Vanessa Malcarne - US grants

DESCRIPTION (provided by applicant): Men and women of Hispanic American (HA) heritage are difficult to recruit to clinical trials. Multiple factors contribute to this circumstance, including differential access to health care and health education associated with individuals'socioeconomic and linguistic characteristics, unique environmental and social forces that interplay within this cultural group, and cultural differences in attitudes, responsibilities, and practices related to health and disease. The NCI developed a customized Clinical Trials Education Series for HAs (CTES) in Spanish to help address the difficulty of recruiting HA participants to clinical trials. However, this series has not been systematically evaluated for its efficacy, and focus groups found it to be too complex for lay audience applications. In response, fotonovelas were developed but lack content needed to promote shifts in knowledge, attitudes, and behaviors. This project will adapt the best program components of the CTES into a single linguistically- and culturally-aligned clinical trials education program in English and Spanish. This adapted program will serve as the centerpiece of a randomized controlled trial to assess the program's capacity to help raise HAs'scientific literacy and positively change their attitudes about clinical trials participation in the intervention group, and then to assess whether the increased scientific literacy and improved attitudes in that group mediate subsequent response to invitations to participate in research studies. Their responses will be compared to control group members'changes in literacy and attitudes, and responses to the same research study invitations. In addition, intervention versus control participants'responsiveness to an invitation to participate in the PI's Ambassadors for Clinical Trials Program (ACTP) will be compared (ACTP promotes participation in research studies by having Ambassadors help studies recruit other members of their community). Baseline data collection will also include validated demographic, health, cultural, and psychosocial instruments to allow the researchers to determine whether personal characteristics of the participants moderate response to the clinical trials education program. The overarching study goal is to determine whether the NCI's education program can be adapted and applied to begin the process of creating a shift in knowledge, attitudes, and behaviors within the HA community related to clinical trials participation. If this educational program is effective, there will be an immediate and long term public health benefit. The program will have the immediate effect of creating a positive shift in knowledge and attitudes toward research study participation within the HA community. This will subsequently benefit the region's research community by creating a pool of HA community members who can be directly invited to participate in research studies and who can help open the community's doors to the research community. Ultimately this will advance the health and well being of the HA community as greater participation in health research increases the generalizability of research findings to this community.

DESCRIPTION (provided by applicant): The Deaf community experiences many of the same barriers to good health information and care as other minority communities. However, in comparison to other minority communities, very little research has examined health disparities in the Deaf community. Our long-established community-campus partnership has taken a number of steps to addressing the needs of the Deaf community, including training of health care providers in Deaf culture and American Sign Language (ASL), improving ASL interpreters' understanding of health-related information, and developing education programs in ASL to promote cancer prevention and early detection. Still lacking is a program to teach the Deaf community about cancer from the point of diagnosis through treatment and survivorship. In this project, our partnership will create a new and innovative education program called Coping with Cancer: A Program for the Deaf Community in American Sign Language. This will be a trilogy of cancer education videos in ASL with captioning and voiceover that will give members of the Deaf community and their loved ones access to the kind of information that hearing people have when the diagnostic, treatment and survivorship processes are underway for cancer. The three videos will focus on: 1) the diagnostic process and medical decision-making; 2) common cancer treatments; and 3) coping with and managing cancer and maintaining quality of life. After the three videos are developed, each will be scientifically tested in a national randomized controlled trial with control group cross-over to assess each video's capacity to increase the knowledge Deaf persons have about cancer diagnosis, treatment, and management. The videos will also be tested to see if they positively change Deaf persons' confidence for dealing with the challenges presented by cancer, specifically measuring changes in knowledge, self-efficacy, and fatalism at baseline (pre- intervention), immediate post-intervention, and two-month follow-up. Deaf individuals in the experimental group in this study will see one of the three newly developed cancer videos. Control group members will initially see an exercise video and then will be invited to cross over into the experimental group to view one of the cancer videos. Baseline data collection will also include demographic, health status, health literacy, Deaf acculturation, and health locus of control measures to allow the researchers to determine whether personal characteristics of the participants moderate response to the education program. The two-month follow-up will determine whether gains are maintained over time. If this educational program is effective, there will be both immediate and long term public health benefits. The program will have the immediate effect of increasing knowledge and understanding of cancer diagnosis, treatment, and survivorship issues in the Deaf community nationwide. The programs that will be created can be accessed anywhere and without cost by the Deaf community and their loved ones, as well as healthcare professionals who serve the Deaf community. This will have the long term benefit of providing a set of educational tools that can continue to educate the community on an ongoing basis.

? DESCRIPTION (provided by applicant): Increasing the number of scientists and clinicians from underrepresented communities has been recognized as one means to help reduce the nation's cancer disparities. The Creating Scientists to Address Cancer Disparities Program (CSP) is an intensive bio-behavioral science training program designed to facilitate underrepresented community college science majors' (CSP scholars) successful transfer to UCSD and SDSU followed by their matriculation into graduate school. Transferring students begin the CSP during the summer before they transfer and continue to receive mentoring from CSP faculty throughout the remainder of their college years. The program has basic and behavioral science majors working and learning side-by-side in a public health community-based laboratory as a model of how multidisciplinary teams of bio-behavioral scientists can work together to address health disparities. CSP begins with an 8-week public health laboratory- based Summer Science Enrichment Program (SSEP). The SSEP includes seminars to give students a solid understanding of cancer and bio-behavioral issues related to the development of cancer disparities. It also includes workshops to increase participants' likelihood of successfu progression into graduate school and beyond. Students also learn a variety of hands-on research methods to use in the field, as they work within community-campus partnerships. The field experience will assure that they gain a working knowledge of how to identify, research, and resolve health disparities. This summer training is followed by continued academic training and mentoring via a required 10-month lab placement for a minimum of one academic credit in the PIs' public health laboratory. During this 12 month-long training, students will prepare and submit an abstract to present their research findings at a national scientific conference. Each CSP scholar will work with program faculty to identify other sources of support and funding to continue the scholars' laboratory experiences beyond their first 12 months. CSP will make it possible for its transferring students to access programs that are not normally accessible in transferring students' first year. This community college-focused CSP is grounded upon the literature and the team's current R25E grant that facilitates community college students' successful transfer to UCSD and SDSU. The CSP has clearly defined, measurable outcomes for assessing its success, using the same rigorous data collection and evaluation methods that were proven successful in earlier training programs.