Reduce Cancer Health Disparities Research Articles

Perspectives of an NCI T32 Training Program Designed to Train a Diverse Workforce in Cancer Health Equity Research.

With cancer health disparities on the rise in the United States (USA), there is an increased need for novel approaches to address these challenges. One such approach that may help address these disparities is increasing diversity in the biomedical research workforce. The Cancer Health Equity and Career Development Program (CHECDP) embodies this approach by recruiting and training underrepresented minorities in cancer research to develop the skills and training needed to be competitive for independent research careers, thus diversifying the biomedical research workforce. The training model that CHECDP employs is unique with its funding through the NCI training mechanism, its strong institutional support, and its participant-driven curriculum. The curriculum includes educational, career, and leadership opportunities that are continuously evaluated for sustained impact. The program has been comprised of mostly under-represented minorities that have been propelled to independent careers with a high rate of funded career development awards. Our T32 program serves as a model of success for other programs seeking to diversify the biomedical research workforce and reduce cancer health disparities.

Health Disparities among Patients with Cancer Who Received Molecular Testing for Biomarker-Directed Therapy.

Health disparities present a barrier to successful oncology treatment. The potential for precision oncology to reduce health disparities has not previously been analyzed. We performed a retrospective analysis of 12,627 patients from six major cancer centers whose tumors underwent molecular testing at Caris Life Sciences between 2010 and 2020. Kaplan-Meier and Cox regression were used to describe and analyze overall survival. The molecular and demographic features of the cohort were analyzed by χ2 and ANOVA tests. Black patients composed 25% of the cohort and White patients 63%. Among this molecularly-tested cohort, there were minimal outcome differences based on race, geographic location, or poverty level. When analyzing the interaction of age, race, and sex, racial-based disparities were noted primarily for young non-White women in the study cohort but were more pronounced for men and women of all ages in the broader patient population within the Surveillance, Epidemiology, and End Results database. Mutations in five genes-APC, EGFR, STK11, TP53, and KRAS-were found to affect overall survival among our cohort, and their prevalence varied by race in specific tumor types. Real-world outcomes data in mutation-defined cohorts also provided additional context to previously reported therapeutic response trends. Our study shows that patients who undergo molecular testing display reduced racial health disparities compared with the general population, whereas persistent racial disparities are influenced by age and sex. Genomic-driven racial disparities should be examined at a tumor lineage-specific level. Increased access to molecular testing for all eligible patients may play a role in improving health equity. Significance: This study is the largest of its kind to analyze health disparities and genomic features among a diverse multiinstitutional cohort of patients who underwent molecular testing. Continuing to increase awareness of and access to molecular testing approaches may help to reduce cancer health disparities and improve outcomes for all patients.

Building partnerships to improve clinical trial accrual in rural and Native American communities through community health educator interventions.

180 Background: Rural populations and racial minorities are often underrepresented in cancer clinical trials. The low representation is determined by multilevel factors, including lack of geographic access to facilities in rural locations and mistrust in the medical and scientific community. Presented here are partial results of an educational intervention to improve clinical trials-related knowledge among rural residents and racial minorities. Methods: The Center to Reduce Cancer Health Disparities (CRCHD) from the National Cancer Institute (NCI) developed the study materials, that were available in English or Spanish, to be utilized according to participants' preferences. The University of Wisconsin Carbone Cancer Center implemented this intervention in northern Wisconsin, which consisted of a baseline questionnaire, a recorded educational intervention, and a post-educational questionnaire. The chosen community is largely rural and Native. The questionnaires consisted of 11-knowledge- and 6-intention-related questions. After being screened by the rural Community Health Educator (CHE), subjects self-administered the intervention online or received the intervention from the CHE during tribal or other educational group events in rural communities. Results: Between January and May 2024, 62 participants started the intervention. Participants’ mean age was 45.1 (±15.36) years, 64.5% (40/62) were female, and 53.2% (33/62) self-identified as American Indian/ Alaska Native. All resided in rural community, defined as Rural-Urban Continuum Codes 7 or 8. Three participants did not respond to the post-educational questionnaire, and one skipped its intentions section. Although the two questions about informed consent presented the highest percent of correct answers post-intervention, the median total knowledge score pre and post-intervention remained the same (p>0.05). Post-intervention, participants more often agreed it is important for minority groups to participate in clinical trials, reported being likely to search for a clinical trial they might be eligible for, join a clinical trial, and talk to family/friends about joining a clinical trial (p<0.05). Conclusions: The CHE successfully engaged rural community members to participate in the intervention. In addition, the intervention facilitated building trust and partnerships for future cancer-related community driven work.

