Abstract ED04-02: Reducing cancer health disparities through community-centered interventions: Overview

Presenters in this Workshop are project leaders or core directors in this first-ever National Cancer Institute/National Center on Minority Health and Health Disparities jointly funded program project (P01 CA109091-01A1) based on community-based research and interventions in controlled trials to reduce a cancer health disparity affecting a racial/ethnic minority population group. As a result of thisWorkshop, presenters will discuss the (1) “Conceptual Framework for Community Interventions to Reduce Cancer Health Disparities”; (2) “Methodological Issues and Tools for Community-based Trials to Reduce Cancer Health Disparities”; (3) “Research and Biostatistical Design Issues in Interventions to Reduce Cancer Health Disparities” and (4) “Reducing Cancer Health Disparities through a Targeted Media Campaign to Promote Hepatitis B Screening among Vietnamese Americans”. As a result of thisWorkshop, participants should expect to visualize the gamut of issues from conceptual through both qualitative and quantitative methodological and research design. In the final presentation, concepts, methods, and design issues are exemplified in one of the three research studies in this program project entitled “Liver Cancer Control Interventions for Asian Americans”. In the Overview, the context for this program project will be described in terms of the rationale for focusing on liver cancer as the cancer health disparity of focus; the rationale for the three Asian American ethnic groups included; the formulation of goals and objectives; the preliminary work and studies that led to this research; and the operational conduct of this program project. Hepatitis B-induced liver cancer was chosen as the cancer health disparity of focus because of the overwhelming data and literature that documented this particular disparity as one that disproportionally affects Asian Americans the most and in particular, Vietnamese, Hmong, and Koreans who are the focus of this research. We based our focus on hepatitis B since it is not only a serious health condition but also a very common precursor to the development of almost invariably fatal hepatocellular carcinoma (primary liver cancer). Among Asian Americans, hepatitis B is typically transmitted from mother to child during the birthing process but it can also be transmitted through sexual intercourse. While universal infant vaccination for hepatitis B and successive requirements for hepatitis B vaccinations for school entry may eventually spare children and future generations from hepatitis B, the most recent CDC recommendations encourages adults from higher hepatitis B surface antigen lands of origin such as those from Southeast Asia and Korea to be serologically tested for hepatitis B. In this program project, the overall research goal is common for all three of our R01-level projects, namely, to increase the proportion of Asian American adults to be serologically tested for hepatitis B. With the knowledge of the serological test results and outside the scope of this research study, follow-up such as vaccination if not infected or earlier treatment to extend life as appropriate may be initiated. While the overall research goal is the same for all three projects, the three projects differ in research design and intervention approaches. Additionally, our program project is distinctive in that each of the three projects focuses on a single Asian American ethnic group rather than combining all ethnic groups in a single study. We believe there is considerable value to this approach and this approach will be explained. The program project was funded beginning in September 2006. In reality though this program project could not have been initiated without the years of previously conducted preliminary work and the earning of trust through collaborations among multiple investigators and community leaders scattered over several geographically dispersed sites. We believe the proper conduct of community-centered studies must be carefully conducted; applying lessons learned from various methodologies may be useful; however, the most important aspect is the requirement to earn the community9s trust and that once earned must be maintained as a privilege and not a right.