South Florida Center for Reducing Cancer Disparities

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1 Building partnerships. Conducting research. Fighting cancer. DCO CONNECT Disparities & Community Outreach Core Newsletter June 2012 Issue 12 In the first half of 2012, the DCO Core experienced many successes, including SUCCESS (see below). This issue of DCO Connect includes updates on projects for which the DCO Core is providing services. All Community Advisory Boards are actively engaged in studies. We have displayed posters, given presentations, submitted papers to journals, and are included in several new grant proposals. One of our research associates, Marsha Stevens, left for another position, and Dr. Kobetz has been on maternity leave for the past few months. The DCO Core remains a vital shared resource to facilitate UM s research focus on reducing health disparities. As always, please contact me or Dr. Kobetz if you have any questions. Dorothy Parker, DCO Core Manager South Florida Center for Reducing Cancer Disparities In this issue SUCCESS 1 FIT for Life 2 Smoking Cessation Support Groups Medical Decision Making 3 Cancer Disparities Grant, INSIGHT SFCCC, DCO Core Services Last year, a NCI grant established the South Florida Center for Reducing Cancer Disparities (SUCCESS), led by Cancer Center investigators, Drs. Olveen Carrasquillo and Erin Kobetz. The DCO Core is involved with the research intervention that aims to increase screening and knowledge of cervical cancer and HPV. SUCCESS also includes a project to increase awareness of HPV among HIV positive Haitian women (HAPPI), lead by Dr. Sonjia Kenya, as well as training for medical students. The intervention compares three strategies that involve either a combination of education, Community Health Workers (CHW) navigation, and/or Pap tests or cervical self sampling testing. Activities are guided by Community Advisory Boards in these communities: Little Haiti, Hialeah and West Perrine. The CHWs are representative of each community s population, and are responsible for recruitment and outreach. To date, more than 1,200 women have been assessed. Over 300 meet the study criteria and have been enrolled into the randomized study. To be eligible, women must live in Hialeah, Little Haiti or West Perrine, be between 30 and 65 years old, and not have had a Pap test in the past three years. The goal is to enroll 600 women in the next two years. Each woman participates for six months. Those who were randomized to the education only arm will be referred for a Pap test or offered the self sampling test at the end of the six month period. Brendaly Rodríguez manages the Center; Martha Gonzalez and Dinah Trevil coordinate and train the CHWs, conduct interviews, serve as liaison with community partners (Citrus and CHI), and facilitate the Community Advisory Boards (see page 2). We also attend local health fairs and community events to recruit women. In July, the SUCCESS team will attend the annual NCI Health Disparities Summit in Bethesda, Maryland and present a poster on their accomplishments to date. DCO Core Community Leadership Board Next meeting: September 13, :00 1:30 pm (location to be announced) Spring

2 DCO Core Core Director: Erin Kobetz, PhD, MPH Manager & Newsletter Editor Dorothy Parker, MHS Research Associates Martha Gonzalez, MA Dinah Trevil SUCCESS Manager Brendaly Rodríguez, MA Office Location: Clinical Research Building 1120 NW 14th St., 10th Floor Mailing Address: 1120 NW 14th St., C202 Miami, FL Reducing Colorectal Cancer Disparities: FIT for Life Recruitment and interventions are underway on a state funded project to increase screening for colorectal cancer. The research team includes Drs. Olveen Carrasquillo, Erin Kobetz, Daniel Sussman, David Lee, Tulay Koru Sengul and Maria Abreu. Martha Gonzalez and Dinah Trevil, DCO Core staff, are also involved. The study, funded by a Florida Bankhead Coley Cancer Research Program Team Science Program grant, aims to test the feasibility of using the Fecal Immunochemical Test (FIT) as a screening tool in two communities, Little Haiti and Hialeah. It builds on the model used in the SUCCESS (see page 1) by involving Community Health Workers (CHWs), Community Advisory Boards (CABs), and a neighborhood health center. Two approaches are being tested: 1) a group based intervention in Hialeah, in partnership with Citrus Health Network, and 2) individualbased interventions in Little Haiti conducted by a CHW, Monica Oriol. With input from the CABs and CHWs, the Core helped develop the educational material a flip chart in Creole for Little Haiti and a PowerPoint Presentation in Spanish for the Hialeah groups. Participants can be enrolled in the study if they live in either Hialeah or Little Haiti, are age 50 75, and if they have not had recent colonoscopy or FOBT. All participants are given the FIT kit to use. Anyone with a positive result is referred for additional care. The goal is to recruit 250 people at each site. To date, almost 30 have participated in the groups in Hialeah and over 60 have been enrolled in Little Haiti. SUCCESS Investigators Receive Awards Dr. Olveen Carrasquillo received the Society of General Internal Medicine s Herbert W. Nickens Award for his work with underserved minority communities and as an advocate for ending health disparities. Dr. Erin Kobetz was selected by the Returned Peace Corps Volunteers of South Florida and the Miami Dade Teacher of the Year Coalition for the 2012 Spirit of Service Learning Award in higher education. Community Advisory Board Photos Little Haiti L to R: Marlene Bastien, Chrystelle Jean, Marie Jose Ledan, Valentine Cesar West Perrine L to R: Shelia McCann, Dinah Trevil, Sandra Rodriguez, Roxana Brehm, Tabitha Derenoncourt, Lourdes Exume, Marvine Ortiz, Susy Scott, Teresa Miller, Hermine Pollard Hialeah L to R: Martha Gonzalez, Daisy Castellanos, Maria Azqueta, Denise Fuentes, Carolina Naveiras Spring