Abstract B023: Incorporating the Patient Voice: An Evaluation of NCI-Designated Cancer Centers and Patient Reported Experiences with Genomic Medicine

Abstract Since the National Cancer Act established the Cancer Centers Program in 1971, NCI-designated cancer centers (NCI-CCs) throughout the country have been mandated to translate state-of-the-art cancer research to communities and enhance clinical care for patients within their catchment areas, including minority and underrepresented populations. Precision oncology, which leverages genetics to optimize personalized treatment plans for patients, has promising potential to address cancer health disparities. In this era of targeted personalized care, though genetics has been incorporated into cancer centers, it is unknown how these innovations are being communicated to the public and communities served. There is particularly limited knowledge surrounding how cancer centers may integrate patient reported experiences with genomics into fulfilling their overall mission and reducing cancer health disparities. The objective of this study was to evaluate how cancer centers are publicly sharing information related to their work in understanding and assessing patient experiences with the use of genetics to guide cancer care. For all NCI-CCs involved in clinical care (n=65), we conducted a review of publicly available and published information, using each cancer center website as a point of origin. While almost all the NCI-CCs discuss providing personalized care and perform genetic testing, we found that the majority (51%) indicate that they assess patient-reported outcomes with genomic medicine, such as symptom monitoring during clinical trials. Fewer (38%) indicated having at least one study or that they assess patient experiences and perspectives with genomic medicine that extended to broader measures, like hereditary testing or pharmacogenomic testing to guide treatment. Forty-five percent of NCI-CCs indicate that any pharmacogenomic testing is performed through standard care, research studies, or otherwise. Finally, about 1 in 3 (35%) indicate that they have departmental resources dedicated to monitoring patient experience at their institutions. Some centers described having an established infrastructure dedicated to measuring and incorporating patient reported experiences into programmatic activities, such as offices and annual events dedicated to patient experience. These centers reflecting a built-in infrastructure were 8 to 12% more likely to publicly communicate and describe targeted activities to assess patient reported outcomes and experiences with genomic medicine and/or provide genetic testing. The use of genomics in research and clinical care continues to expand, yet its impact on the minority and underrepresented communities that cancer centers serve remains uncharacterized. Comprehensive understanding of patient reported experience with genomic medicine is lagging and serves as a key opportunity to potentially address cancer health disparities. As leaders in cancer care, NCI-CCs have the opportunity to enhance communication with communities surrounding genomics and improve the patient-centered care they provide. Citation Format: Amanda S. Andriessen, Loren Saulsberry. Incorporating the Patient Voice: An Evaluation of NCI-Designated Cancer Centers and Patient Reported Experiences with Genomic Medicine [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 B023.

Abstract B112: Empowering cancer advocates: Evaluating the impact of a comprehensive training program

Abstract The Cancer Advocacy Training Program aimed to enhance participants' knowledge, skills, and confidence in cancer advocacy, particularly addressing disparities in cancer health outcomes. This evaluation assesses the program's impact through pre- and post-training survey comparisons. The program included 25 participants from various states and focused on comprehensive training. Surveys measured changes in knowledge, attitudes, self-perceived skills, and confidence. Results showed that accurate identification of cancer's main categories increased from 83% to 96%, and awareness of the NCI's mammogram recommendations rose from 70% to 96%. Recognition of the root causes of health disparities remained at 100%, and belief in the inclusivity of cancer advocacy roles was consistently high. Understanding of trust dynamics in advocacy increased by 50%, and recognition of essential political advocacy components improved by 14%. Specific learning outcomes indicated consistent identification of research advocates, a 23% increase in knowledge of strategic funding sources, a 31% improvement in understanding health communication audiences, a 19% rise in awareness of patient advocacy benefits, and a 13% increase in comprehension of informed consent. Confidence in advocacy skills also saw significant improvements. "Extremely confident" participants increased to 33% in problem-solving, adaptability, and communication with stakeholders. Confidence in fundraising and partnership building rose to 19%, evaluation of advocacy outcomes to 24%, identifying key issues to 29%, presentation skills to 33%, and using digital tools to 29%. Self-efficacy results demonstrated notable gains: confidence in solving difficult problems related to cancer advocacy increased with participants reporting "extremely confident" rising from 11% to 33%. Confidence in adaptability under stress improved significantly, with "extremely confident" participants rising from 11% to 33%. Effective communication with stakeholders saw a significant increase, with "extremely confident" participants rising from 17% to 33%. Fundraising and partnership-building confidence increased from 6% to 19%, and confidence in evaluating advocacy outcomes improved, with "extremely confident" participants rising from 6% to 24%. The program effectively enhanced participants' knowledge, attitudes, and advocacy skills, integrating theoretical and practical learning. Gains in confidence across problem-solving, adaptability, and communication skills underline the program's success in preparing participants for real-world advocacy. Participant feedback confirmed the program's relevance and efficacy, suggesting future iterations should emphasize diversity in advocacy and deepen content on key topics. This program serves as a valuable model for empowering cancer advocates and addresses the critical need for targeted training to reduce cancer health disparities. Citation Format: Manisha Salinas, Monica Albertie. Empowering cancer advocates: Evaluating the impact of a comprehensive training program [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 B112.

