Background

1. Education Intervention Analysis (GT, GW, HW, JH, MR, UDC, UVA, WHC) Health Education Training (GT, GW, HA, HW, JH, MR, UDC, VCU, WHC) Improving Clinical Trial and Biospecimen Bank Accrual and Cancer Risk Study Enrollment (GT, GW, HW, JH, UMD, UVA, WHC) Health Literacy/ Education Community- based Participatory Research (GT, GW, HW, JS, MR, UDC, UVA, WHC) Health Information Communication (GT, GW, HA, HW, JH, MR, UDC, WHC) Patient Navigation (GT, GW, JH) Cancer Screenings Clinic-based interventions (GT, GW, HW, JS, UVA, WHC) Community-based interventions (GT, GW, HW, JS, UVA, WHC) NCI CRCHD Geographic Management Program (GMaP): Catalyzing inter-institutional collaborations for enhanced cancer health disparity (CHD) research and outreach for patient navigation SH Hijaz, MPH. ; SA Reisinger, MPH; PG Shields, MD; CD Williams, PhD; SR Patierno, PhD George Washington University Cancer Institute (SRP, SHH); Georgetown University Lombardi Comprehensive Cancer Center (PGS, SAR), Howard University (CDW) Summary- Region 1 Background Phase I: Develop Infrastructure Region 1 (DC, MD, VA): - Bowie State University - Georgetown University - George Washington University - Hampton University - Howard University - Johns Hopkins University - Morgan State University - University of the District of Columbia - University of Maryland- Baltimore - University of Maryland- Eastern Shore - University of Virginia - Washington Hospital Center - Virginia Commonwealth University • Phase II: Resource Assessment • Survey Tools: • Readiness Assessment Tool (RAT): NCI survey tool- institutional data collected on: • - Communication abilities - Biospecimen banking - Bioinformatics • - Emerging technology - Clinical trials - Training programs • Resource Assessment Database (RAD): Region 1-specific tool, obtains a more thorough understanding of institutional resources and cooperation potential, including more qualitative information- institutional data collected on: • - Communication abilities - Biospecimen banking - Bioinformatics • - Emerging technology - Clinical trials - Training programs • - Community outreach - Institutional Infrastructure - Social & Behavioral oncology • In 2009, the NCI Center to Reduce Cancer Health Disparities (CRCHD) launched its GMaP initiative • Groups cancer health disparity (CHD) research and outreach efforts according to geographic region • Goal: create a regional network wherein resources can be pooled to facilitate progress through inter-institutional collaborations with large-scale funding 6 Regions across the country: • George Washington University Cancer Institute (GWCI) selected as the Region 1 GMaP coordinating hub • Georgetown Lombardi Comprehensive Cancer Center selected as Region 1 BMaP coordinating hub (focused on Biospecimen Banking for CHD research) Phase III: Implementation Plan (in progress) Institutional resources, interests, and project proposals are gathered to pinpoint project themes that are most optimal for inter-institutional collaboration. Mechanisms by which institutional interests can be proposed and pursued: - Collaborative Outreach Networks for Community Engagement and Research Translation (CONCERT) - Collaborative Networks for Laboratory and Clinically-based Research - Collaborative Networks for Inter-Institutional Training • BMaP: Survey of three Region 1 institutions* on metabolomics specimens by type and race. • Human biospecimens from racial and ethnic populations that can be used to study metabolomics, accessible to investigators through collaborative mechanisms: • - African American: 113745 - Native American: 745 Total: 127902 • - Asian: 7259 - Native Hawaiian / Pacific Islander: 84 • - Hispanic: 6611 - Other: 3958 • * Georgetown University, George Washington University, Howard University, & Virginia Commonwealth University CONCERT Implementation Diagram: Conclusion Region 1 GMaP Institutional Interest by Topic CONCERT The RAT/RAD data submitted thus far indicates a wide variety of resources within Region 1 that can be brought together to meet the goal of addressing CHDs as a whole. The Phase III Implementation Plan, whereby Region 1 will use collected Regional information to brainstorm unique and important collaborations between Region 1 institutions, is in progress. The mechanisms that have been structured, which will serve as the means by which future project proposals can be assessed and pursued, have been separated into the community/outreach-based, laboratory/clinical-based, and training-based. Future G/BMaP effort will be focused on further development of these mechanisms and direct pilot projects utilizing these tools in order to assess their feasibility and potential impact. Research Question: What is the role of patient navigation in health care education, social attitudes, health behavior changes, and participation in clinical trials, biospecimen banking, and cancer risks studies as related to CHDs? Overarching Hypothesis: Patient navigation mediates the effectiveness of interventions to reduce cancer disparities by improving health literacy, providing social support, and increasing access to health education.  The mediating effects result in enhanced capacity to use health information, improved adherence to cancer screening recommendations, and increased likelihood of participating in clinical trials, biospecimen banking, and cancer risk studies. Patient Navigation