Abstract B9: A health disparities and clinical trials advocacy partnership to reduce colorectal cancer among Pacific Islanders in Southern California
Authors: Tanjasiri Sora P. , Gonzales Maria , Peters Ruth , Nacpil Lianne , Harris Nancy , Harness Jay 
Published: December 2010

Abstract
Introduction: Pacific Islanders (PIs) are indigenous people from the Pacific who experience enormous cancer disparities in colorectal cancer (CRC) in Southern California, with incidence rates of 55/100,000 among PI males and 60/100,000 PI females, compared to only 40/100,000 among non-Hispanic white (NHW) males and 50/100,000 NHW females. Yet no programs outside of Hawai'i exist to assist PIs with accessing early CRC detection, diagnosis and treatment services.
Methods: Patient navigation offers support and guidance to underserved populations, and in 2010 a NCI Community Cancer Center Program hospital (SJO: St. Joseph Hospital of Orange) and a Community Network Program (WINCART: Weaving an Islander Network for Cancer Awareness, Research and Training) instituted a community-based participatory research (CBPR) partnership for Chamorros, Marshallese, and Samoans in Orange County, California. The unique CBPR navigation effort involves three bilingual/bicultural PI health educators (at three WINCART affiliated community-based organizations) and a PI lay navigator (at SJO) to (1) effectively navigate PI men and women to a medical home in order to participate in CRC screening; (2) assisting patients with positive or suspicious findings to access additional diagnostic services, treatment and clinical trials advocacy; and (3) to ensure patient receives appropriate re-screening and diagnostics ideally in a St. Joseph Hospital community based medical home.
Results: Preliminary activities have included development of clinical-community protocols for enrolling and tracking patients from screening through treatment, clinical trials education in a colorectal prevention trial as applicable and development and translation of culturally tailored CRC educational materials (including a flipchart, bookmark, and resource list) into the three PI languages. These materials and protocols have been pre-tested with PI adults age 50+ years, and are being implemented to assess improvements in regular screenings/re-screenings (when needed), diagnosis, and support services that a patient or family may need to ensure completion of treatment plans, with comprehensive data on navigated patients to be entered into SJO's existing navigator database.
Conclusions: This is the first PI-specific CBPR navigation program in the continental U.S. and is based upon a partnership between two disparity-oriented institutions/programs (SJO and WINCART) to address the many critical factors (including mitigating the inability to pay for services, or to qualify/pay for healthcare insurance and clinical trials education) related to accessing culturally competent cancer care for PIs. Our CBPR navigation effort holds the potential to become a model for other clinical-community partnerships that aim to expand cancer services to small, ethnically distinct populations in the U.S.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B9.