Community Outreach Research Articles

Abstract B098: Engagement of community advisory board in cancer biology, cancer therapeutics, cancer prevention and control and clinical research for decision making and priority setting

Abstract Background. Community involvement in decision-making ensures that the research addresses the real-world needs and concerns of the populations it aims to serve. Engaging community members helps researchers understand cultural nuances and barriers that might affect health behaviors and access to care. This awareness can guide the development of culturally competent strategies and communication; however, little is known how community voices are incorporated in cancer research. Methods. The Community Outreach and Engagement (COE) at Cedars Sinai Cancer Center (CSCC) developed a Community Advisory Board (CAB) with 24 community members from Korean, Filipino, Black, H/L, and LGBTQ+ communities and patients, survivors, and family members from the entire geographic of Los Angeles County (LAC), as well as 3 CAB sub-committees: 1) Community Scientists Committee; 2) Data Dissemination Committee; and 3) Trans and Non-Binary Research Advisory Committee (T-RAC), each of which meets 4-5 times a year. The CAB member selection strategy entailed inviting leaders, long-time organizers, cancer advocates, and policy experts in LAC. CAB and each sub-committees meet four times a year, and collaborates with CSCC leaders to jointly set priorities for research and outreach initiatives through discussions, follow-up surveys, and written reports. Results. Through CAB engagement, CSCC expanded priority cancers to include cervical and gastric cancers. CAB members are integrated into CSCC and collaborate on research initiatives—an engagement that has been transformative. For example, there has been system-wide impact on inclusive collection of LGBTQ+ data in outreach, research, clinical trials, and patient care, including a new LGBTQ+ focused clinic initially proposed by COE. The clinic is now in operation and serving members of the LGBTQ+ community. CAB volunteers are also engaged in scoring proposals for CSCC pilot developmental funds. They review clinical trial protocols, provide recommendations that inform approval or revocation to the Protocol Review and Monitoring Committee (PRMC), and meets regularly with Clinical Research, Cancer Clinical Trials Office (CCTO), and Principal Investigators who develop trials. To date, there have been 5 IIT protocols and 113 protocol reviews with COE and community input. Lastly, the Data Dissemination Committee ensures catchment data are disaggregated and provided back to marginalized communities through town halls (e.g., Filipino Town Hall, Out Against Tobacco Town Hall), training (e.g., Learning Collaborative: LGBTQ+ Communities and Tobacco Use), and reports to inform media and elected officials. Conclusion. The active engagement of community members in decision making in cancer research has led to more inclusive, culturally competent, and impactful research and outreach initiatives, enhancing the relevance and impact of cancer research across diverse populations. Citation Format: Zul Surani, Alexandra Caro, Richard Zaldivar, Ghecemy Lopez, Lourdes Barajas, Reener Balingit. Engagement of community advisory board in cancer biology, cancer therapeutics, cancer prevention and control and clinical research for decision making and priority setting [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B098.

Abstract B035: Mayo Clinic Cancer Comprehensive Center Community Outreach and Engagement Internal Medicine Residents Rotations

Abstract Introduction: The Community Engagement Internal Medicine Residents Rotation (IMRR) connects Mayo Clinic Florida (MCF) medical professionals to partners in the Florida catchment area to better understand administrative operations, the referral processes of these organizations and how best they fit the needs of the communities they serve. The goal is to give residents exposure to a more diverse population including rural, Black and Hispanic/Latin as well as connecting them with partners where community- based research is conducted. This IMRR is also designed to encourage cancer-focused community based research (CBR). We learned that the lack of patient diversity at MCF was a drawback to resident recruitment and developing an interest in cancer focused health disparities research. We agreed to assist in this potential solution to the diversity deficit. Methods: The goal for the elective is to provide senior residents with an introduction to community engagement and cancer focused community engaged research. The elective consists of one week of didactics and one of experiential learning. The first week includes an introduction to cancer health disparities in our catchment areas and how to conduct cancer focused CBR. During the second week, residents interact with community partners focused on providing care and cancer education to those who otherwise may not have access to resources. Strategically, these partners are those with whom we are engaged in cancer research initiatives. Internal Medicine Residents (IMR) complete visitation paperwork that included Background Screenings and Sovereign Immunity Contracts. We limit the number of IMR to two in order to accommodate some of the smaller community clinic spaces. IMR visit community partners for no less than a half day each and at the end of the rotation they debrief and complete rotation evaluations. Data: Rotation evaluations aggregated to date indicate 91.67% of IMR feel the rotation meets the goals and objectives. In addition, evaluation comments indicate an improved understanding of population health as well as community resources for improved health and wellness in underserved populations. Anecdotal comments also show evidence of increased understanding of cancer focused CBR and cancer related health disparities. Conclusion: IMMR through community outreach and engagement visits have increased understanding of how partners address varying cancer burden needs. The IMRR has increased residents’ awareness of how environment impacts access to healthcare and improved cost-conscious ordering and treatment plans (medications). IMR better understand the significance of how social determinants of health (SDOH) resources impact community. IMR are better equipped to help patients and their families navigate to additional SDOH solutions and are familiar with the referral process for community safety net resources. The offer of this type of IMRR has enhanced recruitment to MCF training programs and significantly increased IM and fellow participation in cancer focused CBR initiatives and studies. Citation Format: Monica Albertie, Chelsea Reeves, Noreen Stephenson, Folakemi Odedina. Mayo Clinic Cancer Comprehensive Center Community Outreach and Engagement Internal Medicine Residents Rotations [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B035.

