Dr. Karriem Watson, DHS, MS, MPH ...¢  Abstract: Our goal is to work with Citizen Scientists to inform

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  • Dr. Karriem Watson, DHS, MS, MPH Associate Director of Community Outreach and Engagement, UI Cancer Center at UIC

    Senior Research Scientist &Co-Director OCERIS UI Cancer Center at UIC Director of Community Engaged Research Mile Square Health Center

    Research Assnt. Professor UIC School of Public Health

    Cancer Disparities: How Community Engagement Can Improve Rural and Urban Outcomes

  • OBJECTIVES • Identify cancer disparities among rural and urban

    populations in Iowa;

    • Discuss the importance of "quadruple diversity" - race, place, age and geography - in clinical and translational research;

    • Identify how community engagement can improve cancer disparities among rural and urban populations.

  • MORE IN COMMON THAN NOT

  • The UICC Leadership Response to Needs of Its Catchment

    Severe housing problems Higher pollution Higher unemployment Lower income

    Smoking Excessive alcohol Physical inactivity

    Obesity Diabetes

    STI Lower cervical and colon

    screening

    Prostate Colon Lung

    Cervical

    Breast Colon Lung

    Behavior

    Higher Mortality

    Higher Incidence

    SES

    Higher burden of socioeconomic/structural and individual level barriers compared to the US.

    6.1 million residents ● 25% racial/ethnic minorities ● 2 urban counties ● 3 rural counties

    • Cook, Will, Livingston  MUA La Salle  HPSA • Urban counties  more structural risks • Rural counties  more individual risks • African American women  3X cervical cancer mortality compared to US

  • SNAPSHOT OF CANCER DISPARITIES AND PRIORITIES IN IOWA

    Breast

    Melanoma

    Colorectal

    Higher Than

    National Average

    Liver

    Lung

    Pancreatic

    Cancers on the Rise

    Modifiable Behavioral Priorities

    Tobacco

    Vaccinations

    Sun Exposure

    Physical Activity

    Diet

    Alcohol

    Data retrieved from Iowa Cancer Plan 2018-2022

  • TOBACCO & LUNG CANCER: URBAN VS RURAL IN THE UICC & IOWA

    Rural: Variability in access to care (i.e. availability of specialists); Differences in penetrance of social networks & Unique engagement approaches

    Urban: Unique epigenetic factors; Contextualization of race/ethnicity & Widespread engagement

    opportunities

    Shared: Health beliefs/knowledge toward screening and prevention; Lack of innovation in biomarkers to

    improve screening and early detection; Financial toxicity associated with late stage diagnosis

  • SOCIOECOLOGICAL MODEL: ADDRESSING HEALTH DISPARITIES ACROSS RURAL AND URBAN

    Retrieved from https://www.cdc.gov/cancer/crccp/sem.htm on 10/16/17

    Socioecological and Cancer Disparities

    1:1 Navigation

    Shared Decision Making

    Role of FQHCs

    Project Brother-

    hood

    USPSTF Society of Behavioral Medicine

    https://www.cdc.gov/cancer/crccp/sem.htm%20on%2010/16/17

  • RURAL Variability in access to care (i.e. availability of specialists); Differences in penetrance of social networks & Unique engagement approaches

  • URBAN Unique epigenetic factors; Contextualization of race/ethnicity & Widespread engagement opportunities

  • SHARED: CANDACE’S STORY

    “Cancer is like a hurricane, but community awareness can help”

    • Diagnosed with Colon Cancer at the age of 36 while raising 5 daughters as a single parent;

    • Knew something was wrong and 1st stop was to go to ER, but sent home;

    • While working as a bus driver, went back to ER 1 month later for similar complaints and dx of Ovarian Cysts and Fibroids….BUT

    • Another ER visit 6 months later resulted in Colon Cancer Diagnosis

  • SHARED: A TRANSFORMATIONAL APPROACH TO DIVERSITY

    10

    “Reflecting the country’s rich diversity to produce meaningful health outcomes for communities historically underrepresented in biomedical research.”

  • PRECISION ENGAGEMENT”: A NEW APPROACH TO EVIDENCE BASED ENGAGEMENT

    Precision Medicine Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in lifestyle, environment, and biological makeup.

    It is a radical shift in how each of us can receive the best care possible based on our unique characteristics.

    NIH Definition of Precision Medicine

    Precision Engagement

    Precision engagement is an innovative concept deployed by the UI Cancer Center OCERIS that takes into account principles of community engagement it factors in where a person lives, what they have access to, the cultural norm of social networks within the community and capitalizes on where and how people organically convene and engage.