Abstract B121: Enhancing opportunities for underrepresented minorities conducting cancer and cancer health disparities research nationwide: The Transformative Educational Advancement and Mentoring (TEAM) network

Abstract Background: The Transformative Educational Advancement and Mentoring (TEAM) network is a program funded by the Center to Reduce Cancer Health Disparities (CRCHD) of the National Cancer Institute (NCI). In support of the NCI’s goal to reduce cancer health disparities, the CRCHD drives workforce diversity efforts by supporting trainees from backgrounds underrepresented (UR) in cancer biomedical and behavioral sciences research. The two TEAM programs launched at minority-serving institutions (MSIs) in 2023: The Southwest TEAM (STEAM) network and San Diego State University’s (SDSU) Advancing Cancer Careers for ExceLlence (ACCEL). Each program has a unique model designed to best serve trainees in their respective regions, but both provide: 1) Diverse Training Champions (TCs), role models and navigators who act as the primary point of contact for scholars, provide direct services to trainees, ascertain member needs, develop programmatic offerings, and connect trainees to program components; 2) a mentorship program for pre and postdoctoral scholars and early stage investigators (ESIs); 3) targeted recruitment and professional development of UR scholars; and 4) tailored linkages to professional development and employment opportunities, and NCI/CRCHD funding priorities. This work summarizes the strategies planned across both programs to promote recruitment and retention of investigators from UR backgrounds and cultivate professional development opportunities for students and ESIs. Approach: The STEAM network includes the University of New Mexico, New Mexico State University, Northern Arizona University, and Burrell College of Osteopathic Medicine and leverages the unique programs and expertise of these MSIs to collectively train diverse cancer health disparities researchers with interests in serving Native American, Hispanic and rural communities in the Southwestern United States. The ACCEL Program supports excellence, inclusion and transformation of the cancer research science force, expanding and strengthening the pipeline of UR scholars pursuing cancer research. SDSU, a Carnegie Foundation high activity research institution is one of few institutions to be both a Title Ill/Title V eligible institution for diversity. ACCEL works in close collaboration with the University of California San Diego Moores Cancer Center. We will discuss opportunities and approaches employed by each program in support of scholars to increase the number of diverse scholars in these research pipelines and demonstrate the effectiveness of such coordinated efforts. Conclusion: Supporting TCs to focus on scholars within regional programs will prove to be an efficient and effective way to increase recruitment and retention of diverse investigators in NCI research and community programs. Using novel strategies like TCs, the programs will support the attainment of career goals and enhance and diversify workforce capacity across the cancer research and care continuum. Citation Format: Dolores D. Guest, Martha M. Grimes, Andrew L. Sussman, Elizabeth Y. Jimenez, Graciela Unguez, Ahmed Mohammed, Naomi Lee, Jani Ingram, Krystal Charley, Kristin Gosselink, Jill Nery, Avesta Basraki, Natalie Gude, Rebecca Lewison. Enhancing opportunities for underrepresented minorities conducting cancer and cancer health disparities research nationwide: The Transformative Educational Advancement and Mentoring (TEAM) network [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 B121.

Accelerating Progress to Reduce the Cancer Burden through Prevention and Control in the US.

Improvements in cancer prevention and control are poised to be main contributors in reducing the burden of cancer in the US. We quantify top opportunities to accelerate progress using projected life years gained (LYG) and deaths averted as measures. We project that over the next 25 years, realistic gains from tobacco control can contribute 0.4 to 17 million additional LYG per intervention and 8.4 million additional LYG from improving uptake of screening programs over the lifetime of 25 annual cohorts. Additional opportunities include addressing modifiable risk factors (excess weight, alcohol consumption), improving methods to prevent or treat oncogenic infections, and reducing cancer health disparities. Investment is needed in the pipeline of new preventive agents and technologies for early detection to continue progress. There is also a need for additional research to improve the access to and uptake of existing and emerging interventions for cancer prevention and control and to address health disparities. These gains are undeniably within our power to realize for the US population.

Towards precision cancer medicine for Aboriginal and Torres Strait Islander cancer health equity.

Delivering cancer control at scale for Aboriginal and Torres Strait Islander communities is a national priority that requires Aboriginal and Torres Strait Islander leadership and codesign, as well as significant involvement of the Aboriginal community-controlled health sector. The unique genomic variation observed among Aboriginal and Torres Strait Islander peoples may have implications for standard and precision medicine. Yet, Aboriginal and Torres Strait Islander peoples are absent from, or under-represented within, human reference genome resources, genomic studies, cancer studies, cancer cell lines, patient-derived xenografts and cancer clinical trials. Genomics-guided precision cancer medicine offers an opportunity to reduce cancer health disparities experienced by Aboriginal and Torres Strait Islander peoples through personalising prevention, diagnosis, treatment and long term management. Here, we describe what is required to ensure that Aboriginal and Torres Strait Islander peoples can receive the benefits of precision cancer medicine. Equity of access to care, an Aboriginal and Torres Strait Islander cancer workforce, and appropriate genome reference resources are important for safe and effective cancer medicine. Building Indigenous data sovereignty principles and Aboriginal and Torres Strait Islander governance into research is required to protect Aboriginal and Torres Strait Islander rights and collective interests. Aboriginal and Torres Strait Islander community engagement should be undertaken to develop an understanding of the unique cultural and ethical considerations for precision cancer research. Local and national genomic health research guidelines are needed to define a consensus best practice in genomics research with Aboriginal and Torres Strait Islander peoples.

Metabolic Dysregulation and Cancer Risk Program (MeDOC): a transdisciplinary approach to obesity-associated cancers.

