University Of Guam Research Articles

Validating Constructs of the Depression, Anxiety, and Stress Scale-21 and Exploring Health Indicators to Predict the Psychological Outcomes of Students Enrolled in the Pacific Islands Cohort of College Students.

The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental health challenges, such as suicide, and examine the predictive impact of selected health indicators on DASS-21 variables. Three years of data (2017-2019) were pooled from the Pacific Islands Cohort of College Students (PICCS) study conducted annually at the University of Guam. In total, 726 students were included in the secondary data analysis. MPlus statistical software was used to perform a confirmatory factor analysis (CFA) for the validation and structural equation modeling (SEM) for the predictive modeling. The results from the CFA suggested an acceptable model fit (RMSEA: 0.073, CFI: 0.901, TLI: 0.889, RMR: 0.044), while SEM suggested that sleep quality and physical activity were significant predictors of DASS-21 variables. Therefore, the DASS-21 is a valid instrument for measuring depression, anxiety, and stress among emerging adults in Guam.

Abstract 3472: Tailored cancer outreach efforts of a community outreach core working with Native Hawaiian and Pacific Islanders in Hawaiʻi

Abstract Background The Community Outreach Core (COC) of the Pacific Island Partnership for Cancer Health Equity (PIPCHE) aims to improve health equity for historically underserved populations including Native Hawaiians and other Pacific Islanders (NHOPIs), and Filipinos. PIPCHE is a partnership between the University of Hawai’i Cancer Center and the University of Guam whose efforts are focused in Hawaiʻi, Guam and the U.S. Affiliated Pacific Islands (USAPI). The COC directly addresses the disproportionately high rates of health disparities and cancer incidence and mortality found within NHOPIs often due to multiple complex historical, social, cultural, and environmental factors. Cancer is the second leading cause of death in Hawai’i between 2014-2018, as well as the second most common cause of death in nearly all USAPI jurisdictions. The COC uses research-tested, community-engaged approaches to modify determinants of cancer in these groups. Methods Outreach efforts have addressed NHOPI cancer inequities by raising awareness of high cancer burdens experienced by these underserved communities. Efforts include resource sharing and data collection at various venues in Hawaiʻi such as health/wellness fairs, public housing, and Pacific Islander churches. Outreach Advisory Council meetings were held biannually with community health leaders to discuss ongoing and future initiatives/resource sharing. The COC provided health providers and students with cultural competency training on more efficient strategies to work with these unique NHOPI groups. The COC provided presentations and short talks across the U.S, including a Health Providers Symposium on lung cancer across the Pacific. Outreach efforts have included tailored NCI-based Screen to Save (S2S) colorectal cancer education to NHOPIs. Results Forty-seven major outreach events were conducted from 2021 to November 2023. These include: 1 Health Providers’ Cancer Symposium, 5 Outreach Advisory Council meetings, 5 Cultural Competency trainings and class lectures, 11 conference/community and short talk presentations, and 25 community outreach events. There were 1,900 attendees reached during these regional and national outreach activities. The COC works with professional audiences at the national level to inform these groups about cancer and the health burdens of NHOPIs. A total of 97 Pacific Islanders received the S2S education and completed a pre-posttest with positive increases in means found for all 14 questions. Conclusion The PIPCHE COC has been able to reach NHOPIs though community partnerships to deliver culturally tailored cancer prevention education and efforts within Hawaiʻi, as well as shed light nationally of the cancer burdens these populations face. The S2S education has been able to raise awareness of cancer screenings and holds promise as a potential strategy to address cancer burdens of NHOPI communities. Citation Format: Mark Lee Willingham Jr., Kevin D. Cassel, Angela Sy, Munirih Taafaki, Tressa P. Diaz, Antoinette Kleiner, Angelina Mummert. Tailored cancer outreach efforts of a community outreach core working with Native Hawaiian and Pacific Islanders in Hawaiʻi [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 3472.

TERRITORY MARKETING: STUDY OF KEY TRENDS IN THE SCIENTIFIC RESEARCH DEVELOPMENT

Territorial marketing is a multifaceted scientific direction that includes elements of branding, use of digital technologies, performance evaluation and consideration of cultural factors. It is an important tool for territories' economic, social, cultural and ecological development. It helps attract investment, support local businesses, improve the quality of life for residents, preserve cultural heritage and promote sustainable development. The purpose of the article is to study the main trends in publishing activity on the subject of territory marketing. The authors have systematised the research areas of territory marketing: the conceptual foundations of territory marketing, territory branding strategies, the use of digital technologies in territory marketing, measuring the effectiveness of marketing campaigns, and the influence of cultural and social factors. With the help of the Scopus tools, the peculiarities of publication activity on territory marketing were investigated. For the period from 1990 to 2023, more than 1,573 publications were analysed. Italy, the USA, France, Spain, Great Britain, Australia, Portugal, India, and Canada are among the leading countries in publishing activity. Key subject areas include Social Sciences, Business, Management and Accounting, Economics, Econometrics and Finance, Environmental Science, Engineering, and Medicine. The most significant publications are affiliated with the Polytechnic Institute of Cávado and Ave, Portugal, the University of Guam, Guam Island, and Charles Darwin University, Australia. The authors conclude that socio-economic development and territorial development strategies focus on increasing competitiveness by preserving and using existing, as well as forming and implementing new competitive advantages, which determines the positioning of the territory. Given this, the relevant strategies for developing territories and cities should ensure the convergence of management and economic activities of the subjects of the territorial system, effective management of production infrastructure, and provision of consumer needs. In the face of global environmental challenges, marketing territories can contribute to promoting environmentally friendly technologies and practices. This helps to attract investments in sustainable projects and increase the population's environmental awareness.

