NCI awards grant to reduce cancer-related health disparities among Latinos

A $4 million, five-year grant from the National Cancer Institute will create a Texas regional Community Networks Program Center (CNPC), called Latinos Contra El Cancer, to reduce cancer-related health disparities among Texas Latinos.

The center is a joint project of The University of Texas Health Science Center at Houston (UTHealth) School of Public Health and The University of Texas MD Anderson Cancer Center. It will engage the community at all levels to develop effective and culturally appropriate cancer prevention and control programs among Latinos.

According to the 2009 U.S. Census, Texas is home to 9.1 million Latinos - a relatively young and rapidly growing population.

"The number of Latino cancer cases is projected to increase dramatically in the next several decades. The center's efforts are designed to build capacity in the Latino community throughout the state to deliver evidence-based cancer prevention and control policies and interventions," says David Wetter, Ph.D., chair of the Department of Health Disparities Research at MD Anderson.

"It's a really exciting opportunity and collaboration because we're building on the strengths of both the UT Health School of Public Health and MD Anderson," says Maria Fernandez, Ph.D., associate professor of Health Promotion and Behavioral Sciences at the School of Public Health. "We bring our expertise in health promotion, intervention development and community-based participatory research, where the community participates fully in all aspects of the research process, and the already established regional infrastructure of the School of Public Health."

MD Anderson brings Mano a Mano, a Mexican-American cohort study, and the expertise in addressing cancer-related risk behaviors.

"Together, we can do so much more," says Fernandez.

The CNPC combines innovative research, a multi-faceted training program and extensive community outreach to reduce cancer-related health disparities in Latinos.

Research focus on smoking, diet and activity
The goal of the research program's intervention study is to develop and evaluate innovative approaches to reduce cancer risk related to the three leading behavioral risk factors for cancer: smoking, poor diet and physical inactivity. It will focus on participants in Mano a Mano, which is a long-term health study of people of Mexican origin living in Harris County. The study collects information on participants and their families, including date, place of birth and health status, and updates the information regularly for up to 10 years.

"Mano a Mano is the infrastructure for the research program," says Melissa Bondy, Ph.D., cohort principal investigator and professor in MD Anderson's Department of Epidemiology. "We maintain data on everyone in the study so we can recruit certain types of people when needed for interventions, such as smokers or those with higher body mass index."

The goal of the project's study is to apply quantitative and qualitative methods to investigate demographic, acculturation and psychological factors and their interaction with the social environment. That information will be used to determine how those factors influence Mexican-American's willingness to provide biologic specimens, such as blood samples, for crucial aspects of comprehensive research such as bio-banking.

"We're looking at barriers and how to overcome them," says Wetter. "We need to increase minority participation in bio-banking and clinical trials so we can develop interventions and treatments that will work across this particular ethnic group."

Wetter and Lovell Jones, Ph.D., director of the Center for Research on Minority Health and professor of Health Disparities Research at MD Anderson, are principal investigators on the research core.

Training: Strengthening the cadre
The goal of the project's mentored training program is to prepare new and early stage investigators to conduct cancer disparities research in Latino communities. An emphasis is on building skills and capacity to conduct community-based participatory research. Shine Chang, Ph.D., professor of Epidemiology at MD Anderson, is director of the training core.

Wetter, Bondy, Fernandez, and Jones lead the administrative core to provide strategic leadership, oversight and support for the project.

Outreach: Understanding and engaging community partners
The goal of the project's outreach program is to increase the use of evidence-based cancer control interventions in communities by building on existing community partnerships, infrastructure and programs.

Fernandez, the principal investigator of the outreach core, says "There is a tremendous amount of knowledge, experience and expertise in the community that needs to be tapped into if we're going to have a real impact."

The outreach program will have three phases:
* Develop a community network and regional advisory groups in Houston, El Paso and the lower Rio Grande Valley.
* Conduct an assessment of community needs and resources. Using the Texas 2-1-1 call system in Houston, Weslaco and El Paso, a survey will be conducted to analyze cancer risks among callers. The 2-1-1 call system provides free and confidential information and referrals for help with food, housing, employment, health care, counseling and more.

* Delivery of effective cancer control programs in Houston, El Paso and the lower Rio Grande Valley.

Ultimately, these partnerships and community participation will help bridge the gap between what we know works to prevent and control cancer and what is actually benefiting Latino communities.