Abstract C115: Yale Cancer Disparities Firewall Project: Taking lifestyle change and cancer screening into the community to reduce cancer disparities
Authors: Jone Beth A , Herbst Roy , Suttiratana Sakinah C , Killins Monique , Stevens Denise , Green Briyana , Prinz Jacqueline , DeJesus Jose 
Published: September 2020

Abstract
Background: Cancer incidence rates in Connecticut are well above the national average with the greatest burden on African Americans, Hispanic/Latinos, and those with low socioeconomic status. In 2018, we launched the Yale Cancer Center’s (YCC) Cancer Disparities Firewall Project with the goal of providing a protective firewall around our catchment’s at-risk populations, specifically targeting breast, prostate, lung, and colorectal cancer. Methods: The Aims of the Cancer Disparities Firewall Project are to: 1) expand community outreach & education; 2) establish a “health” navigation program; 3) create infrastructure to support sustainable change. Strategies to accomplish Aims 1 & 2 require our presence in communities, workplaces, and other venues that are not always associated with health care institutions. Focusing on 2 key components of the cancer control continuum, prevention and early detection, and adapting for individual settings (e.g., minority populations are concentrated in mostly urban areas of the state), we conduct health fairs, provide “Ask the Doctor” forums, and hold free screening events on a regular basis. Supported by a bicultural/bilingual male and female staff, we provide outreach in Spanish and English. For Aim 2, we established a “health” navigation program that provides geo-coded linkages to care in the communities where people live by combining skilled health navigators with a digital platform, NowPow. As accessing services to support lifestyle change (e.g., tobacco treatment, weight management) and timely cancer screening may be low priority, we screen for social determinants of health (SDOH), as well as cancer prevention barriers and tailor referrals to services accordingly. Based on multiple points of contact beginning with in-person enrollment at a community based event, we facilitate access by building relationships that continue as needed. The third aim is to build sustainability into our efforts through internal and external partnerships. Results: Since June, 2018, community outreach and education events (Aim 1) have increased by 80%, as has documented outreach to individuals (from 3345 to 5500), with racial/ethnic profiles that reflect the target population. In its first 2 months, the health navigation arm of the project (Aim 2) has recruited 141/511 individuals into navigation with 30% (42/141) currently followed (71.4% female, 65% AA, 20%H/L, 6% other). Now working with almost 100 community and institutional partners in order to assure sustainability (Aim 3), as one example, we partner with a local community college to build a cancer track into a patient navigation program, adapting the curriculum as needed. Summary: Addressing the four cancers that drive observed cancer disparities, our approach uses outreach and technology to increase our navigation in-reach to vulnerable communities, and is an important step toward establishing linkages to care. Further, this work lays the foundation for new implementation strategies and research.
Citation Format: Beth A Jone, Roy Herbst, Sakinah C Suttiratana, Monique Killins, Denise Stevens, Briyana Green, Jacqueline Prinz, Jose DeJesus. Yale Cancer Disparities Firewall Project: Taking lifestyle change and cancer screening into the community to reduce cancer disparities [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 C115.