Improving Participation in Advance Care Planning in The Guam/Micronesia Geriatric Community Through Education

The University of Guam (UOG) School of Health (SOH) received a grant in 2019 for the Guam/Micronesia Geriatrics Workforce Enhancement Program (GWEP) funded by the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services (DHHS). The vision of the grant is to transform current health systems serving the elderly and those with Alzheimer’s disease and related dementias. The framework of the 4Ms – what matters, medication, mentation, and mobility is being used to help make this vision a reality through the creation of age-friendly health systems for the elderly. The Guam/Micronesia GWEP chose to focus on what matters out of the 4Ms during years 1-3 of its grant cycle. Specifically, advance care planning (ACP) was addressed at the Guam Memorial Hospital Authority (GMHA) Skilled Nursing Unit (SNU) and in the Guam/Micronesia geriatric community. A chart review was done at the GMHA SNU, which showed low participation in ACP, 25% of the census for that time period. Several reasons for this were revealed through discussion with GMHA SNU personnel. They included lack of awareness or knowledge about ACP as well as language and cultural barriers. After training about ACP was conducted by Guam/Micronesia GWEP, chart reviewed showed participation in ACP improved to 100% at the GMHA SNU. Given this success, the intention is to continue with trainings in ACP through grant year 3 in the hopes of helping patients and their families as well as health care personnel in the Guam/Micronesia community understand how ACP helps to ensure that health care systems respect what matters most to geriatric patients and their families, and in doing so works toward establishing a more age-friendly health system. Keywords: Advance care planning; GWEP; 4Ms; Guam; Micronesia, Age-friendly health system, Elderly, Barriers to participation in ACP

Abstract 3684: Using key informants to guide community outreach for cancer topics and areas of focus for Filipino communities

Abstract Since 2003, the University of Hawai‘i Cancer Center (UHCC) and the University of Guam (UoG) have worked in partnership to explore health disparities/inequalities for different Pacific Island Populations (PIP). Investigators explore health behaviors and sources of health disparities and equity among Micronesian and Filipino community members in Hawai‘i, Guam, and the neighboring U.S. Associated Pacific Islands (USAPI) through the Pacific Island Partnership for Cancer Health Equity (PIPCHE). The Community Outreach Core of the partnership works towards objectives that include assisting and promoting PIPCHE research, ensuring inclusion PIP and Filipino community perspectives in research, and building healthcare providers’ competencies. This work aims to directly address the disproportionately high rates of cancer incidence and mortality found amongst these groups in Hawai‘i and Guam. Currently, few cancer control initiatives are designed to specifically address Micronesians and Filipinos, which comprise 40% of Hawai‘i’s population and 70% of Guam’s population. Colorectal cancer is the second leading cause of death for men and the third leading cause of death for Filipinos in Hawai‘i. Also, Micronesians and Filipinos are highly underrepresented among cancer researchers and cancer health care professionals; culturally-grounded approaches to achieve parity in cancer control are sorely needed which remains a focus of the COC. To address the needs of the Filipino community in Hawai‘i, we conducted five semi-structured interviews with Filipino community members to facilitate community engagement, build relationships, and direct future areas for cancer control. Another goal was to establish a relationship-building process to recruit members for the COC Outreach Advisory Council to guide future community efforts. Participants ranged in age; however, all five identified as female were born in various parts of the Philippines, and migrated to Hawai'i at different ages. Some findings from the interviews included the need for culturally tailored and translated cancer materials and resources, a charge to focus on colorectal and breast cancer initiatives, and provide translated health communications utilizing local radio and faith-based organizations. These members were then asked to serve on our Outreach Advisory Council for a period of 5 years to help shape the COC’s efforts towards community engagement with the Filipino community. These planned community-focused efforts should be modeled to ensure shared community-based decision-making for this minority population. Citation Format: Mark Lee Willingham, Kevin Cassel, Angela Sy, Munirih R. Ta'afaki, Reyna Bodnar, Lilnabeth P. Somera, Tressa P. Diaz, Angelina G. Mummert, Harmony C. Palaganas. Using key informants to guide community outreach for cancer topics and areas of focus for Filipino communities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3684.