Abstract B174: A unique partnership between the Office of Military Affiliated Communities and the UChicago Cancer Center leads to career pathways in clinical research

Abstract Background: The Clinical Trials Support Office (CTSO) priority is to recruit diverse individuals who are highly motivated and aligned with our cancer center mission and vision. Due to the competitive market, rates of internal staff turnover, and growing demand for clinical research professionals, the CTSO needed to find new ways to recruit talent but also look for ways to enhance workforce diversity. Goals: Increase exposure and skill building for clinical research jobs by identifying new populations with translatable skills. Create training and education pipelines (leveraging Community Outreach and Engagement (COE), Cancer Research Training Education Coordination (CRTEC), and Plans to Enhance Diversity (PED) to identify and hire the next generation of clinical research professionals. Hire, train, and retain a diverse, equitable, and inclusive CTSO team. Methods: The University Provost’s Equal Opportunity Programs launched the Department of Defense (DoD) SkillBridge Program through the Office for Military-Affiliated Communities (OMAC). This program connects servicemembers and spouses to partners who provide civilian work experience through specific industry training, apprenticeships, or internships during the last 180 days of military service with the goal of easing the transition to civilian careers. Many veterans, transitioning servicemembers and their spouses have experience in operations and logistics or have served as medical professionals in the military. We knew these diverse skills could qualify them for career opportunities within the field of clinical research which led to a partnership between the CTSO and OMAC. Through this unique partnership, the CTSO worked with OMAC to connect these individuals with opportunities in the clinical research space. This collaboration allows the CTSO to provide military servicemembers (and their spouses) with internship opportunities or a full-time position in clinical research roles. Outcomes: Since the launch of the OMAC partnership, 6 candidates (5 servicemembers, 1 spouse) were selected to take part in the CTSO internship program. Internships spanned across data management (2), clinical research coordination (1), regulatory (2), and finance (1). We successfully converted 5 of the 6 interns to direct hires and the CTSO is recruiting additional interns this year. Lessons Learned: This pilot partnership highlights the transferable skills of highly trained servicemembers. Essential skills for complex oncology trials include performing under pressure, accountability, adherence to protocols, health and safety awareness, leadership, teamwork, and integrity. The CTSO benefited from engaging skilled interns and was able to create a pipeline in the saturated Chicago job market. According to OMAC, transitioning from military service poses challenges for servicemembers and their families, including housing, food insecurities, and employment. This partnership allows servicemembers to ease transitional challenges, gain work experience, and get a head start on their next career after military service. Citation Format: Lauren Wall, Aspen Ward, Terrell Odom, Amanda Spratt, Sara Moellering, Camilla Frost-Brewer, Kristen Kipping-Johnson, Eileen Dolan, Russell Szmulewitz. A unique partnership between the Office of Military Affiliated Communities and the UChicago Cancer Center leads to career pathways in clinical research [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B174.

Abstract B036: Native American cancer prevention outreach strategies: Approaches developed for outreach teams working with Native Nations and Native American urban communities

Abstract Community-directed outreach activities developed to provide cancer education and/or to promote cancer screening are quite varied and difficult to evaluate. The published literature offers few recent descriptions of cancer education efforts or interventions designed to enhance awareness of cancer risks or screening recommendations for specific underserved populations, e.g., Native Americans. Furthermore, the National Institute of Health’s guidance for Community Outreach Cores provided in Funding Opportunities for Center awards, is brief and offers few parameters and examples. This brevity is most evident in comparison with the lengthy descriptions provided for Research and Education Cores. This elusive language may be purposeful, recognizing the diversity of communities and technical assistance needed by research teams. The challenge, Outreach Cores use quite different approaches and generally do not share effective strategies that could be tested with other communities. The Outreach Core of the National Cancer Institute funded Native American Cancer Prevention Partnership (NACP), has employed several innovative strategies in the 2019-2024 funding period. To encourage increased national dialogue about culturally appropriate cancer-related outreach with underserved communities and outreach support for research teams, two strategies of the NACP Outreach Core are described. The intention is to contribute to the limited outreach literature and to inspire emerging or existing cores developing plans for engaging underserved communities and/or supporting research teams involved in community-based work. One NACP approach involves the development of a podcast series to provide cancer-related education and personal stories specifically by public health practitioners, health care providers and Native American patients, for Native American audiences. The second approach was designed to enhance research teams’ skills in reporting their activities and outcomes with communities. The Community Dissemination and Application Training (C-DAT) was developed to improve institutional and investigator capacity to conduct respectful research and share relevant research findings with Native American communities. C-DAT was supplemented with a Directory for Reaching Relatives Using Media (DRRUM), that contributes to investigators’ knowledge of dissemination venues used in Native American communities The DRRUM provides contacts and additional information on regional Native Nations or Native serving social media platforms/groups and tribal radio stations. NACP’s outreach activities are shared in an effort to initiate a Best Practices Inventory upon which outreach cores and interventions could draw. Unfortunately, evaluation continues to be a challenge, and is generally limited to reach and does not address impact. Citation Format: Nicolette Teufel-Shone, Carol Goldtooth-Begay. Native American cancer prevention outreach strategies: Approaches developed for outreach teams working with Native Nations and Native American urban communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B036.