With the escalating prevalence of obesity, the association between obesity and cancer is a growing public health concern. Obesity will soon surpass tobacco smoking as the most important preventable cause of cancer. Obesity-driven mechanisms can alter cell functions to induce metabolic changes, chronic inflammation, and insulin resistance that are believed to contribute to cancer risk and development; yet the specific underlying biological mechanisms of obesity-related cancer development are largely unknown. The Metabolic Dysregulation and Cancer Risk Program: a transdisciplinary approach to obesity-associated cancers (MeDOC) is a trans-National Cancer Institute research initiative supported by the Division of Cancer Control and Population Sciences, the Division of Cancer Biology, the Division of Cancer Prevention, and the Center to Reduce Cancer Health Disparities. The overall purpose of the MeDOC Program is to advance our understanding of the underlying mechanisms that connect obesity, metabolic dysregulation, and increased obesity cancer risk as well as identify markers that will enhance cancer risk prediction, improve screening for high-risk individuals, and identify targets for preventive and therapeutic interventions for cancer interception or treatment. This report describes the funded research projects, the Coordinating Center, and the goals of the MeDOC program.

Barriers to accessing cancer care from patients’ perspective: A single cancer center experience.

e13520 Background: Jefferson Einstein Hospital is a safety-net hospital that serves a diverse and primarily disadvantaged community in North Philadelphia. The population in this city has 21.5% of individuals living in poverty, which is almost double the rate in Pennsylvania. According to the National Cancer Institute’s Center to Reduce Cancer Health Disparities (NCI-CRCHD), people from low socioeconomic backgrounds and specific demographics often bear a more significant disease burden than the general U.S. population. Certain population groups experience cancer disparities due to their likelihood of encountering obstacles or barriers in accessing healthcare. This study aims to identify critical barriers hindering the receipt of quality cancer care for the population served by this hospital. Methods: We identified 51 adult patients who received a new cancer diagnosis between 2022 and 2023. Barriers to accessing cancer care were defined through a literature review and expert consensus. These barriers were assessed via a survey containing fixed-choice items aimed at eliciting obstacles to accessing cancer care among newly diagnosed cancer patients undergoing treatment at the hospital. Information on these barriers was collected prospectively during survey administration and analyzed using descriptive statistics. The frequency of specific barriers within the five categories was calculated, and subjects were classified based on the presence or number of barriers. Results: A total of 51 patient surveys were evaluated. Among these surveys, 24 (47%) reported transportation issues, and 3 (6%) reported caregiving responsibilities. Ten (20%) patients encountered economic barriers, while 11 (22%) faced challenges related to their support system. Nineteen (37%) patients experienced barriers related to health literacy, and 15 (29%) specifically struggled with cancer-related health literacy. Additionally, cultural barriers were identified in 12 (24%) patients. Conclusions: Our study highlights the prevalent barriers faced by newly diagnosed cancer patients in accessing cancer care, including transportation, health literacy, financial constraints, and cultural factors. These findings underscore the importance of integrating patient perspectives into future initiatives aimed at addressing these challenges. By prioritizing patient input and enhancing patient navigation programs, we can effectively mitigate these barriers and improve access to cancer care for individuals in need. [Table: see text]

Expanding active living after cancer to underserved cancer survivors and their caregivers.

Physical activity improves physical and psychological health in cancer survivors. This study evaluated Active Living After Cancer (ALAC), a community-based program to improve physical activity, physical function, and quality of life (QOL) in minority and medically underserved cancer survivors and their caregivers. Participants completed 12 weekly ALAC sessions and assessments of physical activity, physical functioning, and QOL at baseline and follow-up (week 12). Paired samples t tests were used to assess changes in outcomes over time. A total of 540 cancer survivors (mean age = 61.1 [SD = 11.3] years) and 87 caregivers (mean age = 62.3 [SD = 13.1] years) were enrolled. Most were women (91.4%), Hispanic (61.1%) or non-Hispanic Black (19.3%), and medically underserved (86.4%). The percent of cancer survivors meeting physical activity recommendations increased from 28.9% to 60.2% (d = 0.75), and the number of sit-to-stand repetitions in a 30-second period increased from 12.3 to 14.3 (d = 0.39) from 0-12 weeks. Cancer survivors reported statistically significant improvements in physical (t score Δ = 1.7, d = 0.06) and mental (t score Δ = 2.3, d = 0.31) health-related QOL. Caregivers also improved their physical activity, physical function, and QOL, and there were no statistically significant differences between breast and other cancer survivors and between cancer survivors and caregivers. The ALAC program demonstrated increased physical activity, physical function, and QOL in medically underserved cancer survivors and their caregivers. Furthermore, ALAC was successfully implemented by community partners and serves as a good model for reaching medically underserved cancer survivors and improving survivorship. Additional efforts are warranted to further extend reach, improve cancer survivorship, and reduce cancer health disparities among underserved cancer survivors.