Abstract PO-242: Pacific Island Partnership for Cancer Health Equity

Abstract The Pacific Island Partnership for Cancer Health Equity (PIPCHE) aims to develop cancer and cancer health disparities (CHD) research at the University of Guam (UOG) and the University of Hawai‘i Cancer Center (UHCC), focusing on Pacific Island (PI) populations; collaborate with community organizations that work with underrepresented PI populations to promote cancer health equity and enhance opportunities for research training and workforce development; implement evidence-based and culturally-relevant public health interventions and cancer prevention and control strategies with and within underrepresented communities; expand scientific collaboration among PIPCHE members and research faculty at UOG and UHCC, with an emphasis on Early Stage Investigators (ESI) of PI ancestry; and sustain, strengthen, and continuously evaluate the Partnership's activities. An infrastructure comprised of 4 principal investigators, over 30 multidisciplinary faculty, administrative staff, and external and internal reviewers, backed by institutional and NCI support, has supported 18 years of research, training, and outreach designed to reduce CHD and advance health equity among PI in Guam (GU), Hawai‘i (HI), and the U.S. Associated Pacific Islands (USAPI). Since 2009, PIPCHE has funded 26 research projects addressing cancer research priorities of regional and global relevance, including breast, cervical and liver cancers as well as Areca (betel) nut chewing, practiced by 600 million users worldwide and associated with oral pre/carcinoma. Over 100 peer-reviewed manuscripts have been published, over 100 abstracts presented, and since 2015, 234 grants secured. To address the underrepresentation of PI in biomedical sciences, the Partnership has supported, trained, and mentored 69 graduate students including 21 undergraduates, 37 master's students (5 of whom went on to pursue a PhD), and 11 students endeavoring towards a doctoral degree. Two PhD graduates are now members of UOG's faculty, conducting CHD research in GU. In addition, ESIs at UOG and UHCC receive mentorship and career development; since 2015, 14 ESIs have received support. Outreach projects have explored community-based participatory approaches to cancer prevention; efforts currently focus on advancing HPV vaccination and colorectal cancer screening, and cultural competency training for health professionals serving PI in GU and HI. Outreach activities have contributed to the introduction and passage of significant cancer prevention and control legislation in Guam and Saipan. Dedicated leadership and longstanding collaborations have led to the development and sustainability of Guam's Cancer Registry and the first NCI Community Oncology Research Program in Guam. In conclusion, the PIPCHE has significantly increased PI-focused cancer and CHD research at UOG and UHCC, underrepresented PI students are pursuing careers in cancer research, and communities are engaged in research, training and outreach to advance cancer health equity in HI, GU and the USAPI. Supported by NCI grants U54CA143727 and U54CA143728. Citation Format: Neal A. Palafox, Rachael T. Leon Guerrero, Brenda Y. Hernandez, Margaret Hattori-Uchima, Hali R. Robinett. Pacific Island Partnership for Cancer Health Equity [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-242.

Abstract PO-036: University of Guam/University of Hawai‘i Cancer Center Partnership: A seventeen-year investment in cancer health equity in Pacific Islanders

Abstract The University of Guam (UOG)/University of Hawai‘i Cancer Center (UHCC) Partnership aims to grow cancer research capacity at UOG, develop cancer health disparities research at UHCC focusing on Pacific Islanders (PI), raise awareness of cancer and cancer prevention in Guam (GU), Hawai‘i (HI) and the United States Associated Pacific Islands (USAPI), and increase the number of cancer and biomedical science researchers of PI ancestry in the US. An infrastructure comprised of 4 principal investigators, over 30 participating faculty, administrative staff, and external and internal reviewers, backed by institutional support and NCI sponsorship, has supported 17 years of research, training, and outreach designed to reduce cancer health disparities and advance health equity among PI in GU, HI, and the USAPI. Since 2009, the Partnership has funded 22 cancer research projects addressing cancer research priorities of global and regional relevance, including cervical cancer and Areca (betel) nut chewing - a traditional practice associated with oral pre/carcinoma, affecting 600 million users worldwide. Over 100 peer-reviewed manuscripts have been published, over 100 abstracts presented, and 21 grants secured. To address the underrepresentation of PI in biomedical sciences, the Partnership has supported and trained 35 graduate scholars; 23 master’s students at UOG and 12 doctoral students at UH. Two PhD graduates are now faculty members at UOG and engaged in cancer health disparities research. UOG’s Micronesian Studies Program offers a cancer health disparities track, developed by the Partnership and tailored for the Pacific region. In addition, UOG/UHCC faculty, junior investigators, and pre/postdocs receive mentorship, career development, and summer research fellowships; since 2015, 16 early career professionals have received support. Outreach projects have explored community-based participatory approaches to cancer prevention. Youth tobacco use prevention and cessation projects in Guam resulted in landmark tobacco control legislation, decreased tobacco use and increased tobacco taxes, which now sustain cancer programs and patient services in Guam including the Guam Cancer Registry. Current outreach efforts aim to increase colorectal cancer screening and HPV vaccination while building knowledge and awareness among physicians serving PI in GU and HI. Dedicated leadership and longstanding partner collaborations led to the first NCI Community Oncology Research Program site in 2019, providing therapeutic cancer clinical trials in Guam. In conclusion, research capacity at UOG has significantly increased, disparities research at UHCC has expanded, underrepresented PI students are pursuing careers in cancer research, and communities have been engaged in research, training and outreach to advance cancer health equity in HI, GU and the USAPI. Supported by NCI grants U54CA143727 and U54CA143728. Citation Format: Rachael T. Leon Guerrero, Margaret Hattori-Uchima, Hali R. Robinett, Carl-Wilhelm Vogel, Neal A. Palafox. University of Guam/University of Hawai‘i Cancer Center Partnership: A seventeen-year investment in cancer health equity in Pacific Islanders [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-036.

