetics, and health behaviors. All three of these envision the individual patient and her provider as the agents of change. A fourth realm of research and practice with potential to contribute to the primary prevention of cancers targets environmental and social factors over which the individual has little control, but governments, businesses, and communities do. These include environmental carcinogens in consumer products, workplaces, and air and water pollution. For example, flame retardants, dry cleaning solvents, formaldehyde, and diesel exhaust are widespread and often pose disproportionately high risks for people in low-income communities. Historically, laws and regulations have been the primary tools for controlling environmental and workplace contaminants, but despite important successes, significant cancer risks from pollution still occur. This presentation explores two questions based on our recent policy and program research: 1) What does systems analysis tell us about actions that impede and hold promise for reducing exposure to environmental carcinogens at the scale needed? 2) How might a systems approach inform the integration of environmental carcinogen reduction into cancer prevention research and practice? Particularly in the current political climate, system-level interventions that shift dominant narratives about cancer, prioritize interdisciplinary research, and harness market forces deserve prioritization. Citation Format: Polly J. Hoppin, David Kriebel, Molly Jacobs. A systems approach to cancer prevention [abstract]. In: Proceedings of the AACR Special Conference on Environmental Carcinogenesis: Potential Pathway to Cancer Prevention; 2019 Jun 22-24; Charlotte, NC. Philadelphia (PA): AACR; Can Prev Res 2020;13(7 Suppl): Abstract nr IA21.

Abstract IA01: The global impact of environmental carcinogenesis and interventions for prevention

Abstract The global burden of cancer is projected to increase markedly over the next two decades, driven by population aging, population growth, and changes in exposure to known risk factors. The greatest percent increases will be in low- and middle-income countries, the majority of which currently do not have the health care infrastructure to meet this challenge. At the same time much is known about the causes of different cancer types worldwide, with the major contribution arising from environmental and behavioral factors. This recognition provides a foundation to counter the projected increases in cancer burden. However, for a number of these risk factors there remains a gap in developing preventive interventions, whereas for others interventions are available but often fail to be implemented in effective programs. In addition, the etiology of a number of common cancer types remains unexplained. Based on the projected cancer burden, the spiraling costs of therapy, and the unavailability of effective treatment in many parts of the world, prevention should be a priority in overall cancer control planning in every country. Similarly, research on cancer prevention (establishing etiology, preventive interventions and their implementation) should be better supported. To progress, cancer prevention must draw upon new knowledge on carcinogenic mechanisms and the associated technology to address knowledge gaps in innovative ways. There is a major opportunity for interdisciplinary prevention research to provide the basis for a reduction in the projected rises in cancer burden worldwide. Translation of knowledge about causes and prevention into observed reductions in cancer rates is a long and hazardous journey. Researchers should become more aware of the inherent hurdles and active opposition that lie in the way of achieving the goals of cancer prevention. Notably, the tactics of vested interests in casting doubt on the scientific evidence base for prevention should be widely disseminated and understood if researchers are to see their efforts bring benefits. Only by combining the evidence base with a well-planned strategy for implementation will the full fruits of cancer prevention research be realized. Citation Format: Christopher P. Wild. The global impact of environmental carcinogenesis and interventions for prevention [abstract]. In: Proceedings of the AACR Special Conference on Environmental Carcinogenesis: Potential Pathway to Cancer Prevention; 2019 Jun 22-24; Charlotte, NC. Philadelphia (PA): AACR; Can Prev Res 2020;13(7 Suppl): Abstract nr IA01.

Diet and Cancer Prevention Research: From Mechanism to Implementation.

Between 30% to 50% of cancer cases are estimated to be preventable through reduced exposure to tobacco, occupational carcinogens, and infectious agents, and adoption of lifelong healthy eating and a physically active lifestyle. In the past, diet and cancer prevention research has aimed to understand the effects of specific foods and nutrients on cancer-related mechanisms. More recently, there has been a shift in emphasis toward a more holistic focus on patterns of diet, reflecting the goal to understand the impact of adhering to broader public health recommendations. It is increasingly apparent from observational studies that different patterns of diet and physical activity are manifest in a metabolic state that is more, or less, conducive to the acquisition of genetic and epigenetic alterations leading to carcinogenesis. Experimental studies in cell systems, animals and humans have expanded our understanding of the many mechanisms by which specific dietary constituents may modulate inflammation and immune function, carcinogen metabolism, hormone and growth-factor regulation, DNA repair capacity, cell-cycle control, and proliferation and apoptosis. However, few mechanistic studies in animal models have evaluated diets containing the complex mixtures that make up human diets. Overall, more studies are needed across the continuum of prevention research, from basic mechanistic research on the effects of diet patterns on fundamental biologic processes to studies testing the efficacy of implementing lifestyle-directed cancer prevention strategies.