Abstract 3554: Using All of Us cancer data on the Researcher Workbench to advance career development

Abstract This session will provide an overview of the All of Us Research Program (All of Us) dataset, discuss a mechanism to build the capacity of research institutions using the All of Us dataset, and outline the career benefits researchers experienced from using the dataset. All of Us is building a national health dataset to accelerate medical breakthroughs. It is used by cancer researchers to advance health research and career development. This dataset is large and diverse, both in the data types available as well as the demographics of participants: as of April 2023, health data from 413,450+ participants is available to researchers, from a variety of distinct data types, including survey responses, physical measurements, electronic health records, whole genome sequencing, wearable data, and genotyping arrays, with 75% of participants self-identifying as underrepresented in biomedical research and about 45% of participants self-identifying as racial and ethnic minorities. Researchers already leverage this dataset, with All of Us data used in more than 210 publications across peer-reviewed journals. In addition, this dataset is useful for cancer researchers - All of Us EHR data indicates over 60,700 participants are diagnosed with at least one type of cancer, and more than 10% of research projects underway (725/6,945 as of September 2023) using the All of Us dataset are cancer-related, making it the top condition studied by researchers. To help build capacity at research institutions, All of Us collaborated with the NCI Center to Reduce Cancer Health Disparities (CRCHD) Partnerships to Advance Cancer Health Equity (PACHE) to develop a Notice of Special Interest (NOSI) titled Administrative Supplements to Support "All of Us" and Health Disparities-Related Pilot Research Projects at NCI CRCHD-Funded PACHE Partnerships. The focus of this NOSI was on P20 and U54 awards associated with research projects led by PACHE researchers interested in exploring the connections between social determinants of health outcomes and populations experiencing cancer health disparities. NIH awarded investigators at the following institutions: City College of New York, University of California, Irvine, and Temple University. Principal investigators of these awards will provide an overview of their work, describe how they analyze the All of Us dataset, and discuss how their use of the dataset has helped advance their career as cancer researchers: Karen Hubbard (City College of New York) Project Title: Relative and Intersectional Analysis of social determinants of Lung Cancer Risk among Black and Hispanic All of Us respondents Hannah Lui Park (University of California, Irvine) Project Title: Improving breast cancer risk assessment and prevention in Asian American women Lin Zhu (Temple University) Project Title: Elucidating the Roles of Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease among Asian American Patients with Chronic Hepatitis B Citation Format: Karriem S. Watson, Rubin Baskir, Division of Engagement and OutreachAll of Us Research Program, Karen Hubbard, Hannah L. Park, Lin Zhu. Using All of Us cancer data on the Researcher Workbench to advance career development [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3554.

Engaging the Asian American Community to Address Cancer Burden: Experiences and Lessons Learned

Abstract: Background: Reducing cancer health disparities in Asian Americans requires orchestrated efforts and partnerships. Objectives: To describe the approach used by the University of Texas MD Anderson Cancer Center, HOPE Clinic, and Asian American organizations to understand and engage Houston's Asian American communities in cancer research, as well as to share lessons learned. Methods: The community-academic-medical partnership used community-based research principles to build the partnership, form the community advisory board, conduct a community needs assessment, and offer cancer prevention engagement and education. Results: Some lessons learned included balancing language needs with limited resources, incorporating more time and resources to conduct health research in an ethnically diverse community, and promoting awareness of research and its role in cancer prevention in Asian American communities. Conclusions: Community–academic–medical partnerships are promising ways to engage the community, draw on combined expertise, and create research and programs that are scientifically strong and meaningful to the community.

Abstract B134: The art of science: Painting a new image of genomic research in the indigenous communities of the Southwest

Abstract Introduction: The Patient Engagement-Cancer Genome Sequencing Research Center (PE-CGS; NCI U2C CA252973) based at the University of New Mexico Comprehensive Cancer Center (UNMCCC) with partners at Mayo Clinic Comprehensive Cancer Center, the Translational Genomics Research Institute, and the Black Hills for American Indian Health Research Center are developing culturally appropriate strategies and methods to address the underrepresentation of American Indians (AIs) in genomic research. Our efforts are directed towards the implementation of tailored cancer prevention, diagnosis, and treatment strategies that reduce cancer health disparities in Tribal communities. Methods: The PE-CGS Center has three units, each tasked with specific research components to engage AI participants in participatory, clinically-meaningful genomic research: 1) the Participant Engagement Unit; 2) the Genomics Characterization Unit; and 3) the Engagement Optimization Unit (EOU). The Center also has a Tribal Advisory Committee, composed of Tribal Governors, Presidents, and tribal health advocates and experts, who provide direction on all research matters. The PE-CGS EOU uses iterative rapid-cycle research techniques to optimize engagement and shares these strategies with other units for timely implementation. To date, the EOU has developed and implemented three key efforts. First, to aid in recruiting participants for the study, the EOU tailored a series (6) of participant-facing informational materials that include artwork from a local AI artist who combined her traditional and scientific knowledge to prepare complementary imagery. Second, the EOU is currently implementing a series of semi-structured discussions to document participant perceptions on criteria including engagement, communication, and education. Lastly, the EOU implemented a survey among UNMCCC providers on their return of results processes. Results: EOU discussions are ongoing and have provided important perspectives on participant satisfaction and areas for improvement. Participants have commended study staff on their efforts to make enrollment straightforward. Participants report discussing the study with family prior to enrolling, highlighting the importance of continuing to engage with the entire community on the goals of the study. The provider return of results survey is complete (n=42/62, response rate=68%); one key finding was that providers who return somatic test results rarely provide participants with a hard copy of the results or utilize complementary materials that might enhance their explanation of the test findings. Conclusion: The EOU serves an innovative function through its rapid-cycle methods to optimize participant engagement. Although participants are generally pleased with their study participation, there are numerous opportunities for improvement. The informational materials represent a novel contribution to the field of genomic research. Efforts will continue to implement optimized processes for effective engagement of AI communities in genomic research and cancer care delivery. Citation Format: Shoshana Adler Jaffe, Kendal Jacobson, Joseph Rodman, Cindy Blair, Debra MacKenzie, Mallery Quetawki, Tamar Ginossar, V. Shane Pankratz, Andrew Sussman, Ursa Brown-Glabermen, Jeffrey Trent, Cheryl Willman, Shiraz I. Mishra. The art of science: Painting a new image of genomic research in the indigenous communities of the Southwest [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B134.