Abstract C125: University of Guam/University of Hawaii Cancer Center partnership: Fifteen years of progress in addressing cancer health disparities in Pacific Islanders

Abstract The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) Partnership aims to grow cancer research capacity at UOG; develop cancer health disparities research at UHCC focusing on Pacific Islanders (PI); raise awareness of cancer and cancer prevention in Guam (GU), Hawaii (HI) and the US Associated Pacific Islands (USAPI); and increase the number of cancer and biomedical science researchers of PI ancestry in the United States. An infrastructure comprising 5 principal investigators, over 30 participating faculty, administrative staff, and external and internal reviewers, backed by institutional support and NCI sponsorship, has supported 15 years of research, training, and outreach designed to reduce cancer health disparities and advance health equity among PI in GU, HI, and the USAPI. Since 2009, the Partnership has funded 18 cancer research projects addressing cancer research priorities of global and regional relevance, including cervical cancer and betel nut chewing—a traditional practice associated with oral pre/carcinoma, affecting 600 million users worldwide. Approximately 75 manuscripts have been published, approximately 100 abstracts presented, and 16 grants secured. To address the under-representation of PI in biomedical sciences, the Partnership has supported 30 graduate fellows, including 8 doctoral students at UH. Two PhD graduates are now faculty members at UOG and engaged in cancer health disparities research. UOG's Micronesian Studies Program now offers a cancer health disparities track, developed by the Partnership and tailored for the Pacific region. In addition, UOG/UHCC faculty, junior investigators, and pre/postdocs receive mentorship, career development, and summer research fellowships; to date, 8 UOG faculty have participated in the summer fellowship program at UHCC, and two have subsequently secured pilot funding. Outreach projects have explored community-based participatory approaches to youth tobacco use prevention and cessation in Guam, and the use of social networking to reduce tobacco-related cancer risk. Community-based participatory research has also led to landmark tobacco-control legislation in Guam, resulting in decreased tobacco use and increased tobacco taxes, a percentage of which supports cancer programs and patient services in Guam, including the Guam Cancer Registry. Current outreach efforts aim to increase cervical cancer screening among Micronesian migrants and build cancer-prevention knowledge and awareness among physicians who serve them in Guam and Hawaii. In conclusion, the Partnership has significantly increased research capacity at UOG and cultivated interest in cancer research among under-represented minority students at the partnering institutions. Supported by NCI grants U54CA143727 and U54CA143728. Citation Format: Carl-Wilhelm Vogel, David C. Ward, Neal A. Palafox, Hali R. Robinett, Rachael T. Leon Guerrero, John A. Peterson. University of Guam/University of Hawaii Cancer Center partnership: Fifteen years of progress in addressing cancer health disparities in Pacific Islanders [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C125.

Abstract D040: University of Guam/University of Hawaii Cancer Center Partnership: Sixteen years of progress in addressing cancer health disparities in Pacific Islanders

Abstract The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) Partnership aims to grow cancer research capacity at UOG, develop cancer health disparities research at UHCC focusing on Pacific Islanders (PI), raise awareness of cancer and cancer prevention in Guam (GU), Hawaii (HI) and the US Associated Pacific Islands (USAPI), and increase the number of cancer and biomedical science researchers of PI ancestry in the United States. An infrastructure comprised of 4 principal investigators, over 30 participating faculty, administrative staff, and external and internal reviewers, backed by institutional support and NCI sponsorship, has supported 16 years of research, training, and outreach designed to reduce cancer health disparities and advance health equity among PI in GU, HI, and the USAPI. Since 2009, the Partnership has funded 19 cancer research projects addressing cancer research priorities of global and regional relevance, including cervical cancer and Areca (betel) nut chewing - a traditional practice associated with oral pre/carcinoma, affecting 600 million users worldwide. Ninety peer-reviewed manuscripts have been published, over 100 abstracts presented, and 19 grants secured. To address the underrepresentation of PI in biomedical sciences, the Partnership has supported 33 graduate students including 7 doctoral students at UH. Two PhD graduates are now faculty members at UOG and engaged in cancer health disparities research. UOG’s Micronesian Studies Program now offers a cancer health disparities track, developed by the Partnership and tailored for the Pacific region. In addition, UOG/UHCC faculty, junior investigators, and pre/postdocs receive mentorship, career development, and summer research fellowships; to date, eight UOG faculty have participated in the summer fellowship program at UHCC and most had received U54pilot funding. Outreach projects have explored community-based participatory approaches to youth tobacco use prevention and cessation in Guam, and the use of social networking to reduce tobacco-related cancer risk. Community-based participatory research has also led to landmark tobacco control legislation in Guam, resulting in decreased tobacco use and increased tobacco taxes, a percentage of which supports cancer programs and patient services in Guam including the Guam Cancer Registry. Current outreach efforts aim to increase colorectal cancer screening and HPV vaccination while building knowledge and awareness among physicians who serve Pacific Islanders in Guam and Hawaii. In conclusion, research capacity at UOG has significantly increased, disparities research at UHCC has expanded, and underrepresented minority students are pursuing careers in cancer research. Supported by NCI grants U54CA143727 and U54CA143728. Citation Format: Rachael T Leon Guerrero, Margaret Hattori-Uchima, Hali R Robinett, Carl-Wilhelm Vogel, Neal A Palafox. University of Guam/University of Hawaii Cancer Center Partnership: Sixteen years of progress in addressing cancer health disparities in Pacific Islanders [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D040.

