Abstract A56: Sustainability and health education: Training public health students to deliver cancer information in Puerto Rico
Authors: Moreno Laura , Rivera Yonaira , Vélez Himilce , Jiménez Julio , Vadaparampil Susan , Muñoz-Antonia Teresita , Torres José , Quinn Gwendolyn 
Published: May 2016

Abstract
Introduction: Cancer is the leading cause of death among Hispanics, currently the largest and fastest growing minority group in the US. Education plays an essential role in reducing cancer health disparities. Although community health workers (promotores) in Hispanic communities has been successful in health promotion and education initiatives, funding and training resource limitations may impact this model's sustainability and dissemination. In an effort to address these limitations, the NCI-funded U54 partnership between Moffitt Cancer Center and Ponce Health Sciences University (PSHU) developed a cancer education program to effectively deliver education in the community. The training program utilizes a culturally adapted version of “Cancer 101: A Cancer Education and Training Program” (Cancer 101) meeting the cultural needs and social context of Hispanics in Puerto Rico (PR). The purpose of this study was to train graduate public health students to disseminate cancer education to PR communities, Given that these students are likely to provide health education in a variety of community settings and contexts as part of their routine job responsibilities, to develop a sustainable cadre of public health professionals to deliver cancer education.
Methods: Graduate students (n=32) from PHSU's Public Health program participated in a two-day Cancer 101 training, where they learned how to deliver nine cancer modules to the community: Cancer in PR, risk factors and prevention, early screening, diagnosis and stages, treatment, cancer and chronic illnesses, support for the survivor and the caregiver, biobanking, and cancer genetics. Participants also learned adult facilitation techniques and how to administer and analyze module pre- and post-tests. After each module was presented and discussed, cancer knowledge was assessed by using a total of 54 items to measure concepts discussed within each module, both before and after the training. At the end of the two-day training, participants completed a training evaluation, with items informed by the Social Cognitive Theory (SCT), which addresses the dynamics between communication and behavior change. Participants were asked to read each item and indicate if each statement was true, false, or if they were not sure. Items were recoded (1=correct, 0=incorrect or not sure) and scores added for total module scores, with higher scores meaning higher knowledge. Basic demographic frequencies were calculated and paired t-tests were conducted to measure students' gained knowledge. Lastly, means and standard deviations were calculated on evaluation items that assessed SCT constructs of self-efficacy, observational learning, facilitation, and outcome expectations.
Results: Training participants were mainly female (78.1%), 26.7(+3.9) years old and enrolled in a Masters-level program (81.3%). The pre and post-test mean score (SD) were 38.25(4.00) and 49.63(2.65) out of the 54 questions with a 11.38 point increase in overall cancer knowledge [t(31)=14.88, p&lt;.000], with all but one module (Module 3: Cancer Screening [t(31)=1.28, p=0.211]) showing statistically significant increases after receiving the two-day Cancer 101 training. Participants also evaluated the training favorably upon completion, reporting satisfactory comments in the open-ended responses and high levels on measured SCT constructs, which are important to ensure information is adequately delivered to community members.
Conclusion: The Cancer 101 training allowed students to learn how to deliver cancer education to local communities. The availability of well-trained graduate students to serve as health educators is an innovative, sustainable way to deliver health education to local communities. These trained students will assist in efforts to disseminate cancer information and increase knowledge and attitudes about cancer prevention, early detection, treatment, and research in southern PR.
Citation Format: Laura Moreno, Yonaira Rivera, Himilce Vélez, Julio Jiménez, Susan Vadaparampil, Teresita Muñoz-Antonia, José Torres, Gwendolyn Quinn. Sustainability and health education: Training public health students to deliver cancer information in Puerto Rico. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A56.