    One Size Does Not Fit All…..

  • COMMUNITY ENGAGEMENT DRIVES AND INFORMS RESEARCH

    Retrieved from https://iims.uthscsa.edu/community.html on 9/20/2019

    https://iims.uthscsa.edu/community.html

  • RURAL ENGAGEMENT IN THE UICC CATCHMENT AREA Study: Illinois Rural Cancer Assessment (IRCA) A statewide, cross-sectional survey conducted from 01/2017-09/2018 of the health status and needs of adult, rural-dwelling cancer survivors

    Rural Cancer Survivors will account for approximate 3.5 Million survivors by 2020. Research shows that compared to urban populations, rural cancer survivors face increased challenges in overall Quality of Life (QOL) compared to urban cancer survivors.

  • Robert H. Lurie Comprehensive Cancer Center of Northwestern University

    Northeastern Illinois University

    University of Illinois at Chicago

    U54 Partnership

    NCI U54: A Research Pilot to Demonstrate Health Equity Research

    ENGAGING CITIZEN SCIENTISTS TO TEST THE ACCURACY OF A CANCER BIOMARKER IN AFRICAN AMERICAN MEN

    Josef Ben Levi EdD Marcus Murray, MPH Tiffany McDowell PhD Ivanhoe Hall Karriem Watson DHS, MPH, MS Adam Murphy, MD, MBA

  • Specific Aims Abstract: Our goal is to work with Citizen Scientists to inform and aid in the recruitment of an AA cohort of 125, 40-79y/o men to assess the normal distribution and potential of Prostate Health Index (PHI) as a prostate cancer screening test.

     Aim 1. Recruit and train a cohort of 8-12 Citizen Scientists to support the engagement of their social networks and to inform community engagement and recruitment of a cohort of healthy controls.

     Aim 2. Expand the cohort of African American men by recruiting 125 asymptomatic African American men age 40-79y/o without elevated PSA or prostate cancer to establish normal age-adjusted ranges for Prostate Health Index.

     Aim 3. Compare the distributions of Prostate Health Index scores and serum PSA between three risk groups: African American community dwelling low risk men; African American men with negative prostate biopsies; and African American men with high-grade prostate cancer.

  • Aim 1. Recruit and train a cohort of 8-12 Citizen Scientists to support the engagement of their social networks and to inform community engagement and recruitment of a cohort of healthy controls.

    4 MPIs recruited 8 lay AA males into research based on their interest in AA male health, prostate cancer and/or willingness to engage their social networks for worthwhile research

    LEAD Citizen Scientist: Dr. J. Ben Levi-NEIU (MPI)

  • Impact: Social Network Engagement and Cohort Recruitment Event CS involved n Movember 3-on-3 (0 high PSA)

    Observing 1

    Trinity Church/PHEN (1 high PSA)

    Observing, planning 4

    Washington Park 1-3 (9 high PSA, 2 missing)

    Co-leading 103

    Trinity/Men’s Health (1 high PSA)

    Facilitating, registering, recruiting, co-leading

    24

    Carruthers Center (0 high PSA)

    Facilitating, registering, co-leading

    7

    Recruitment total 139 17

  • Patient Navigators: Navigation Manager: Barbara Williams Nasima Mannan Paola Torres

  • MAMMOGRAPHY SCREENING WITHIN MILE SQUARE HEALTH CENTER

    0

    200

    400

    600

    800

    1000

    1200

    2017 2018

    Chart Title

    Mammography Screening Column1 Column2

  • UI Cancer Center Awarded $1.5Million to Address Cancer Disparities on South and West Side

  • Black/ African American

    Latino/Hispanic

    Asian American Native

    Hawaiian/ Pacific Islander

    Middle Eastern/ North African

    Sexual orientation/

    gender identity

    Geography (rurality) Disabilities

    Age

    Sex

    Income

    Education

    Thank You & Questions

    Slide Number 1 objectives More in Common than Not Slide Number 4 Snapshot of cancer disparities and priorities in Iowa Tobacco & Lung cancer: Urban vs Rural in the uicc & Iowa Socioecological Model: Addressing Health disparities across rural and urban Rural Urban SHARED: Candace’s story SHARED: A Transformational Approach to Diversity precision engagement”: A new approach to evidence based engagement Community engagement drives and informs research Rural Engagement in the UICC Catchment area NCI U54: A Research Pi