Addressing Cancer Health Disparities in the Pacific Peoples of Hawai'i, Guam, and the US Associated Pacific Islands Through Pacific-Focused Research Capacity Building.

Sociocultural, geographic, and biologic factors contribute to cancer health disparities (CHDs) in Indigenous Pacific peoples (IPPs) in Guam, Hawai‘i, and the US Associated Pacific Islands (USAPI). IPPs experience a greater burden of CHDs that are associated with late-stage diagnosis and poor survival outcomes compared with majority populations in the United States. A 16-year partnership between the University of Guam (UOG) and University of Hawai‘i Cancer Center (UHCC) aims to advance health equity in Guam, Hawai‘i, and the USAPI through cancer research, training, and outreach. Investigators at collaborating institutions study issues of regional and cultural relevance in IPPs, including breast, cervical, liver, and oral cancers and use of tobacco and betel nuts (Areca nuts). Junior faculty with IPP ancestry or those who are focused on CHDs in IPPs receive mentorship and career development opportunities, academic fellowships are provided for graduate students, and Pacific Island communities are engaged through a participatory development process. The partnership has generated more than 90 peer-reviewed publications, more than 100 abstracts, and 11 grant awards. Thirty graduate scholars from under-represented minorities have been trained, including two who are now UOG faculty and are conducting independent research, contributing to the partnership, and mentoring scientists of tomorrow. Participatory community engagement has contributed to the passage of significant cancer prevention and control legislation in Hawai‘i, Guam, and Saipan. Research capacity at UOG has increased significantly, and research at UHCC has expanded to address issues unique to IPPs. Graduate students from under-represented minorities are pursuing careers in cancer research. A regional research infrastructure has been established to support team science, and research findings are informing public health policy and planning.

318-LB: Acanthosis Nigricans and Obesity among College Students on Guam

Obesity has been associated to Acanthosis nigricans (AN), but there is a dearth in studies regarding this association in Pacific Islander populations. Data collected pertaining to health indicators of obesity in a cross-section of students—recruited to participate in the Pacific Islands Cohort on College Students (PICCS) during August to December 2017, was analyzed. The purpose of this analysis was to determine the relationship between obesity (obese and non-obese groups decided by using Body Mass Index (BMI)) and AN (presence/absence) of a non-random sample of 303 college students (CS) at the University of Guam. Of 299 CS, mean age was 21 ± 6 years and 45% were males and 55% were females. Anthropometric measurements were taken by undergraduate research students trained to use standardized stadiometer, weight scale, and measuring tape and ascertain AN presence/absence (neck area). Of 299 CS, height mean was 164 ± 32 cm and weight mean was 72 ± 20 kg. Of 294 CS, waist circumference mean was 88 ± 28 cm. The BMI mean of 299 CS was 27 ± 7. The relationship between presence/absence of AN in obese and non-obese groups was statistically significant, X2 (N = 282) = 16.37, (p = 0.000). Of 282 participants, 21.5% of the obese group had AN present while 5.1% of the non-obese group had AN present as well. These results may be further investigated and may assist in raising awareness regarding the association between obesity and AN presence/absence to the people of Guam; which may better assist in strategies of obesity screening. Disclosure V.D.C. Flisco: None. Y.C. Paulino: None. Funding National Institutes of Health

Computing4Change winners

Following an intense three-day competition held at SC18, a team of four undergraduates took home the top prize of $250 in the Computing4Change contest for their project, Resisting Cultural Acceptance of Violence. This team consisted of: Peizhu "Pam" Qian (Simmons College), Hoano Rosario (Chaminade University of Honolulu), Nilo Espinoza (University of Guam), and Claire Fiorino (San Diego State University).

Advancing Cancer Health Equity in Pacific Islanders: A 15-Year Investment in Cancer Research, Training and Outreach in Guam, Hawaii and the U.S. Associated Pacific Islands

Background: Pacific Islanders (PI) in Guam (GU), Hawaii (HI), and the U.S. associated Pacific Islands (USAPI) experience greater cancer health disparities compared with majority populations in GU, HI, and the U.S. continent. Social determinants including geographic, socio-cultural, and economic factors are barriers to health and health care, leading to late stage diagnosis and poor survival outcomes. PIs are also highly underrepresented among cancer researchers. Aim: The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) partnership aims to grow cancer research capacity at UOG, develop cancer health disparities research at UHCC focusing on Pacific Islanders (PI), raise awareness of cancer and cancer prevention in GU, HI and the USAPI, and increase the number of cancer and biomedical scientists of PI ancestry in the U.S. Methods: An infrastructure comprised of five principal investigators and approximately 30 participating faculty, administrative staff, and community and scientific advisory members, supported by funds from the National Cancer Institute and the partnering institutions, has provided 15 years of support for cancer research, training, and outreach designed to reduce cancer health disparities and advance health equity among Pacific Islanders in GU, HI and the USAPI. Results: Fifteen collaborative research projects have been funded through the partnership. Many of these projects have focused on the prevention of unhealthy lifestyle behaviors that lead to increased cancer risk. Prepilot, pilot and full research projects address cancer health disparities of regional relevance and global importance, notably breast, cervical and oral cancers as well as tobacco and betel nut use. A betel nut cessation intervention, the first of its kind, shows promising quit rates. This research has resulted in over 80 publications, 100+ abstracts, and 9 grant awards. The partnership has recruited and trained 26 underrepresented graduate scholars in cancer health disparities, including two scholars who have since joined UOG's faculty and are now independently conducting research, participating in the partnership as investigators, and mentoring tomorrow's scientists. UOG faculty and early stage investigators continue to receive mentorship and career development support. Outreach activities have contributed to the introduction and passage of significant cancer prevention and control legislation in Guam and Saipan. Outcomes are communicated through the partnership's Website, social media, and community reports and seminars. Conclusion: The partnership has significantly increased research capacity at UOG and cultivated interest in cancer research among underrepresented minority students at the partnering institutions. A regional research infrastructure has been established, and research findings are informing public health policy and planning. Resources have been leveraged to address PI cancer health disparities in GU, HI, and the USAPI.