3 Updates on Funded Studies Smoking Cessation Support Groups Investigators: Drs. David Lee, Noella Dietz, Monica Webb Hooper, Margaret Byrne, Antoine Messiah Project Support has successfully completed five smoking cessation groups. Between December 2011 and May 2012, 42 people participated in one of five groups that meet weekly at the Liberty Square Community Center for eight consecutive weeks. Of the 42, 76% attended at least five sessions. Group members also participated in a focus groups in which they offered feedback on the sessions. The DCO Core has been involved in all phases of this project, from the pre award survey of households in Liberty Square, involving the Liberty City Community Health Advisory Board, and hiring and supervising the people hired to conduct the intervention. We are also consolidating time and activity reports for Dr. Byrne s costs analysis component of the study. Dorothy Parker was the first author on a team paper, "Developing an Urban Community Campus Partnership: Lessons Learned in Infrastructure Development and Communication" that has been accepted for publication in Progress in Community Health Partnerships. This has been a true team. In addition to the UM investigators and the DCO Core staff, five people from the community were hired: Tracy Kelley, Community Research Coordinator, and Dedra Brown, Pamela Burnett, Willie Duckworth and Keith Rolle, Group Leaders. UM and the Liberty Square Resident Council have a Memorandum of Understanding that includes the provision of office space and space for the intervention sessions. The next step will be follow up interviews with group participants and analyzing the results. We will also continue to find resources for those interested in smoking cessation. Dr. Webb Hooper continues to sign up people for her studies, and the University of Miami AHEC has offered to provide programs in Liberty City. Medical Decision Making Investigator: Margaret Byrne, PhD Participation in Cancer Clinical Trials Dr. Margaret Byrne is completing her NCIfunded project to develop and evaluate an online decision aid to help cancer patients make decisions about participating in clinical trials. The DCO Core has provided services on this project for the past three years. The focus is on African American and Hispanic patients, two groups that are often under represented in therapeutic clinical trials. Martha Gonzalez from the DCO Core recruited and interviewed English and Spanish speaking cancer survivors. The Beautiful Gate, the Cancer Support Community and Liga Contra el Cancer were partners in the first phase of the study and helped us recruit participants. In the second phase, Martha recruited and interviewed cancer survivors who provided feedback on the new online decision aid. To date, over 60 people have evaluated it. The web site will be adapted for print and distribution. Lung Cancer Screening Decisions Screening for lung cancer remains a controversial topic. To help smokers at high risk for lung cancer make informed decisions about whether to be screened, Dr. Byrne and her colleagues at the University of Kentucky have been working on a decision aid. Using pilot data collected in interviews conducted by DCO Core staff and others from 2007 to 2009, Dr. Byrne received a twoyear NCI R21 grant in June Over the past two years, Martha Gonzalez has worked on this grant. She conducted 20 interviews in English and Spanish with at risk individuals from both Miami Dade and Broward Counties as well as interviews with health care providers utilizing conjoint methodology. The results were combined with 20 interviews conducted in Kentucky. The results are being used to seek funding to develop and test a web base decision tool. Other Project Updates Oral Cancer Screening Dr. Elizabeth Franzmann continues her study to screen for oral cancer. Adults age 40+ who use tobacco and drink alcohol may be eligible for free screening and referral for follow up care. The screening clinic is at the Liberty Square Community Center. Call for more info. Project CARE (Cope, Adapt, Renew, Empower) Dr. Suzanne Lechner s project is approaching it's final year. She is still enrolling African American women who have recently completed treatment for breast cancer. For more information call Back on Track Drs. Gail Ironson and Jarrard Goodwin completed their NIH funded study in February. The project offered stress management to 106 people who were randomized to one of three interventions. Thank you to our partners at the Jessie Trice Community Health Center, specifically Dr. Fabian Thurston and Myriam Gerstein. And thank you to the Liberty City Community Health Advisory Board for their input and assistance with recruitment. Spring