Abstract A110: The CaRE2 health equity center Contact Registry: Engaging underrepresented community participants in cancer research

Abstract Background: One of the most common barriers in community participant engagement in cancer research is lack of information, and at times, not being invited to participate. Contact Registries serve as a valuable tool to address this challenge, as they connect community members with cancer health research opportunities. Potential participants can choose to participate in studies they find of interest and are prime candidates for. The Florida-California Cancer Research, Education, and Engagement (CaRE2) Health Equity Center, Community Outreach Core (COC), developed a contact registry designed to engage Black/African American (B/AA) and/or Hispanic/Latinos/a (H/L) individuals in ongoing research studies conducted across our bicoastal center institutions which includes the University of Southern California Norris Comprehensive Cancer Center, the University of Florida, and the Florida Agricultural & Mechanical University. The CaRE2 Contact Registry was implemented in August 2022 by the CaRE2 COC, with the primary objective to increase the number of underrepresented minority individuals participating in cancer research. Methods: Individuals are recruited into the registry utilizing both in-person and online methods. Information is provided in English and Spanish, and data is stored on REDCap. For in-person enrollment, a consent form and OPT-IN survey is completed; our online recruitment utilizes additional screening questions to ensure eligibility. The COC in Florida and Los Angeles promote the registry at local community events and through social media accounts and website (https://care2healthequitycenter.org/the-care2-contact-registry/). A $10.00 physical or electronic gift card is provided as compensation. Results: As of April 30th, 2024, 1,328 individuals have enrolled in the Registry, with participants from FL (887 = 69.5%) and CA (389 = 30.5%); with 737 participants being B/AA (57.8%), 506 H/L (39.7%), 26 non-Hispanic White (2.0%), and 6 individuals self-identified as other race/ethnicity (0.5%). We enrolled 873 female (68.5%) and 402 male (31.5%) participants. A total of 90.4% of enrollees are willing to participate in health research involving surveys, 23% in health research studies requiring saliva (24.1%), hair (23.4%), or blood (22%) sample donations. When registrants were asked for future research interest 99.9% responded Yes. Conclusion: Community participants have a high interest in engaging in research studies regardless of race/ethnicity if its via surveys, attending focus groups, and/or joining community forums. There is greater hesitancy when asked to provide biospecimens (blood, hair or saliva). Mechanisms to understand the reasons for this hesitancy, and address them, to appropriately incentivize individuals about donation of biospecimens are needed. Community efforts that connect potential enrollees to cancer studies of interest can support increased participation in cancer research among B/AA and H/L communities. Citation Format: Carolina Aristizabal, Eduardo Ibarra, Fern Webb, IIeana Guzman, Brooke Hensel, John Luque, Rosa Barahona, Diana Wilkie, Mariana C Stern, Sandra Suther, Lourdes Baezconde-Garbanati. The CaREhealth equity center Contact Registry: Engaging underrepresented community participants in cancer research [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A110.

Abstract A160: Navigating underserved populations across the cancer continuum: Establishing cancer support and navigation project

Abstract Background. Cancer disproportionately affects underserved communities, including those who face economic, racial, ethnic, and social barriers. These barriers contribute to delays in diagnosis and treatment, resulting in poorer outcomes. Methods. To address this gap, Cedars Sinai Cancer Center Community Outreach and Engagement (COE) has developed the Cancer Support and Navigation Project to improve cancer-related outcomes for underserved cancer patients by providing navigation that eliminates barriers to timely diagnosis and treatment of cancer. The project focuses on reducing barriers for underrepresented sexual, gender, financial, racial, and ethnic minority community members, who are either at risk of being diagnosed with cancer or those have already been diagnosed with cancer, and their loved ones, by offering tailored science-based cancer information, education, navigation, support resources, access to care and cancer support. Our project is targeting geographic areas and groups within the Los Angeles County (Catchment Area) that experience higher incidence of late-stage diagnosis such Latinx, LGBTQ+, Korean, Filipino, Black and immigrant communities. Our COE team has 3 dedicated navigators who are multi-ethnic, multi-lingual, and representative of populations with intersectional identities to provide direct services to community members. Additionally, our COE team has recruited, trained and engaged over 42 community health workers/promotoras/navigators from the community to disseminate cancer health information and navigate people through the cancer continuum. Results. We have disseminated over 1000 flyers and participated in over 100 tabling events throughout Los Angeles County. Additionally, we have developed partnership with various Federally Qualified Health Clinics, including Adventist Health White Memorial Hospital, Central Neighborhood Christian Health Center, Comprehensive Community Health Centers, Saban Community Clinic, Koryo Health Foundation. To date, COE has navigated n=733, who predominantly identify as Hispanic/Latino/a/e/x, Koreans, and LGBTQ+. Most have identified the following areas for navigation: assistance with medial-related care such as cancer screening, diagnosis, or treatment, financial, language barrier, food security and nutrition, insurance coverage, emotional/relationship, social support/isolation, mental health, behavioral, or stress, transportation, housing, and many others. Conclusion. The project's efforts have highlighted the critical importance of providing targeted navigation services to reduce cancer disparities and improve health outcomes for underserved communities. By addressing the unique needs of these populations and eliminating barriers to care, the Cancer Support and Navigation Project at Cedars Sinai Cancer Center COE has made a substantial and positive impact on the lives of many individuals and their families, paving the way for more equitable cancer care and support. Citation Format: Janeth Zelada, Emma Ngula, Min Jung Sung, Ghecemy Lopez, Reener Balingit, Zul Surani. Navigating underserved populations across the cancer continuum: Establishing cancer support and navigation project [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A160.