Abstract A44: University of Guam/University of Hawaii Cancer Center Partnership: Fourteen years of progress in addressing cancer health disparities in Pacific Islanders

Abstract The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) Partnership aims to grow cancer research capacity at UOG; develop cancer health disparities research at UHCC focusing on Pacific Islanders (PI); raise awareness of cancer and cancer prevention in Guam (GU), Hawaii (HI), and the U.S. Associated Pacific Islands (USAPI); and increase the number of cancer and biomedical science researchers of PI ancestry in the United States. An infrastructure comprising 6 principal investigators, over 30 participating faculty, administrative staff, and external and internal reviewers, backed by institutional support and NCI sponsorship, has supported 14 years of research, training, and outreach designed to reduce cancer health disparities and advance health equity among PI in GU, HI, and the USAPI. Since 2009, the Partnership has funded 17 cancer research projects addressing cancer research priorities of global and regional relevance, including cervical cancer and betel nut chewing--a traditional practice associated with oral pre/carcinoma, affecting 600 million users worldwide. Approximately 75 manuscripts have been published, approximately 100 abstracts presented, and 13 grants secured. To address the under-representation of PI in biomedical sciences, the Partnership has supported 30 graduate fellows, including 76 doctoral students at UH. Two PhD graduates are now faculty members at UOG and engaged in cancer health disparities research. UOG's Micronesian Studies Program now offers a cancer health disparities track, developed by the Partnership and tailored for the Pacific region. In addition, UOG/UHCC faculty, junior investigators, and pre/postdocs receive mentorship, career development, and summer research fellowships; to date, six UOG faculty have participated in the summer fellowship program at UHCC and two have subsequently secured pilot funding. Outreach projects have explored community-based participatory approaches to youth tobacco-use prevention and cessation in Guam, and the use of social networking to reduce tobacco-related cancer risk. Community-based participatory research has also led to landmark tobacco-control legislation in Guam, resulting in decreased tobacco use and increased tobacco taxes, a percentage of which supports cancer programs and patient services in Guam including the Guam Cancer Registry. Current outreach efforts aim to increase cervical cancer screening among Micronesian migrants and build cancer prevention knowledge and awareness among physicians who serve them in Guam and Hawaii. In conclusion, the Partnership has significantly increased research capacity at UOG and cultivated interest in cancer research among under-represented minority students at the partnering institutions. Supported by NCI grants U54CA143727 and U54CA143728. Citation Format: Carl-Wilhelm Vogel, David C. Ward, Neal A. Palafox, Hali R. Robinett, Rachael T. Leon Guerrero, Robert A. Underwood, John A. Peterson. University of Guam/University of Hawaii Cancer Center Partnership: Fourteen years of progress in addressing cancer health disparities in Pacific Islanders [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A44.

Abstract A48: University of Guam/University of Hawaii Cancer Center Partnership: Thirteen years of progress in addressing cancer health disparities in Pacific Islanders

Abstract The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) Partnership aims to grow cancer research capacity at UOG, develop cancer health disparities research at UHCC focusing on Pacific Islanders (PI), raise awareness of cancer and cancer prevention in Guam (GU), Hawaii (HI) and the US Associated Pacific Islands (USAPI), and increase the number of cancer and biomedical science researchers of PI ancestry in the United States. An infrastructure comprised of 6 principal investigators, over 30 participating faculty, administrative staff, and external and internal reviewers, backed by institutional support and NCI sponsorship, has supported 13 years of research, training, and outreach designed to reduce cancer health disparities and advance health equity among PI in GU, HI, and the USAPI. Since 2009, the Partnership has funded 15 cancer research projects addressing cancer research priorities of global and regional relevance, including cervical cancer and betel nut chewing - a traditional practice associated with oral pre/carcinoma, affecting 600 million users worldwide. Over 70 manuscripts have been published, 90 abstracts presented, and 9 grants secured. To address the underrepresentation of PI in biomedical sciences, the Partnership has supported 26 graduate fellows, including 6 doctoral students at UH. One PhD graduate is now a faculty member at UOG and engaged in research supported by the Partnership. UOG's Micronesian Studies Program now offers a cancer health disparities track, developed by the Partnership and tailored for the Pacific region. In addition, UOG/UHCC faculty, junior investigators, and pre/postdocs receive mentorship, career development and summer research fellowships; to date, five UOG faculty have participated in the summer fellowship program at UHCC and two have subsequently secured pilot funding. Outreach projects have explored community-based participatory approaches to youth tobacco use prevention and cessation in Guam, and the use of social networking to reduce tobacco-related cancer risk. Community-based participatory research has also led to landmark tobacco control legislation in Guam, resulting in decreased tobacco use and increased tobacco taxes, a percentage of which supports patient services in Guam as well as the Guam Cancer Registry. Current outreach efforts aim to increase cervical cancer screening in the islands. In conclusion, the Partnership has significantly increased research capacity at UOG and cultivated interest in cancer research among underrepresented minority students at the partnering institutions. A regional research infrastructure has been established and resources continue to be leveraged to address PI cancer health disparities in Guam, Hawaii, and the USAPI. Master's and PhD-trained graduates of the program are now participating in and directing cancer studies relevant to their communities, and mentoring future scientists committed to the Pacific Region. Supported by NCI grants U54CA143727 and U54CA143728. Citation Format: Carl-Wilhelm Vogel, David C. Ward, Neal A. Palafox, Hali R. Robinett, Rachael T. Leon Guerrero, Robert A. Underwood, John A. Peterson. University of Guam/University of Hawaii Cancer Center Partnership: Thirteen years of progress in addressing cancer health disparities in Pacific Islanders. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A48.