4 Outcome Disparities for Breast and Lung Cancer in Florida This summer, the DCO Core will begin work on another project with Dr. Margaret Byrne. It is a grant funded by the State of Florida s James and Esther King Biomedical Research Project which will involve detailed analysis cancer incidence data from the Florida Cancer Data System and hospital discharge data from the Agency for Health Care Administration to examine disparities in survival rates for breast and lung cancer patients in Florida. The goal is to better understand these disparities as they relate to patients socio demographic factors, including race, ethnicity and education, as well as hospital characteristics. The DCO Core will help disseminate the findings to the general public and to health care providers and policy makers. During the next nine months, the we will arrange for Dr. Byrne to present the findings to our Community Leadership Board and each of the four CABs to get feedback on how the research findings could be useful and how to best communicate results. The Core will also arrange for presentations to state cancer control leaders such as members of the Florida Cancer Control and Research Advisory Council and the Florida Cancer Plan Council. Based on input from these groups, material will be developed to help individuals and health care providers make decisions that may improve cancer outcomes. Vision Screening for Adults with Diabetes INSIGHT is a multi center study funded by the Centers for Disease Control and Prevention that offers vision screening to medicallyunderserved adults with diabetes. The DCO Core s involvement builds on our community partnerships for smoking cessation studies. People who have diabetes and who smoke are at greater risk of developing diabetic retinopathy. UM is one of the four centers that are providing screening for diabetic retinopathy. The UM team includes Drs. David Lee, Margaret Byrne, and Byron Lam from the Bascom Palmer Eye Institute, and others. While the other study locations are providing screening at hospitals and eye centers, we are offering the screening at the Jessie Trice Community Health Center, and we hired three people from the community to conduct the screening. Two are graduates of the Miami Dade College Optionary Program Stephanie Oliden and Tracy Similien, and the third, Yolanda Davis Camacho, has worked at UM on other research projects. The DCO Core staff, Dorothy Parker and Marsha Stevens, set up the screening site at the Jessie Trice Community Health Center, which has been referring many patients. The Core is also recruiting people from anywhere in Miami Dade County. Flyers have been broadly distributed through other CABs and at heath fairs and other events. The Liberty City Community Health Advisory Board has helped promote the project. Special thanks to CAB member Linda Lott, who is the Outreach Coordinator at Jessie Trice. The Core is also helping Dr. Byrne with the cost analysis component of this study. David Lee gets tested by Tracy Similien during Nidek camera training. Future CDC Projects Drs. David Lee, Margaret Byrne, Noella Dietz and researchers from Bascom Palmer recently submitted another grant application to CDC to evaluate approaches to increasing screening and treatment for glaucoma, another eye disease that disproportionately affects Hispanics and some Blacks. If funded, the DCO Core and the CABs will play a significant role by recruiting, training and supervising a team of Community Health Workers who will follow up with people who receive free screening from the Bascom Palmer mobile vision unit. The van will be scheduled at sites throughout the county based on input from CAB members as well as the results of a spatial modeling analysis that will be conducted by Dr. Naresh Kumar of the Department of Epidemiology and Public Health. Spring

5 Southeast Florida Cancer Control Collaborative The DCO Core staff are involved in the SFCCC as part of our outreach and network activities. Dorothy Parker is the SFCCC Administrator and maintains the SFCCC ListServ, which has over 400 members, as well as the SFCCC web site ( Martha Gonzalez, Dinah Trevil and Brendaly Rodríguez are active members of the Disparities Workgroup which has organized a media campaign for the past several years to provide information about cancer to the local Haitian American and Hispanic community. Several Community Health Workers involved in DCO Core projects have also been involved with SFCCC education programs. community and SFCCC Nutrition Workshop, April 28, Le Pine Restaurant This year, the SFCCC had four projects funded by the Florida Department of Health Comprehensive Cancer Control Program: A healthy eating cooking and shopping workshop held April 28 at Le Pine Restaurant, Bay Harbor Radio programs on Radio Mega and Alma Vision on breast and colorectal cancer, and educational forums at four Haitian churches. Revised website and the addition of searchable speakers database Educational programs on ovarian cancer sponsored by Gilda s Club New promotional material for SFCCC Special thanks to the Health Council of South Florida who served as the fiscal agent for the grant this year. The next SFCCC meeting will be June 14, 2012 at Broward General Medical Center, Ft. Lauderdale. More information is on the SFCCC web page: Dr. John Cordia and Valentine Cesar on Radio Mega DCO Core Services The DCO Core is a shared resource that provides service to University of Miami Sylvester Comprehensive Cancer Center faculty to facilitate community based research. The Core staff has experience and expertise in the full spectrum of research services. Pre and Post Award Services are offered to Cancer Center investigators at no charge. Pre award services include consulting with the Community Advisory Boards on outreach and recruitment strategies for specific populations, providing descriptive cancer and demographic data, and facilitating agreements and letters of support from community partners. Post award services include working on journal manuscripts, presentations, and dissemination of results within the community. Fee Based Services for Funded Projects include negotiating campus community partnerships, outreach, recruitment of study participants, data services for quantitative and qualitative studies, developing study materials development for diverse audiences, and training community health workers. Investigators interested in working with the DCO Core are asked to complete our Getting Started with the DCO Core form on under Links, Forms & Documentation. For more information, contact Dr. Erin Kobetz or Dorothy Parker see page 2 for contact information. DCO Core staff at UM Zubrod Poster Session, May 2012: L to R: Dinah Trevil, Dorothy Parker, Martha Gonzalez Spring