Abstract B002: Cancer health equity and research advocacy program among immigrant communities

Abstract Introduction: In an effort to ensure an all-inclusive initiative that would close the disparity gap among the immigrant communities in Florida, we developed a pilot project under the Inclusive Cancer Care Research Equity (iCCaRE) for Black Men Consortium with generous support from the Mayo Clinic Comprehensive Cancer Center (MCCCC). The objective is to train cancer advocates to engage their communities and develop and implement cancer prevention and screening navigation programs. The central hypothesis for this program is that community-driven cancer advocacy will significantly improve cancer awareness, knowledge, prevention, risk reduction, screening uptake, and early detection among Black immigrants. Methods: We collaborated with immigrant communities’ leaders to brainstorm on the current state of healthcare access and disparities experienced by Black immigrants and to set program and research priorities through listening sessions. Cancer advocates were trained to engage their communities to (1) develop and implement cancer risk reduction and education programs using train-the-trainer approach, (2) mobilize the resources within the community for cancer health promotion, prevention, and screening strategies, (3) partner with key stakeholders to accomplish targeted objectives; (4) raise funds to support advocacy activities; and (5) develop and successfully organize community-centered programs. Results: We are currently working with 10 Black immigrant organizations, including immigrant churches across different ethnicities, including Nigeria, Ghana, Cameroon, Liberia, South Africa, Haiti, Jamaica, and across different cities in the United States. Eighteen community cancer advocates, including breast and prostate cancer survivors, caregivers, and community influencers, were trained to engage the immigrant communities in cancer risk reduction and research in Florida using multiple channels, including in-person community programs and online engagement approaches. We have engaged 720 immigrants in cancer risk reduction education and the need to participate in research during advocate-led in-person community outreaches. We currently have 26 immigrants who have volunteered in the Mayo Clinic Community Research Registry. The program is ongoing, and we anticipate that more than 750 will be engaged, and 100 will volunteer to be registered in the Mayo Clinic Community Research Registry. Conclusion: Advocate-led advocacy in immigrant communities will provide evidence for compelling arguments about the feasibility and availability of the Black immigrant population for robust and sustainable research and program engagements to eliminate disparity and advance cancer health equity. Citation Format: Opeyemi O. Bolajoko, Caleb Ramirez, Shannon Pressey, Noreen A. Stephenson, Vinessa A. Gordon, Binta Onyibe, Kingsley Efe, Austin Okaiwele, Mubo Oloruntobo, Brittany M. Norris, Folakemi T. Odedina. Cancer health equity and research advocacy program among immigrant communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B002.

Abstract B060: Bridging gaps in cancer care: Evaluating community health worker presence in Alabama on rates of cancer screening and lifestyle-related outcomes

Abstract Purpose Alabama has the 7th highest cancer mortality in the US. The University of Alabama at Birmingham O’Neal Comprehensive Cancer Center—the only NCI-designated comprehensive cancer center in the state—endeavors to reduce cancer mortality and burden. For 25 years, its Office of Community Outreach and Engagement (OCOE) has applied a community health worker (CHW) outreach and engagement model for cancer awareness, navigation to screening and healthy lifestyle promotion. OCOE hired and trained CHWs to provide services in counties with highest cancer burden. CHW presence fluctuated over time due to grant-funding and other extraneous events. This study evaluates the association of CHW presence with cancer screening and lifestyle-related outcomes. Methods We utilized latest CDC PLACES data (drawn from 2018 and 2020 Behavioral Risk Factor Surveillance System) which provides model-based, population-level age-adjusted prevalence estimates of county-level cancer screening (breast, cervical, colon) and lifestyle outcomes (physical inactivity, obesity, smoking). We evaluated change in rates over time between counties with and without CHW presence using linear mixed effects models. Results Compared to counties without CHW presence, those with CHW presence in 2020 had 0.7% higher mammography rate in 2018 (95% CI: -0.8, 2.3) and 0% difference in mammography rate per year change (95% CI: -0.6, 0.7); counties with CHW presence in both years had 2.8% higher mammography rate (95% CI: 1.1, 4.6) and 0.2% faster increase in mammography rate per year (95% CI: -0.5, 1.0). Counties with CHW presence in both 2018 and 2020 had 1.8% lower rate of colon cancer screening in 2018 (95% CI: -3.6, 0.02) and 1.3% increase in colon cancer screening per year (95% CI: 0.5, 2.1). Counties with CHW presence in 2020 had 1% higher physical inactivity rate in 2018 (95% CI: -2.3, 4.3) and 0.3% faster decrease in physical inactivity rate per year (95% CI: -1.0, 0.4); counties with CHW presence in both years had 3.6% higher physical inactivity rate in 2018 and 0.2% faster decrease in physical inactivity rate per year (95% CI: -0.8, 0.5). Counties with CHW presence in 2020 only had 1.8% higher obesity rate in 2018 (95% CI: -1.7, 5.2) and 0.9% faster decline in obesity rate per year (95% CI: -2.2, 0.4); counties with CHW presence in both years had 5.1% higher obesity rate in 2018 (95% CI: 1.9, 8.3) and 0.3% faster decline in obesity rate per year (95% CI: -1.6, 0.9). There were no statistically significant differences for cervical cancer screening or smoking. Conclusion The OCOE CHW model provided access, education and empowerment for AL residents to obtain cancer screenings and participate in healthy lifestyle behaviors. CHW presence (particularly sustained presence over time) was associated with improved mammography and colon cancer screening, reduced physical inactivity and reduced obesity. Further study of CHW presence and these outcomes during and post COVID-19 is ongoing. Expansion of the CHW model across the entire state is a priority to reduce cancer mortality among Alabamians. Citation Format: Mackenzie E. Fowler, Claudia Hardy, Silvia Gisiger-Camata, Francine Walton, Rochelle Wallace, Tara Bowman, Aldenise P. Ewing, Timiya S. Nolan. Bridging gaps in cancer care: Evaluating community health worker presence in Alabama on rates of cancer screening and lifestyle-related outcomes [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B060.