Abstract B131: Social drivers of adverse health outcomes among cancer survivors

Abstract Purpose of the Study Disparities in health outcomes among cancer survivors are often driven by differences in social-ecological resources. Poor health outcomes and multiple chronic conditions often manifest as a result of shared demographic and social risk factors. The aim of this study was to examine the social drivers that predict adverse health outcomes among cancer survivors. Methods Data from the national longitudinal Population Assessment of Tobacco and Health (PATH) Study was used to examine social drivers of several adverse health outcomes: tobacco use, sleep trouble, high cholesterol, diabetes, and high blood pressure among cancer survivors enrolled in the first cohort (waves 1-3; n=1924). Social drivers included education, financial stress, poverty level, insurance status, and satisfaction with social relationships. Survey-weighted multivariable logistic regression was used to assess demographic and social drivers that predicted health outcomes among cancer survivors. Results Among the 1,924 cancer survivors, most were non-Hispanic, White (77%); 56% female; ages ranged from 18-34 (14%), 35-54 (27%), 55-64 (24%), 65+ (34%). Higher tobacco use was linked (p’s<0.05) to both demographic (males, younger) and social drivers (lower education, poverty, lack of insurance and social dissatisfaction). Trouble sleeping was associated with social drivers including financial stress (p<.001) and social dissatisfaction (p<.0001). High cholesterol was significantly associated with demographics (older age) and social drivers including lower education, access to insurance, and social dissatisfaction (p’s<.05). High blood sugar was significantly associated with demographics (older age, NH Black) and social drivers (lower education and social dissatisfaction (p’s<.05). High blood pressure was significantly associated with demographic (older age, male, NH Black) and social drivers including lower education college (p<.05) and financial stress (p<.05). Conclusions Increased recognition of the critical role of social drivers on health outcomes suggests effective interventions that are sensitive to cancer survivors’ social-ecological contexts are needed to improve health equity and reduce cancer health disparities. Citation Format: Victoria M. Telles, Mateo Banegas, David Strong. Social drivers of adverse health outcomes among cancer survivors [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B131.

Abstract A053: Development and evaluation of a community-informed intervention to improve clinical trial knowledge and interest: Preliminary findings

Abstract Introduction: Nationally, racial and ethnic disparities in cancer clinical trial participation exist. Black Americans are underrepresented in cancer clinical trials, with approximately 9% of clinical trial participants in studies sponsored by the National Cancer Institute (NCI) identifying as Black. As part of work supported by the NCI’s National Outreach Network, we adapted educational materials provided by the Center to Reduce Cancer Health Disparities (CRCHD) for dissemination across KCI’s catchment area. Our study aimed to increase knowledge and interest in clinical trials with a focus on concerns salient among Black Americans. Methods: We adapted a CRCHD educational PowerPoint presentation to create Project FACCTs: Facts about Cancer Clinical Trials, a multicultural online video intervention. Adaptation included input from our cancer center’s longstanding Black American community stakeholders and collaborators. who shared a preference for video format versus PowerPoint presentation and recommended inclusion of a discussion of medical mistrust as well as information on clinical trial costs. Participants were recruited through KCI clinics and community partners. Assessments, provided by the CRCHD, included an 11-item measure of clinical trial knowledge (true/false) as well as 6-item measure of clinical trials interest and attitudes, including likelihood of future participation in a trial (strongly disagree to strongly agree). Assessments were administered as pre- and post-tests. Results: The majority of our 307 participants identified as Black American (59.3%), female (76.9%), college graduates (63.5%), and had health insurance from a former or current employer (49.8%). Overall, clinical trial knowledge was relatively high at both pre-test (mean=86.7% correct) and post-test (mean=87% correct) across the entire sample. A repeated measures ANOVA revealed a statistically significant difference between Black and White participants on clinical trial knowledge from pre-test (Black: 84.5%; White: 94%) to post-test (Black: 85.4%; White: 93%) (F(1,2) =20.6, p=.01). Across the entire sample, a paired samples t-test showed that clinical trial interest increased after viewing Project FACCTs, (t (297)=-8.84, p=.01). A repeated measures ANOVA demonstrated that within groups there was statistically significant improvement in interest and attitudes towards participating in a clinical trial (F(1, 295) = 34.8 p=.01). Between groups, White participants had a higher overall score in clinical trial interest compared to Black participants (F(1, 2) =9.13, p=.01). Conclusions: Project FACCTs shows promise as a tool that can improve community members' knowledge, awareness, and interest in clinical trials. One limitation of the work reported here is that participants already had high clinical trials knowledge so the intervention’s effect on those with low knowledge is an area for future inquiry. Citation Format: Ariel Washington, Brittany Dowe, Rochelle Chapman, Maida Herrera, Madison Pavliscak, Bertram Marks, Hayley Thompson. Development and evaluation of a community-informed intervention to improve clinical trial knowledge and interest: Preliminary findings [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A053.