Developing a Cancer Prevention Health Education Resource: a Primer of Process and Evaluation.

Limited women's health and cancer prevention materials are available that have been validated for vulnerable populations. Such materials are especially important for groups, which have intermittent and typically low-quality healthcare access and are at greatest risk for missing out on women's health and cancer prevention screening. Health education materials are developed from heterogeneous sources. Clinical and research teams have minimal guidance in terms of sources, timelines, outputs, and evaluation in the development of such materials. The goal of this paper is to share our process in developing and evaluating an up-to-date women's health and cancer prevention learning guide appropriate for a target population of women involved in the criminal justice system. A ten-page learning guide was drafted using the current evidence-based data, with the objective of providing educational material on four topics: cervical cancer, breast cancer, sexually transmitted infection, and unintended pregnancy prevention. The learning guide was then tested on a convenience sample of 33 women at a local county jail. Feedback was organized into three parts in which the participants Responded to open-ended question, "What is missing?" Rated each of the four topics for design and content Completed a usability assessment Common themes were participants' interest in learning about side effects of birth control and wanting more information on testing and treatment, specifically for sexually transmitted infections (STIs). Women were satisfied with the cancer prevention information presented to them. This report provides a framework for cancer prevention researchers who are developing health education materials for vulnerable populations.

Impacts of Faith-Based Lifestyle Interventions on Congregational-Level Nutrition and Physical Activity Environment and Policies

Abstract Objectives Hispanics are disproportionally affected by obesity, cancer, and other obesity-related chronic diseases. Building a Healthy Temple (BHT) was a multi-component, faith-based lifestyle intervention implemented in 27 low-income, predominately-Hispanic congregations in San Antonio, TX between 2012 and 2017. One aim of BHT was to assess program effectiveness at improving health-conducive church environment/policy and sustainability of these improvements at follow-up. Methods A key macro-level program component of BHT was the formation of a Health Ministry Committee to initiate church-wide health-conducive environment/policy changes. The Congregational Health Index (CHI) was used to assess church nutrition (17 items) and physical activity (PA, 5 items) environment/policy at baseline, end of program, and follow-up (6 months or more post-intervention). Data were expressed as % of the maximum scores. Friedman test and post hoc analysis were performed with Wilcoxon signed-rank tests and significance of pairwise comparisons, adjusted with Bonferroni correction. Results Eighteen churches completed all 3 CHI assessments. Percentage of total nutrition and PA environment/policy scores for baseline, end of program, and follow-up were 38% (35–45), 64% (53–75), and 69% (64–77), respectively. Post hoc analysis shows significant improvements in nutrition and PA environment/policy scores at end of program (Z = –3.73, P < 0.001) and follow-up (Z = –3.73, P < 0.001) as compared to baseline, as well as significantly higher scores at follow-up compared to end of program (Z = –3.18, P = 0.001). Conclusions Study findings reveal the importance of utilizing congregation-wide macro-level interventions to create health-conducive enviroment/policy changes to facilitate and sustain healthy lifestyle changes in predominately-Hispanic faith community settings. Funding Sources Baptist Health Foundation San Antonio & Cancer Prevention Research Institute of Texas.