Abstract C007: Building capacity in health clinics and community organizations serving LGBTQ+ communities on tobacco prevention

Abstract Background. Tobacco use remains a significant public health issue, particularly among the LGBTQ+ community. Los Angeles County, which is home to the second-largest LGBTQ+ population in the US, has notably higher prevalence of tobacco use compared to the general population, partly due to targeted marketing by the tobacco industry, social stressors, and discrimination. These factors contribute to higher rates of smoking and tobacco-related health disparities; however, little is known about the capacity of community-based organizations, clinical providers, support staff, and other personnel that work closely with the LGBTQ+ community to provide smoking cessation services. Methods. Cedars Sinai Cancer Center Community Outreach and Engagement (COE) assisted in the facilitation of conducting a needs assessment, Clinical Provider and Staff Survey, to assess the opinions of clinical providers and community leaders about tobacco cessation-related topics related to 1) Building culturally competent tobacco cessation services; 2) Reducing health disparities in tobacco cessation services; 3) Improving access to care (Medicaid/Medi-Cal access and uptake) for diverse populations that are affected by tobacco-related disparities; 4) Improving the utilization of tobacco cessation services. The survey was administered online from December 2022 to April 2023 with providers throughout Los Angeles County. Results. A total of 261 surveys were collected which revealed several key issues at the organization level: they do not prioritize tobacco screening, treatment, or referrals; there is no standardized process for client management; staff have limited knowledge on tobacco prevention and patient navigation; and there is limited staff capacity and funding. To address organizational-focused barriers, COE trained 147 clinical providers and staff from 4 local health clinics and organizations and on capacity building, including the basics of tobacco, evidence-based interventions like "Ask, Advice, Refer," and lung cancer screening. Additionally, to address Client/Patient-Focused Barriers for Organizations, such as: lack of motivation to quit, low perception of the severity of smoking, and a lack of culturally competent or targeted cessation resources, COE staff assisted in navigating resources, ensuring both providers and clients were aware of and could access relevant support services. This involved sharing LGBTQ+ affirming resources, including medical care, behavioral health, and housing, and referred smokers to gender-affirming cessation support groups. Conclusion. The survey highlighted the need to enhance service delivery and support for the LGBTQ+ community. With these findings, our COE staff were able to increase organizational capacity through training and education for clinical providers and staff to enhance their knowledge and skills in tobacco cessation and share gender-affirming resources and navigation, which are crucial towards improving the overall effectiveness of tobacco cessation services for LGBTQ+ populations. Citation Format: Victor Cristanto, Alexandra Caro, Reener Balingit, Zul Surani. Building capacity in health clinics and community organizations serving LGBTQ+ communities on tobacco prevention [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C007.

Abstract C006: Understanding barriers to low HPV vaccination in the LGBTQ+ community in Los Angeles: Collecting neighborhood-level data at pride events

Abstract Background The uptake of the Human Papillomavirus vaccine and anal cancer screening remain low among LGBTQ+ communities, especially in Los Angeles County. The LA metropolitan area has the nation’s second largest LGBTQA+ community, with an estimated 523,000 persons representing intersectional identities including the racial and ethnic diversity within lesbian, gay, bisexual, transgender, non-binary and questioning. Significant barriers to vaccination and screening exist, including inadequate knowledge, reluctance to disclose personal information, fear of a cancer diagnosis, and conflicting messages. Methods Cedars Sinai Cancer Center Community Outreach and Engagement (COE) created the Transgender Research Advisory Committee (T-RAC), a subcommittee of our Community Advisory Board, and facilitated bi-directional engagement with the research team to ensure that voices of the community were included in each phase of designing an intervention to increase HPV vaccination. T-RAC has n=8 members representing LGBTQ+ patients, advocates, and community navigators and their roles include: (1) weigh in on all materials development for community audiences, recruitment and research implementation strategies; (2) review the progress of study; (3) provide guidance on developments in the community; (4) contribute to interpretation of study findings; and (5) participate in dissemination of study findings. Results With T-RAC’s advice, a needs assessment survey was developed, and data was collected at Long Beach Pride on May 2024 with N=205 survey respondents. While 82% have heard about HPV, only 48% were vaccinated with at least one dose and only 12% completed all three doses. Among those who have not completed the HPV vaccine series (n=177), 33% are in interested in getting the vaccine, 55% prefer a mobile health clinic, and 70% would be vaccinated at Pride events. Qualitative responses indicated the following barriers to getting screened: “not ready”, “need more information”, “prefer a health provider”, and “unsure about side effects”. For those interested, a mobile health clinic was available during Pride event and N=16 people were vaccinated. Conclusion More outreach, education and engagement are needed to address barriers and low uptake of the HPV vaccine among LGBTQ+. Further, this initiative has led to the application for Research Program Project Grants (P01) and plans to launch a health education initiative, EndHPV, along with continuing to make mobile health clinics available at Pride events throughout Los Angeles County. The role of T-RAC has been instrumental in catalyzing gender-affirming interventions that directly address the unique needs and challenges faced by the LGBTQ+ community and promote equitable access to services for all. Citation Format: Alex Caro, Victor Cristanto, Richard Zaldivar, Marc Goodman, Reener Balingit, Zul Surani. Understanding barriers to low HPV vaccination in the LGBTQ+ community in Los Angeles: Collecting neighborhood-level data at pride events [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C006.

