Abstract D012: Using geographic information systems mapping to target a cancer prevention theater outreach program to the medically underserved
Authors: Escobar Betsy , Oluyomi Abiodun , Valverde Ivan , Montealegre Jane , Jibaja-Weiss Maria 
Published: September 2020

Abstract
Introduction: Breast (BC), Colorectal (CRC), Cervical (CXC) cancers are preventable through early detection. However, these cancer rates remain higher among medically underserved minority populations. Disparities in knowledge and awareness of screening contribute to the increased cancer burden. Group and one-on-one education are evidence-based strategies to promote screening test utilization in these communities. We created an innovative Theater Outreach Program (TOP) to disseminate educational messages in a linguistically and culturally sensitive way to engage minority medically underserved populations. Through the TOP, researchers and clinicians work with local playwrights and actors to develop culturally and linguistically appropriate monologues for African American, Hispanic, and Vietnamese communities. Since the inception of the TOP, we performed monologues in medically underserved areas with a high incidence of relevant cancer throughout our catchment area, Harris County. However, geographic data on screening behaviors may be effective in fine-tuning delivery of our monologues. Methods: Using Esri’s ArcMap 10.4 (Esri, Redlands, CA), we geo-processed cancer screening data at the census tract level. We retrieved data on mammography use, Papanicolaou smear use, fecal occult blood test, sigmoidoscopy, or colonoscopy use from the 500 Cities Project. For our GIS analysis, we first geocoded the locations of all the TOP monologues performed from January 2012-July 2018 (n=260). Using the 500CP 2016 data, we created choropleth maps displaying the percent of the eligible population screened for BC, CRC, and CXC cancer in county census tracts. The percent of screened data were classified into five categories based on the “Natural Breaks Classification” method in ArcGIS. For visualization, we overlaid the TOP geocoded locations “points” on top of the screening prevalence choropleth maps, where each census tract is represented as a “polygon” allowing us to show where the census tract polygons contained the TOP points. Results: BC, CxC and CRC screening rates vary widely across census tracts in Houston. Overall, we presented TOP monologues in areas with the lowest prevalence of screening test utilization. However, there are notable areas (e.g., in the far east quadrant of the city) where TOP monologues have not been presented despite having the lowest screening rates. Conclusion: The yield of GIS maps that we obtained is a robust framework that will help us to monitor diseases in medically underserved minority populations and the use of screening services. These maps enabled us to gain insight into the medical needs and screening services utilization within our catchment area. We will strategically target regions in most need of our cancer prevention performances and linkage to screening services to close the gap of cancer health disparities among minorities.
Citation Format: Betsy Escobar, Abiodun Oluyomi, Ivan Valverde, Jane Montealegre, Maria Jibaja-Weiss. Using geographic information systems mapping to target a cancer prevention theater outreach program to the medically underserved [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 D012.