1009 Sleep Apnea and Colorectal Adenoma in the Veteran Population: A Case-Control Study

Abstract Introduction Colorectal cancer is the third most common cancer in the United States, with over half of colorectal cancers estimated to be the result of modifiable risk factors. Studies relating sleep apnea (SA) and colorectal adenoma (CRA) are limited and the findings are equivocal. The objective of this study was to examine the association between SA and risk of CRA. Methods This was a retrospective cross-sectional case-control study of data collected from 460 veterans, ages 50-79, seen in the colonoscopy clinic at the Michael E. DeBakey VA Medical Center between 2014 and 2018. Information on demographics, sleep history, and co-morbidities were obtained through lifestyle questionnaire. Self-reported SA was diagnosed by a prior sleep study. Cases consisted of 297 participants had pathologically confirmed adenoma (including 117 participants having advanced CRA with villous component or diameter of polyp > 1 cm). Controls consisted of 173 polyp-free participants. The distribution of demographics and lifestyle factors were compared between CRA and non-CRA using the Student’s t or chi-square tests. Odds ratios (OR) and 95% confidence intervals (CI) of CRA in association with CRA were calculated using univariate and multivariate unconditional logistic regression models. The confounding factors included age, sex, ethnicity, obesity, smoking status, alcohol use, hypertension, and sleep duration. Results Compared with non-SA, the multivariable OR (95% CI) for CRA was 0.92 (0.58-1.48); for non-advanced CRA was 1.14 (0.68-1.91), and for advanced CRA was 0.61 (0.32-1.17) in SA participants. Adjustment of sleep duration in the model did not change the risk estimates. Conclusion Sleep-study diagnosed SA was not associated with development of CRA in this veteran population. Further studies are needed to confirm this observation and incorporate the severity and treatment of SA, and undiagnosed SA in risk assessment. Support This research is supported in part by the Gillson Longenbaugh Foundation, and Golfers Against Cancer organization (to LJ), the Cancer Prevention Research Institute of Texas (CPRIT) (RP#140767, to LJ).

Effects of Lycopene on Growth Factor Response in Prostate Cancer Cells

Dietary and nutritional factors are considered critical modulating factors in prostate cancer development. Epidemiological data have suggested to the idea that dietary consumption of lycopene, found in tomatoes, may prevent prostate cancer. This study examined the mechanism by which lycopene interacts with prostate cancer cells, with the goal of discovering less toxic treatment and prevention options. The hypothesis that was addressed was that lycopene interferes with growth factor‐mediated signal transduction in prostate cancer cells. The effects of lycopene on PC‐3, a human prostate cancer cell line, were analyzed using proliferation assays, immunoblot analysis, and confocal microscopy. The growth factors used were lysophosphatidic acid (LPA) and epidermal growth factor (EGF). Lycopene (10 μM) inhibited LPA and EGF‐induced proliferation of PC‐3 cells, confirming previous unpublished results. Lycopene also inhibited activation of Akt in response to LPA and EGF as assessed by immunoblotting. Confocal immunofluorescence microscopy showed that the decrease in activated Akt was most prominent in the cell nucleus. These results confirm the ability of lycopene to inhibit growth factor response in human prostate cancer cells, and suggest new directions for future studies.Support or Funding InformationSupported by the ASPET Summer Undergraduate Research Program, College of Pharmacy and Pharmaceutical Sciences, Sue Harriet Monroe Mullen Innovative Cancer Prevention Research Fund, and the ASPET David Lehr Award.

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 13years. 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.

The Risk of Ovarian Cancer Increases with an Increase in the Lifetime Number of Ovulatory Cycles: An Analysis from the Ovarian Cancer Cohort Consortium (OC3).

Repeated exposure to the acute proinflammatory environment that follows ovulation at the ovarian surface and distal fallopian tube over a woman's reproductive years may increase ovarian cancer risk. To address this, analyses included individual-level data from 558,709 naturally menopausal women across 20 prospective cohorts, among whom 3,246 developed invasive epithelial ovarian cancer (2,045 serous, 319 endometrioid, 184 mucinous, 121 clear cell, 577 other/unknown). Cox models were used to estimate multivariable-adjusted HRs between lifetime ovulatory cycles (LOC) and its components and ovarian cancer risk overall and by histotype. Women in the 90th percentile of LOC (>514 cycles) were almost twice as likely to be diagnosed with ovarian cancer than women in the 10th percentile (<294) [HR (95% confidence interval): 1.92 (1.60-2.30)]. Risk increased 14% per 5-year increase in LOC (60 cycles) [(1.10-1.17)]; this association remained after adjustment for LOC components: number of pregnancies and oral contraceptive use [1.08 (1.04-1.12)]. The association varied by histotype, with increased risk of serous [1.13 (1.09-1.17)], endometrioid [1.20 (1.10-1.32)], and clear cell [1.37 (1.18-1.58)], but not mucinous [0.99 (0.88-1.10), P-heterogeneity = 0.01] tumors. Heterogeneity across histotypes was reduced [P-heterogeneity = 0.15] with adjustment for LOC components [1.08 serous, 1.11 endometrioid, 1.26 clear cell, 0.94 mucinous]. Although the 10-year absolute risk of ovarian cancer is small, it roughly doubles as the number of LOC rises from approximately 300 to 500. The consistency and linearity of effects strongly support the hypothesis that each ovulation leads to small increases in the risk of most ovarian cancers, a risk that cumulates through life, suggesting this as an important area for identifying intervention strategies. SIGNIFICANCE: Although ovarian cancer is rare, risk of most ovarian cancers doubles as the number of lifetime ovulatory cycles increases from approximately 300 to 500. Thus, identifying an important area for cancer prevention research.