Cultural Considerations in the Conduct of Clinical Research: The Guam Experience

Cultural sensitivity provides one of the foundations for a successful clinical research within tribal communities. Researchers involved in the efforts that cross paths with cultural practices of human subjects must be aware of the potential impact as well as the challenges these will pose to the clinical research process. These were some of the insights gained from the research experience of the biomedical research team from University of Guam (UOGCRC) and the University of Hawai’i (UHCC) after conducting a study in Guam which aimed to describe the betel nut chewing practices of its indigents and identify specific biomarkers that occur in the saliva of humans after betel nut (BN) mastication.

Abstract A83: University of Guam/University of Hawaii Cancer Center Partnership: Twelve years of progress in addressing cancer health disparities in Pacific Islanders

Abstract The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) Partnership aims to build capacity to reduce cancer health disparities (CHD) of Pacific Islanders in Guam, Hawaii, and the US-associated Pacific Islands (USAPI) through cancer research, training, and outreach. It has been funded by sequential U56 and U54 grants from the NCI. At the core of the partnership activities are jointly conducted research products of regional relevance and global importance. Over the past period of U54 funding, six research projects were related to betel nut use exploring the associations of betel nut use and health related conditions and behaviors among users in Micronesia; sociocultural factors affecting betel nut chewing in Guam; the influence of betel nut use on the oral microbiome; the identification of alkaloids present in the varieties of betel nut on Guam; identification of salivary biomarkers in betel nut consumption; and the functional assessment of molecular components of betel nut involved in pro-inflammatory mechanisms of immune cells. Other research projects are addressing CHD-related research questions around cancer risk and risk perception: health information trends and needs in the Pacific among adults and youth; feasibility of electrical breast densitometry in assessing breast cancer risk; and breast cancer risk factors for Pacific Islander women. Collectively, over 60 manuscripts have been published, over 75 abstracts have been presented at national and international conferences, and at least 8 new grants have been awarded to members of the partnership. Since the Fall Semester 2009, 16 MS degree students at UOG have received fellowship support from the U54 grant, and two UOG graduates are enrolled in doctoral programs at US mainland institutions. Two students received an MS degree and two students received a PhD degree at UHCC with U54 fellowship support. One PhD graduate is now a faculty member at UOG and engaged in the partnership. Over the past six years, UOG developed a cancer health disparities curriculum tailored for the Pacific region, now a permanently sustained track in UOG's Micronesian Studies Program. In addition, mentorship and career development is provided to early stage investigators (ESI) at UOG: UHCC investigators have mentored 10 UOG ESI since 2009. Four UOG faculty received summer fellowships at UHCC; two subsequently secured pilot funding. Outreach projects are exploring community-based participatory approaches to youth tobacco use prevention and cessation in Guam, and the effectiveness of a social network-based approach to reducing tobacco-related cancer risk. Outreach activities have also contributed to the introduction and passage of significant public health legislation in Guam, resulting in decreased tobacco use and increased tobacco taxes, a percentage of which supports patient services in Guam as well as the Guam Cancer Registry. In conclusion, the unique multi-ethnic, sociocultural, and geographic characteristics of the UOG/UHCC partnership provide for many unique and important cancer research, training, and outreach opportunities with regional and global relevance. The Partnership has significantly increased research capacity at UOG and cultivated interest in cancer research among minority students attending the partner institutions. Outreach has resulted in model tobacco control policy in Guam. A regional research infrastructure has been established and resources have been leveraged to address Pacific Islander cancer health disparities in Guam, Hawaii, and the USAPI. Supported by NCI awards U54CA143727 and U54 CA143728. Citation Format: Hali R. Robinett, Rachael T. Leon Guerrero, Robert A. Underwood, Neal A. Palafox, David C. Ward, Carl-Wilhelm Vogel. University of Guam/University of Hawaii Cancer Center Partnership: Twelve years of progress in addressing cancer health disparities in Pacific Islanders. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A83.