Rabies, The Administration of Vaccines and Public Health Concern, Neglected Challenges and Historical Perspective in China

Rabies virus is transmitted via contact of saliva of a rabid animal with a person ,s mucosa or a skin lesion. It is a fatal encephalomyelitis caused by members of expanding Lyssavirus genus, and the genus included 17 species. The aim of this literature review is to survey on rabies and vaccination in China, threats and challenges to eliminate it, especially in China. The information provided is obtained from randomized control experiments, review articles, and analytical observations and studies which were gathered from various literature sources such as Scopus, Google Scholar, PubMed, and Science Direct. The keywords were dogs, glycoprotein, lyssavirus, post-exposure prophylaxis, and rabies virus. Rabies virus is a bullet shaped enveloped virion, and the classical rabies virus and its field strains are discovered worldwide and induces to rabies in animals and humans. In recent years, China has made wonderful and significant achievements in rabies prevention and control, and currently, the mortality and incidence rate of human infection with rabies have decreased to the minimum level historically, which has caused a notable foundation for the ultimate elimination of human rabies. Generally, five proteins are available in mature rabies virus particles, phosphoprotein, nucleoprotein, glycoprotein, matrix protein, and RNA-dependent RNA polymerase. The main carriers of rabies in China are dogs which are accountable for most of the human rabies deaths in China. Most common way of entry of rabies virus into the body is both via infected neural tissue through open cuts in the skin and salvia. The most notable parameters which limit rabies vaccinations are limited laboratory-based surveillance, diminished community outreach and education, underestimation of the population at risk, irregular vaccine applications in space and time, inaccessible naïve free-ranging dogs, exclusion of puppies, cold chain failure, translocation of cases, effect of other species, including cats, wildlife, and livestock, accessibility to remote hotspots, competing priorities, lack of adequate resources, impact of poverty on responsible social ownership and routine animal health care, cultural disparities, Sisyphean fatigue, frustration and staff burn-out. Rabies remain a public health problem and continue to present health risks for both animals and human; It is important to improve access to PEP in endemic countries where human rabies deaths still happen, but the big problem is its costs that should be curtailed and surveillance strengthened for controlling and eliminating it.

Prototype Facial Response to Cute Stimuli: Expression and Recognition.

Cute, kindchenschema stimuli can evoke a suite of cognitive, physiological, and behavioral tendencies thought to promote caregiving. This research investigated facial expression elements associated with this response to cuteness and assessed the recognizability of an expression combining these elements. In Studies 1 and 2, participants at a community outreach event (Study 1, n = 19) and undergraduate students (Study 2, n = 103) showed spontaneous facial displays while watching videos/photos of baby humans and animals. These were Facial Action Coding System (FACS)-coded, revealing characteristic and statistically distinctive action unit elements of facial expression responses to cuteness. In six follow-up online studies (combined N = 962), including replications with Syrian refugees (n = 103) and Chinese samples (n = 222), a "cuteness prototype" expression combining all elements identified across Studies 1 and 2 (i.e., oblique brows, chin raise, lip tightening, and Duchenne smile) was commonly interpreted as a response to cuteness. These findings add to a growing literature about caregiving-focused motivational states and associated emotion/affect.

Public Libraries Encouraged to Meet the Health Information Needs of Tribal Women in Bangladesh