Corrigendum] Novel polygodial analogs P3 and P27: Efficacious therapeutic agents disrupting mitochondrial function in oral squamous cell carcinoma.

After the publication of the above article, the authors have realized that they failed to properly acknowledge the work performed by their Center for Innovative Drug Discovery High Throughput Screening Core Facility in the paper. The Declarations section of their paper should therefore have also included the following statement: "The UT Health San Antonio Center for Innovative Drug Discovery HTS Facility was funded in part by the Cancer Prevention Research Institute of Texas (CPRIT; grant no.RP160844)". The authors regret their oversight in failing to include this information in the Declarations section of their paper. [the original article was published in International Journal of Oncology 53: 2627-2636, 2018; DOI: 10.3892/ijo.2018.4585].

Radial Profile Analysis of Epithelial Polarity in Breast Acini: A Tool for Primary (Breast) Cancer Prevention.

Preventing cancer is vastly better than treating the disease in terms of a patient's quality of life and healthcare costs. Yet, to screen for chemopreventative drugs or evaluate interventions aimed at lowering cancer risk, quantitative readouts of risk are needed. In the breast and in other organs of epithelial origin, apical-basal polarity is key to homeostasis and is one of the first tissue characteristics lost during cancer initiation. Therefore, apical-basal polarity may be leveraged as an “architectural” determinant of cancer risk. A classic approach to quantify the localization of epithelial polarity markers is visual scoring at the microscope by trained investigators. This approach is time-intensive and limited to low throughput. To increase the speed, accuracy, and scoring volume, we developed an algorithm that essentially replaces the human eye to objectively quantify epithelial polarity in microscopy images of breast glandular units (acini). Acini in culture are identified based on a nuclear stain and the corresponding masks are divided into concentric terraces of equal width. This positional information is used to calculate radial intensity profiles (RP) of polarity markers. Profiles with a steep slope represent polarized structures, whereas more horizontal curves are indicative of non-polarized acini. To compare treatment effects, RP curves are integrated into summary values of polarity. We envision applications of this method for primary cancer prevention research with acini organoids, specifically (1) to screen for chemoprevention drugs, (2) for toxicological assessment of suspected carcinogens and pharmacological hit compounds, and (3) for personalized evaluation of cancer risk and risk-reducing interventions. The RadialProfiler algorithm developed for the MATLAB computing environment and for users without prior informatics knowledge is publicly available on the Open Science Framework (OSF).

Putting Evidence Academies into action: Prostate cancer, nutrition, and tobacco control science

A well-documented challenge in moving public health research into practice is the extended time it takes to implement findings in clinical practice and communities. The Evidence Academy model (Rohweder et al., 2016), developed and first used in North Carolina, is a pragmatic, action-oriented model that aims to shorten this timeline by communicating cutting-edge findings directly to those who can use them and convening individuals working in a single topic area to network and plan activities for the future. The University of Pennsylvania Collaborating Center of the Cancer Prevention and Control Research Network (CPCRN) held three conferences based on the Evidence Academy model: one about prostate cancer in 2015, a second on food access and obesity prevention in 2017, and a third about tobacco control science in 2018. A diverse planning committee of stakeholders helped shape the content, focus,and format of each conference. Local and national experts presented findings to regional audiences of researchers, practitioners, government leaders, and community members. Each Evidence Academy included collaborators and speakers from other Prevention Research Centers (PRCs) and CPCRN network sites. Evaluations and outcomes indicated that the events were successful in achieving their goals and fostered ongoing relationships among attendees. This paper illustrates how the Evidence Academy model was used in a different region and describes lessons learned and follow-up activities that were initiated via the Evidence Academy and with input from participants. Lessons learned may be helpful in developing and evaluating future adaptations of the Evidence Academy model and/or the effectiveness of its components.