Abstract A056: Community scientist research advocacy program: Bridging cancer research and community advocacy

Abstract Community Scientist Research Advocacy (CSRA) programs are designed to connect researchers with community members, to effectively inform and involve the general population on clinical research. More programs like such are needing to be implemented into the community for better outcomes among cancer health disparities. The purpose of our study was to develop and evaluate a novel bi-coastal and bilingual program to inform, educate and empower community members to become cancer research advocates in Florida (FL) and California (CA). Our program was tailored for African American (AA) and Hispanic/Latino/a (H/L) adults. Primary objectives are to increase person power for cancer research advocacy and increase multi-directional communication between cancer advocates with cancer survivors, community members, academic scientists and policy makers. The CSRA program is a 13-week program implemented 100% virtual by the FL-CA Cancer Research, Education and Engagement (CaRE2) Health Equity Center, a bi-coastal partnership between the Florida A&M University, University of Florida, and University of Southern California where participants learned about cancers that disproportionately impact AA and H/L adults. Participants completed surveys at program start, midway, and end to assess knowledge gained and program evaluation, and a mentored advocacy project for community implementation. Five months after program end, we surveyed participants on impact and to provide support for their research advocacy. To date, a total of 26 adults have graduated from our program. We present data from the 2022 CSRA cohort (N = 20) that included participants from FL and CA, which are among the top five states in the U.S with the largest AA and H/L populations. Participants self-identified race, ethnicity, and gender were: 13 (68.4%) AA, 7 (26.3%) H/L, 90% female. This cohort had 90% program completion (N = 18) and 5 advocacy projects on breast cancer, lung cancer, pancreas cancer, and prostate cancer. Participant knowledge had a mean (SD) of 67.9 (7.9) at pre-survey and 71.4 (9.0) at post-survey, with a p-value of 0.2. Participants had a mean (SD) of 60.0 (14.6) at mid-survey and 68.2 (11.0) at post-survey, with a p-value of 0.13. We used a Likert scale to evaluate program expectations, which resulted in a mean (SD) of 94.0 (8.8) participants who ‘agreed’ that they were satisfied with the program at the start compared to a mean (SD) of 91.0 (12.9) of participants who ‘agreed’ that they were satisfied with the program at the end, with an overall p-value of 0.5. In conclusion, we present findings from a novel virtual CCS bi-coastal and bilingual training program tailored for AA and H/L adults that can foster multi-directional communication between cancer research advocates with multiple stakeholders to reduce cancer health disparities. We will further evaluate our program for 2023 cohort implementation. Citation Format: Brooke Hensel, Eduardo Ibarra, Carolina Aristizabal, Ileana Guzman, Rosa Barahona, Brandon Hazelton-Glenn, Ji-Hyun Lee, Zhongyue Zhang, Mariana C. Stern, Lourdes Baezconde-Garbanati, Sandra Suther, Fern Webb. Community scientist research advocacy program: Bridging cancer research and community advocacy [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A056.

Abstract A068: Educating the next generation of cancer researchers: Evaluation of a cancer research partnership training program

Abstract Introduction: The underrepresentation of minorities in cancer research hampers efforts to address disparities among minority populations. To tackle this issue, early mentorship of emerging scientists from underrepresented communities is crucial. The Synergistic Partnership for Enhancing Equity in Cancer Health (SPEECH) is a collaboration between Temple University/Fox Chase Cancer Center, Hunter College (TUFCCC/HC), and funded by the National Cancer Institute. SPEECH aims to reduce cancer health disparities through research, community outreach, and support for underrepresented investigators and students. The Research Education Core (REC) within SPEECH focuses on enhancing training and mentorship, including the Summer Cancer Research Institute (SCRI), providing opportunities for underrepresented minority students in cancer research. Procedures: We conducted a cross-sectional survey with accepted SCRI applicants (i.e., participants) and their peers whose applications to the SCRI were not accepted (non-participants) from four cohorts (2019–2022). Email invitations with a link to a REDCap survey were sent to 51 SCRI participants and 488 non-participants with the goal of investigating any differences between the two groups in knowledge and career goals. In total, 32 SCRI participants and 47 non-participants responded to the survey. One SCRI participant was excluded due to missing data, yielding 31 SCRI participants. About 70% of the participants identified as Asian, Black/African American, or multi-racial. Results: SCRI participants had significantly higher knowledge scores in health disparities (p < 0.001), cancer biology (p < 0.001), and cancer prevention (p < 0.05) than non-participants. SCRI participants also had slightly higher levels of interest in pursuing a graduate-level degree in cancer biology or cancer health disparities-related discipline (41.9% reporting “very interested”) and in pursuing a career in cancer biology or cancer health disparities (41.9% “very interested”), than the non-participants (36.2% and 36.2%, respectively), but the differences were not statistically significant. The two groups had similar rates of pursuing a career in cancer biology, cancer health disparities research, or teaching in academia. In addition, over 90% reported Of those who participated in the SCRI that they “agreed” or “strongly agreed” that the SCRI experience had a positive influence on their plans for continued education (90.3%), increased skills in cancer or cancer health disparities research (93.6%), increased skills on scientific writing (93.6%), increased skills on presenting at a conference (100%), and had a positive influence on their future career plans (90.3%). Summary: Our findings indicate that an intensive 8-week training institute can increase students’ knowledge and capacity in cancer research, demonstrating an overall positive influence of the program on students’ perceived scientific skills and future career plans. Citation Format: Lin Zhu, S.J. Dodd, Yuku Chen, Emily R. Kaminsky, Zhiqing Elaine Liu, Grace X. Ma, Olorunseun O. Ogunwobi, Carolyn Y. Fang. Educating the next generation of cancer researchers: Evaluation of a cancer research partnership training program [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A068.