A Review of: Yesmin, S., Abdul Karim, M., & Atikuzzaman, M. (2023). Community engagement of public libraries for ensuring tribal women’s health literacy in Bangladesh. IFLA Journal, 49(4), 678–693. https://doi.org/10.1177/03400352231198260 Objective – To investigate public libraries’ existing community engagement practices, explore their willingness to provide health information services to tribal communities in Bangladesh, and examine tribal women’s health information-seeking behavior and interest in obtaining health information from public libraries. Design – A cross-sectional study using online interviews and structured questionnaires. Setting – Public libraries and tribal communities in tribal regions of Bangladesh. Subjects – Public librarians (n=11) and tribal women (n=276) from three tribal districts in Bangladesh (Bandarban, Khagrachari, and Mymensingh). Methods – Interviews were conducted with librarians via Zoom in January 2023. Survey questionnaires were distributed to a convenience sample of 300 tribal women from February to March 2023. Data was analyzed in the Statistical Package for the Social Sciences (SPSS), using univariate and bi-variate measures. Main Results – All of the libraries provided print materials (books, newspapers, and periodicals) for reading and lending and offered photocopying and Internet browsing services. Other forms of resources such as microfiches and digital materials, inter-library loan services, and facilities for people with disabilities were not widely available. Most libraries (72.8%) did not provide any specific program (e.g., health-related outreach program) for tribal community engagement, although they all recognized the urgency and value of such programs. Lack of funding and bureaucratic complexities were identified as the top two barriers. Out of the 276 tribal women responding to the survey, close to two-thirds of the respondents indicated they were either moderately or very interested in receiving health information. The top three health topics the respondents sought information on were vaccinations, symptoms of disease, and nutrition. The primary health information sources for the respondents were doctors at nearby community clinics or government hospitals, and none of the respondents sought health information from public libraries. Most respondents acknowledged the importance of being informed about health issues and found it difficult to locate health information on the Internet. High costs and lack of awareness regarding health issues represented the main challenges the respondents encountered when seeking health information. Among the demographic variables, respondents’ religion and age were negatively correlated with their interest in health information, while their education status was positively correlated with it. Conclusion – Public libraries in tribal areas in Bangladesh lacked health information services but recognized the importance of providing them. Tribal women expressed interest in receiving health information, encouraging public libraries to develop and implement related services and programs. Public libraries may consider adding new job titles such as consumer health librarians and partner with other stakeholders for better community engagement. The government of Bangladesh should substantially invest in public libraries as community hubs and minimize bureaucratic hurdles that prevent public libraries from initiating new services. Professional library organizations in Bangladesh may also draw ideas from the study in establishing professional guidelines for health information services and community outreach programs.

Inclusive Crisis Communication in a Pandemic Context: A Rapid Review.

Background: Crisis communication might not reach non-native speakers or persons with low literacy levels, a low socio-economic status, and/or an auditory or visual impairments as easily as it would reach other citizens. The aim of this rapid review was to synthesize the evidence on strategies used to improve inclusive pandemic-related crisis communication in terms of form, channel, and outreach. Methods: After a comprehensive search and a rigorous screening and quality assessment exercise, twelve comparative studies were selected for inclusion in this review. Data were analyzed and represented by means of a structured reporting of available effects using narrative tables. Results: The findings indicate that a higher message frequency (on any channel) may lead to a lower recall rate, audio-visual productions and tailored messages prove to be valuable under certain conditions, and primary healthcare practitioners appear to be the most trusted source of information for most groups of citizens. Trust levels were higher for citizens who were notified in advance of potential exceptions to the rule in the effect of preventive and curative measures promoted. Conclusions: This review contributes to combatting information inequality by providing evidence on how to remove the sensorial, linguistic, cultural, and textual barriers experienced by minorities and other underserved target audiences in COVID-19-related governmental crisis communication in response to the societal, health-related costs of ineffective communication outreach.

Effectiveness of Providing Cash Incentives and Training To Community Health Workers on Active Case Finding for Tuberculosis In Nigeria: A Cluster-Randomized Control Trial

Background Case detection for Tuberculosis remains low in high-burden communities. Community Health Workers (CHWs) are the first point of contact for many rural Nigerians and have been useful in active case finding. This study assessed the effectiveness of cash incentives and training on tuberculosis case detection by CHWs in six Local Government Areas in Nigeria. Materials and Methods A cluster randomized control trial with three arms was conducted. Arm A received cash incentives and training, Arm B received only training, and the control arm (C) received neither. CHWs already working in the communities participated. TB case notification and number of community outreaches held were used to assess intervention effects. Data were analyzed using STATA (v.13) and GraphPad Prism (v.8). Effect sizes were calculated using odds ratios and 95% confidence intervals. Associations were tested using Chi-square (χ²) tests, with significance set at P=0.05. Results Arm A had a 14.4% increase in case notification, Arm B showed a 7.4% increase, and the control arm showed a 39.7% increase from the previous year. Arms A and B had lower odds of TB case notification post-intervention, compared to the control (OR = 0.819 and 0.769, respectively), with no significant difference between them. Arm A also saw a 144.8% increase in community outreaches, compared to 46.7% in Arm B and 22.7% in Control Arm C. Arms A and B had higher odds of carrying out community outreaches post-intervention compared to the control (OR = 1.995 and 1.195, respectively), but no significant differences were found between the groups regarding community outreach. Conclusion While the interventions resulted in an increased number of community outreaches compared to the control, case notification improved more in the control arm than in the intervention arms. Nevertheless, the findings highlight the potential of combining cash incentives with training to improve TB control efforts at the community level. Further exploration of the implementation process may shed light on the observed outcomes and guide future intervention strategies.

Association between health-related behaviors and obstructive sleep apnea among Korean adults

We aimed to investigate the association between health-related behaviors and obstructive sleep apnea (OSA) among Korean adults. A cross-sectional design using national open data was employed. Data from 8,096 adults aged 40 years and above who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2021 were analyzed. The participants’ OSA risk level was assessed using the STOP-Bang questionnaire. A logistic regression analysis was performed to investigate the association between health-related behaviors and high risk for OSA. The association between health-related behaviors and OSA risk remained significant for former smokers (OR = 1.643) and high-risk drinking (OR = 1.365), after adjusting for variables that showed significant differences in general and metabolic characteristics. Implementing lifestyle modifications is crucial for mitigating the health and societal impact of OSA. Understanding and addressing modifiable risk factors, including high-risk drinking and smoking, should be prioritized in nursing intervention. Nursing interventions are critical for preventing and managing OSA among Korean adults. Prioritizing high-risk behaviors through cessation programs and education is essential. Vulnerability of individuals living alone must be addressed through community outreach and support services. Emphasizing routine screenings for pre-hypertension and pre-diabetes, promoting balanced nutrition, and encouraging physical activity are crucial.

