Abstract PR006: Building a sustainable cancer prevention program in partnership with an urban public recreation system
Authors: Alonso Estefania , Pinsoneault Laura , Kwarteng Jamila , Contreras Sandra , Tovar Margaret , Sheean Patricia , Jensik Kathleen , Prado Ana Karen Manriquez , Stolley Melinda R. 
Published: December 2023

Abstract
Cancer is the second leading cause of death in Wisconsin with higher incidence, late-stage diagnosis, and mortality rates in the African American and Hispanic populations. Accessible and affordable programming to address cancer risk is necessary for cities such as Milwaukee, where communities are under-resourced and disproportionately affected by segregation. The Total Wellness (TW) program offers alternatives to these barriers. Developed through a partnership between an academic cancer center and MKE Recreation (MKE Rec), TW provides an accessible and sustainable cancer prevention and lifestyle program for the African American and Hispanic communities in Milwaukee. The intervention focuses on increasing cancer-related knowledge and improving nutrition and physical activity patterns to reduce cancer risk, while also improving overall health and quality of life (QOL). Herein we present the implementation and sustainability results of our TW pilot study. TW is offered as a standing program within MKE Rec. The program promotes adherence to the American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention by following a weekly workbook plan guided by a trained MKE instructor. TW is offered at local community sites and is divided into three 8-week sessions (1.0, 2.0, 3.0) with twice-weekly classes that begin with a 30-minute informational session on topics such as cancer risk, cancer screening, strategies for behavior change, plant-based cooking demos, followed by supervised exercise with strength training. To evaluate the intervention, class registrants were invited to participate in quasi-experimental assessments before and after each 8-week session and included surveys and physical assessments. The RE-AIM (Reach, [Potential] Effectiveness, Adoption, Implementation and Maintenance) framework was used to assess implementation (Winter 2022 – Spring 2023). Reach: TW classes were offered every season with 151 total registrations where 51 registrants participated in evaluations. Efficacy: Significant improvements pre-post were noted for physical activity, diet, weight, blood pressure, sit to stand, hand grip strength, walking distance and cancer knowledge. Adoption: Two MKE Rec sites offer the program each season. Implementation: The program is implemented as developed, four MKE Rec instructors (2 are bi-lingual) have been trained to teach TW, and program content is available in English and Spanish. Maintenance: TW registration is integrated into the MKE Rec system, teacher training is manualized, registration has been consistent for 6 seasons, and class participant satisfaction is high, as reflected in satisfaction survey scores and testimonials. Results support the feasibility, potential efficacy and sustainability of integrating cancer prevention programming into public recreation systems. Ongoing efforts will focus on monitoring program sustainability and exploring related barriers and facilitators. Future work will expand programming to new sites and cities.
Citation Format: Estefania Alonso, Laura Pinsoneault, Jamila Kwarteng, Sandra Contreras, Margaret Tovar, Patricia Sheean, Kathleen Jensik, Ana Karen Manriquez Prado, Melinda R. Stolley. Building a sustainable cancer prevention program in partnership with an urban public recreation system [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR006.