Advancing the use of organization theory in implementation science

Healthcare settings and systems have been slow to adopt and implement many effective cancer prevention and control interventions. Understanding the factors that determine successful implementation is essential to accelerating the translation of effective interventions into practice. Many scholars have studied the determinants of implementation, and much of this research has been guided by the Consolidated Framework for Implementation Research (CFIR). The CFIR categorizes implementation determinants at five levels (characteristics of the intervention, inner setting, individual, processes, and outer setting). Of these five levels, determinants at the level of the outer setting are the least developed. Extensive research in fields other than healthcare suggest that determinants at the level of the outer setting (e.g., funding streams, contracting practices, and public policy) play a central role in shaping when and how an organization implements new structures and practices. Thus, a more comprehensive understanding of outer-setting determinants is critical to efforts to accelerate the implementation of effective cancer control interventions. The Cancer Prevention and Control Research Network (CPCRN) created a cross-center workgroup to review organizational theories and begin to contribute to the creation of a future framework of constructs related to outer setting determinants. In this paper, we report findings from the review of three organizational theories: Institutional Theory, Transaction Cost Economics, and Contingency Theory. To demonstrate the applicability of this work to implementation science and practice, we have applied findings to three case studies of CPCRN researchers' efforts to implement colorectal cancer screening interventions in Federally Qualified Health Centers.

An application of the Science Impact Framework to the Cancer Prevention and Control Research Network from 2014-2018

The Cancer Prevention and Control Research Network (CPCRN) is a strategic collaborative effort focused on accelerating the dissemination and implementation of evidence-based cancer prevention and control interventions to communities. In 2014, the CPCRN Coordinating Center began collecting information in alignment with the Centers for Disease Control and Prevention's (CDC) Science Impact Framework. The Science Impact Framework is a CDC-developed approach to trace and link CDC science to events and/or actions recognized as influential to public health, beyond peer-reviewed publications. The purpose of this paper is to highlight the impact of CPCRN activities using key indicators guided by the CDC's Science Impact Framework. We reviewed annual progress reports submitted by CPCRN centers from 2014 to 2019 to identify the impact indicators. The CPCRN activities were linked to four domains from the Science Impact Framework and its key indicators: Disseminating Science (presentations, training, general communication, and other communication reports), Creating Awareness (requests for expertise, and feedback), Catalyzing Action (grant applications, partnerships and collaborations, research & development, advocacy groups, office practice/point of care changes, and technology creating), and Effecting Change (building public health practice, creation of registries/surveillance, legal/policy changes, and change instilled). Overall, CPCRN activities demonstrate impact beyond peer-reviewed publications and thus should continue building scientific impact to ultimately influence health outcomes.

The Cancer Prevention and Control Research Network (CPCRN): Advancing public health and implementation science

The Cancer Prevention and Control Research Network (CPCRN) is one of the thematic networks of the United States' Centers for Disease Control and Prevention's (CDC) Prevention Research Centers. Network members are academic research centers in the United States who collaborate with public health and community partners to accelerate the use of evidence-based interventions in communities to reduce the burden of cancer, especially among underserved populations. CPCRN studies include geographically dispersed populations, cross-institution partnerships, and opportunities for collaborative learning across network centers. Since its inception in 2002, CPCRN has worked to translate research on community-based intervention strategies into practice to improve cancer screening and reduce cancer risk. This commentary describes CPCRN's role in contributing to public health and the field of dissemination and implementation science. In addition, CDC and the National Cancer Institute describe how their joint support of the network contributes to each organization's goals and missions.