Predictors of Pediatric Asthma Management: Identifying Actionable Results With Geographic Determinants.

Pediatric asthma remains one of the most prominent chronic health conditions among US youth. Geographic determinants such as air pollutants have been identified as playing a role in asthma development and exacerbation. The purpose of this study was to determine geospatial predictors of pediatric asthma exacerbation events and to prioritize housing remediation resources. Electronic medical records were abstracted from a health plan in Southern California. The inclusion criteria that created a sample of 51 557 members were those aged 21years and younger, who had at least 1 asthma-related encounter between January 2019 and December 2021. Diagnoses, age, number of clinic and emergency department visits, and home addresses were included. The air quality index from the closest monitoring station during the study period, residential distance from a primary roadway, and residential distance from manufacturing sites were included in the spatial analysis. The average number of asthma-related clinic visits was 2 across the sample. Individuals with more asthma-related clinic visits residing in public housing were more likely to live within 4 km of industrial manufacturing locations (P <.001), reside closer to a major roadway (P <.001), and experience a higher number of poor air quality days (P <.001). Modeling results show these factors were also significantly predictive of an increase of asthma-related health care encounters. The findings of this study were consistent with previous studies linking asthma and poor air quality and further highlighted some of the additive and potentially exponential challenges that public housing, major roadways, and manufacturing sites provide communities in their proximity. This research can guide environmental interventions, including the frequency of public housing inspections, community outreach, and the development of communication strategies, to reduce asthma-related experiences across neighborhoods.

Pendampingan Kegiatan Posbindu Penyakit Tidak Menular Pada Masyarakat Buta Aksara

The low awareness of the signs of hypertension among wider community is a concern. The symptoms of dizziness that are often considered something normal, therefore they are ignored. As a result, over a long period of time the hypertension as a Non-Communicable Disease (NCD) increasingly due to serious complication as well as heart disease, stroke, and kidney failure. This Community outreach aims to provide Hypertension health education. The methods were organizing community, partnerships, health promotion, and health empowerment. The approach were carried out primarily with health cadres and collaborating with Primary Health Centre, furthermore the activities could held with Posbindu activities simultaneously. The result show that people who illiterate were able to increase their knowledge from 43.75% to 75% regarding the meaning of hypertension, signs and symptoms, complication, and hypertension treatment. Taking everything into account, it is necessary to strengthen cadres as health ambassadors in the community due to prevent NCD.

Birthing Unit Closures: Impacts and Opportunities in Iowa

Objective and ApproachIowa, US has experienced the closure of 41 birthing units in local hospitals since 2000, which is nearly 50% of previously available units. Public health concern about access to prenatal care and birthing support in this predominately rural state has raised attention to the value of using integrated administrative data to understand impacts and direct needed resources. This presentation will showcase a series of analyses using vital statistics birth records, hospital closure records, and statewide home visiting records to understand (a) closure impacts on relevant subgroups and (b) opportunities to strengthen outcomes through service improvements. Results suggest indirect relationships between hospital closure and child/mother outcomes through impacts on prenatal care. Some mothers (e.g., mothers with low maternal education, older mothers, and mothers with previous children) were more susceptible to negative impacts on prenatal care. Data about mother connections with other public service systems (e.g., Medicaid or WIC) suggested buffering effects for some women who were at risk for birthing unit closure impacts. Subsequent phases of research have used integrated administrative data to highlight hospital closure areas where women differentially experienced more positive outcomes to inform community outreach and identification of effective intervention efforts. Conclusions and ImplicationsThis research highlights the value of longitudinal administrative data utilized to address policy-relevant topics in public health. Results suggest opportunities to expand and replicate rural health practices that are working to mitigate risk in geographic areas where women face challenging access to a birthing hospital.

Epidemiology of Anaemia in Children under Five in Uganda: Current Trends, Challenges, and Strategic Approaches

Anaemia in children under five years old is a significant public health issue in Uganda, affecting over half of the vulnerable population and posing challenges to their health and development. The issue is influenced by nutritional deficiencies, infectious diseases, socioeconomic factors, and limited healthcare access. Clinical manifestations include pallor, fatigue, and developmental delays, and early detection is difficult due to non-specific symptoms, resource constraints, and cultural practices. The impact of anaemia on child health and development is profound, affecting physical growth, cognitive and motor skills, and overall well-being. Nutritional interventions, such as iron supplementation, fortified foods, and dietary education, are crucial for managing anaemia. Effective healthcare responses and policies, including routine screenings, treatment programs, and community outreach, are also necessary. Preventive measures and treatment programs are crucial for combating malaria and other infectious diseases. Community-based approaches, including training health workers and implementing grassroots education programs, are essential for improving anaemia management. Addressing gender dynamics and socioeconomic determinants is vital for reducing anaemia rates. Monitoring and evaluation frameworks are essential for assessing the effectiveness of anaemia control programs and guiding future efforts. In conclusion, a coordinated approach integrating nutritional, healthcare, environmental, and socioeconomic strategies is necessary to combat anaemia in Uganda. Through continued efforts and collaboration, the burden of anaemia can be mitigated, leading to improved health outcomes for children under five. Keywords: Anaemia, Children, Uganda, Current Trends, Challenges, Strategic Approaches