A Rehearsal for Revolution: The Hybrid Persona of the Graduate Student Teacher

This mixed-form essay examines the graduate student teacher (GST) by utilizing Augusto Boal’s concept of the spect-actor. This theatre concept is used to illuminate two distinct aspects of the graduate student-teachers’ persona: first their initiation into theoretical literacy, and second, their opportunity for vigorous critical, even revolutionary activism. An embedded graduate student essay explores the author’s personal GST experience within a larger frame of current U.S. university employment trends and against the author’s current university experiences and performances. This work asks: What kinds of power do GSTs command? What kinds of power are they bound by, in their simultaneous, hybrid performance of students and teachers? And, in light of the growing numbers of part-time and temporary faculty teaching at U.S. institutions, what are the ramifications of a shrinking minority of university faculty (the tenured) wielding primacy in institutional policy making and the creation and maintenance of the social and workplace culture? The essay concludes by exploring these issues at the author’s institution, the University of Guam.

Abstract A08: University of Guam/University of Hawaii Cancer Center Partnership: An 11-year partnership to advance cancer health equity in Pacific Islanders

Abstract The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) Partnership aims to build capacity to reduce cancer health disparities (CHD) in Guam, Hawaii, and the US-associated Pacific Islands (USAPI) through cancer research, training, and outreach. Since 2003, the UOG/UHCC Partnership has provided scholarships and training in CHD research to a growing number of graduate students at UOG and UHCC with a special focus on Pacific Islanders who are underrepresented in the fields of cancer research and healthcare. UHCC investigators provide mentorship to early stage investigators (ESI) at UOG through annual meetings and workshops, monthly video teleconferences, electronic communications, and summer fellowships at UHCC. A system has been established to review, award, and evaluate new and ongoing pre-pilot, pilot, and full research projects. Outreach activities draw upon the principles of community-based participatory research to increase tobacco cessation, reduce cancer risk, and strengthen tobacco control policy. Since Fall Semester 2009, 16 master's degree students at UOG have received fellowship support, and two UOG graduates are enrolled in doctoral programs at US mainland institutions. Two PhD students at UHCC are currently receiving fellowship support, and three master's degree students have graduated from UH. One scholar is now in a tenure track faculty position at UOG and engaged in the Partnership. Over the past five years, UOG developed a cancer health disparities curriculum tailored for the Pacific region, now a permanently sustained track in UOG's Micronesian Studies Program. In addition, mentorship and career development is provided to ESI at UOG: UHCC investigators have mentored 10 UOG ESI since 2009. Four UOG faculty received summer fellowships at UHCC; two subsequently secured pilot funding. Research of regional relevance and global importance is jointly conducted by investigators at UOG and UHCC, including six betel nut related pilot projects that are exploring the associations of betel nut use and health related conditions and behaviors among users in Micronesia; sociocultural factors affecting betel nut chewing in Guam; the influence of betel nut use on the oral microbiome; the identification of alkaloids present in the varieties of betel nut on Guam; identification of salivary biomarkers in betel nut consumption; and the functional assessment of molecular components of betel nut involved in pro-inflammatory mechanisms of immune cells. Other research projects are addressing CHD-related research questions around cancer risk and risk perception: health information trends and needs in the Pacific among adults and youth; feasibility of electrical breast densitometry in assessing breast cancer risk; and breast cancer risk factors for Pacific Islander women. Outreach projects are exploring community-based participatory approaches to youth tobacco use prevention and cessation in Guam, and the effectiveness of a social network-based approach to reducing tobacco-related cancer risk. Outreach activities have also contributed to the introduction and passage of significant public health legislation in Guam, resulting in decreased tobacco use and increased tobacco taxes, a percentage of which supports patient services in Guam as well as the Guam Cancer Registry. Almost 50 papers have been published, and at least 7 grants have been awarded to members of the partnership as a result of the work of the partnership. In conclusion, the unique multi-ethnic, sociocultural, and geographic characteristics of the UOG/UHCC partnership provide for many unique and important cancer research, training, and outreach opportunities with regional and global relevance. The Partnership has significantly increased research capacity at UOG and cultivated interest in cancer research among minority students attending the partner institutions. Outreach has resulted in model tobacco control policy in Guam. A regional research infrastructure has been established and resources have been leveraged to address Pacific Islander cancer health disparities in Guam, Hawaii, and the USAPI. Supported by NCI awards U54CA143727 and U54 CA143728. Citation Format: Hali R. Robinett, Rachael T. Leon Guerrero, Robert A. Underwood, Neal A. Palafox, David C. Ward, Carl-Wilhelm Vogel. University of Guam/University of Hawaii Cancer Center Partnership: An 11-year partnership to advance cancer health equity in Pacific Islanders. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A08.

Student Teachers Evaluating and Assessing SCRATCH in the Applied Linguistics Classroom

For the past four years, students and student teachers taking applied linguistics at the University of Guam were required to design class projects using SCRATCH, a free downloadable program from MIT. Their projects had to integrate principles of second language teaching/learning or other subfields of applied linguistics into their projects. In 2012 and 2013, students integrated their computer projects into their lesson plans for elementary, middle, or high school students. This presentation will propose criteria for evaluating students’ computer projects and summarize students’ assessments of and comments about, using MIT's SCRATCH program in foreign language and content area teaching.