Abstract 4185: Establishing sustainable research collaborations in the Caribbean through the utilization of multiple technology platforms

Abstract Introduction: International research collaborations are a critical strategy in tackling immigrant and global prevention and control challenges. Available communications and data technology facilitates collaborations to address global cancer inequities. The purpose of the African Caribbean Cancer Consortium (AC3) is to develop and sustain partnerships to investigate and respond to the increasing cancer vulnerability among African descended peoples worldwide. In the Caribbean, cancer incidence and mortality are rising in persons of African ancestry. We will present preliminary outcomes from our NCI-P20 award. Methods: Our goal is to establish a Caribbean Regional Center of Research Excellence (CRCRE). The project started in Jamaica in partnership with the University of the West Indies-Mona. The CRCRE is building a sustainable research center at the Mona campus that will spread to other campuses throughout the University system. Using ZOOM, WhatsApp, YouTube, GoogleDocs, and REDCap, we will develop a sustainable research infrastructure in the Caribbean. Results: Regional Needs Assessment- Using REDCap, we were able to conduct a research needs assessment across the Caribbean. A survey was developed by the research team and administered within the Mona campus and Caribbean-wide through the AC3 member listserv. We had over 150 respondents representing key stakeholders who identified top priorities to develop sustainable research in the region. The REDCap database for the CRCRE will also house training webinars readily available for users. Mentor-Mentee Program was implemented to match junior faculty in the Caribbean to senior faculty within the AC3 network. Among Caribbean researchers, we are building capacity for basic, translational, clinical and behavioral research. Mentors and mentees will utilize ZOOM, e-mail, Googledocs, WhatsApp and YouTube to facilitate training, mentoring and study processes. Genetic Counseling Training was conducted between genetic counselors at Fox Chase Cancer Center (FCCC) and 3 Caribbean nurses based at Princess Margaret Hospital, Nassau, Bahamas. Nurses received virtual training via NCCN and ZOOM lectures. Nurses then shadowed FCCC genetic counselors. They will utilize ZOOM, WhatsApp and YouTube to facilitate ongoing training, mentoring, and supervision. Discussion: Using communication and data technologies are effective and cost effective platforms for developing and sustaining international cancer prevention and control research in low and middle-income countries including the Caribbean. Caribbeans account for 10% of all immigrants and 50% of all immigrant Blacks. Therefore, attending to and addressing cancer biologic, genetic, environmental and behavioral risk and disparate outcomes among Caribbeans will benefit the Region as well as inform strategies to reduce cancer disparities within U.S. Black population. Citation Format: Elizabeth Blackman, Kimlin Tam Ashing, Camille Ragin, Marshall Tulloch-Reid, J. Robert Beck, Althea Bailey, Ian Hambilton, Natalie Guthrie-Dixon, Georgia Williamson, Andrea Forman, Robin Roberts. Establishing sustainable research collaborations in the Caribbean through the utilization of multiple technology platforms [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4185.

Parental knowledge gaps and barriers for children receiving human papillomavirus vaccine in the Rio Grande Valley of Texas

ABSTRACT Purpose: Despite its availability for more than a decade, the human papillomavirus (HPV) vaccine has low uptake in Texas (49%). The objective of this study was to understand parental knowledge and attitudes about HPV and the HPV vaccine as well as child experience with the HPV vaccine among a medically underserved, economically disadvantaged population. Methods: As part of a Cancer Prevention Research Institute of Texas-funded project to improve HPV vaccination rates, we surveyed parents / guardians of 4th–12th graders (ages 9–17) in the Rio Grande City Consolidated Independent School District (RGCCISD). Descriptive statistics were used to describe parents’ knowledge and attitude and children’s vaccine experience. Results: Of the 7,055 surveys distributed, 622 (8.8%) were returned. About 84% of the respondents were female. About 57.1% of the parents /guardians had female RGCCISD students with a mean age of 11.7 ± 1.8 years. Overall, 43.9% reported receiving a healthcare provider recommendation and 32.5% had their child vaccinated. Higher percentages were reported if the respondent was female and had a female child aged ≥15 years old. Among survey respondents, 28.2% reported their child initiated the HPV vaccine and 18.8% completed the series. Barriers of uptake included work / school schedule conflicts and no healthcare provider recommendation. Conclusions: There are still prominent gaps in parents’ and students’ complete understanding of HPV vaccination, gender preferences for vaccination, and provider recommendations. Future interventions must target men and minority populations in order to increase knowledge and awareness about HPV, the HPV vaccine, and HPV-associated cancers.