Abstract A109: The growth and evolution of GMaP Region 3 Technical Training Summits

Abstract Introduction: The Geographic Management of Cancer Health Disparities Program (GMaP) is a national program funded by the National Cancer Institute’s (NCI) Center to Reduce Cancer Health Disparities with the mission to expand and diversify the pipeline of cancer researchers. GMaP Region 3 is one of seven regions, and is comprised of members from seven Southwestern US states. The University of New Mexico Comprehensive Cancer Center serves as the hub for GMaP Region 3, and has hosted three seminal training Summits. Methods: GMaP Technical Training Summits provided hands-on learning experiences for cancer health disparities (CHD) trainees and promoted collaboration among Region 3’s NCI-designated cancer centers. GMaP Region 6 collaborated with Region 3 to host the final two Summits. Each of the three Summits had differing aims, but the core goals were to strengthen grant writing skills, enhance professional development, in addition to providing opportunities for networking and mentorship. Summit activities included keynote addresses by senior researchers, many of whom are members of historically underrepresented populations, interactive grant writing sessions, and mock grant reviews. Attendee feedback was captured via REDCap surveys and qualitative experience summary reports. Results: Each Summit had increasing attendance: 2016 Summit, n=29, 2019 Summit, n=35; 2023 Summit, n=48. Summit length grew from 1 full day to 2.5 days of sessions. Although the majority of participants were from Regions 3 and 6 there were also attendees from Region 2 and 5 demonstrating the desirability of this type of intensive grant writing training. Attendees were largely satisfied with their experience and in 2023 the overall reception of the summit material was 87% positive. Attendees highlighted the benefits of receiving individualized feedback on their Specific Aims page and the ability to meet people doing similar work. Summits were described as “invigorating” and “motivational”. Participants across the years highlighted the value of hearing from influential researchers in the field and cited these keynote addresses as being “inspirational”. Challenges of hosting these Summits included logistical barriers specifically pertaining to ensuring that scholars had the financial support they needed to attend prior to each event. In addition, tailoring the Summit curriculum and coordinating appropriate speakers was an ongoing learning process. Recommendations: Grant writing is both a science and an art and many scholars, particularly those from underrepresented groups, do not have access to the focused training necessary to develop successful proposals. The GMaP Region 3 Summits provided opportunities for scholars to learn from experienced grant writers and network with their peers. Future efforts to provide tailored grant writing education to newer cancer researchers should be prioritized to support their career development and diversify the types of CHD research proposed and ultimately funded. Citation Format: Shoshana Adler Jaffe, Dolores D. Guest, John Torres, Miria Kano, Andrew Sussman, Shiraz I. Mishra. The growth and evolution of GMaP Region 3 Technical Training Summits [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A109.

State of Cancer Care in America: Achieving Cancer Health Equity Among Sexual and Gender Minority Communities.

In 2017, ASCO issued the position statement, Strategies for Reducing Cancer Health Disparities Among Sexual and Gender Minority Populations, outlining five areas of recommendations to address the needs of both sexual and gender minority (SGM, eg, LGBTQ+) populations affected by cancer and members of the oncology workforce who identify as SGM: (1) patient education and support; (2) workforce development and diversity; (3) quality improvement strategies; (4) policy solutions; and (5) research strategies. In 2019, ASCO convened the SGM Task Force to help actualize the recommendations of the 2017 position statement. The percentage of the US population who publicly identify as SGM has increased dramatically over the past few years. Although increased national interest in SGM health equity has accompanied a general interest in research, policy change, and education around diversity, equity, and inclusion, resulting from public concern over discrimination in health care against Black, Indigenous, and People of Color, this has been accompanied by a surge in discriminatory legislation directly impacting the SGM community. Although much progress has been made in advancing SGM cancer health equity since 2017, more progress is needed to reduce disparities and advance equity. The five focus areas outlined in the 2017 ASCO position statement remain relevant, as we must continue to promote and advance equity in quality improvement, workforce development, patient care, research, and SGM-affirming policies. This article reports on the progress toward reducing SGM cancer disparities and achieving equity across these five areas and identifies future directions for the work that still remains.