Partnership aims to reduce cancer health disparities in Hispanics in Tampa, Ponce

A description of the projects and studies resulting from a research partnership initiated in 2005 between Moffitt Cancer Center in Tampa, Fla., and the Ponce School of Medicine in Ponce, Puerto Rico, has been published in a recent issue of Health Promotion Practice. The partnership, which included three outreach cancer education projects and two pilot research studies aimed at reducing cancer health disparities in Hispanic populations in both Tampa and Ponce, was funded by the National Cancer Institute's Minority/Cancer Center Partnership Program.

The program is intended to serve people in Ponce, Puerto Rico, as well as Hispanics in the greater Tampa Bay area.

"The disproportionate burden of cancer among U.S. Hispanics is well documented," said Gwendolyn P. Quinn, Ph.D., a co-leader on the project, director of the Survey Methods Core Facility at Moffitt and co-author of a paper describing the outreach partnership. "This report describes our initial efforts and the progress of the partnership we forged with colleagues in Ponce, our outreach and cancer education programs, and some early lessons learned as well."

The authors noted that an effective way to address cancer health disparities is through collaborative community-academic partnerships that include outreach programs designed to reach and engage underserved communities. Consideration of cultural diversity factors and behaviors that may impede access to care and screening for Hispanics both in their homeland and in the United States is important, the authors said.

Clement K. Gwede, Ph.D., R.N., lead author and an associate member in Moffitt's Department of Health Outcome and Behavior and associate director of Moffitt Diversity, described the projects and pilot programs.

"The first outreach project was aimed at understanding community level barriers to providing education, awareness and access to cancer screenings," explained Gwede. "The second project identified barriers to cancer care services and identified community priorities for supportive care services. The third project worked to develop cultural competency training for oncologists and other health care providers."

According to Julio Jimenez-Chavez, M.D., of the Ponce School of Medicine, who is a co-leader on the collaborative project and paper co-author, the collaboration represents an effective outreach program that is culturally relevant to Hispanics residing in both communities - in Tampa and Ponce.

"We have already learned valuable lessons," said Jiminez-Chavez, a faculty member in the Ponce School of Medicine's Clinical Psychology Program. "Among them are that the community has been responsive and that it is best to include a patient-centered approach by a wide range of health care providers, not just physicians. Too, culturally specific dissemination routes for information are important."

The collaboration also included two pilot research projects. The first aimed at expanding the efforts of a smoking-relapse prevention intervention targeted toward peri-natal and post-partum women in Puerto Rico. Research from the island indicates that 42 percent of women in Puerto Rico of childbearing age smoke and have tried to quit smoking.

The second project sought to identify knowledge and attitudes related to genetic testing for hereditary breast and ovarian cancer. The authors note that interest in received genetic counseling and testing was high, but resources for these services were not readily available at the time of the study in Puerto Rico. Susan T. Vadaparapmil, Ph.D., M.P.H., associate member of Moffitt and a co-author said: "We have also learned that interest can be generated about genetic testing and counseling among Puerto Rican women."

In their report, the researchers outline their efforts at community-based participatory research and note the value of evidence-based, culturally relevant social marketing practices. They cite the differential resource availability of an infrastructure for cancer prevention between Puerto Rico and the U.S. as a challenge.

"The challenges we found in balancing service and research agendas in communities with disparate levels of resources and infrastructure can inform future initiatives in this partnership as well as serve as an example for similar minority-serving institution/cancer center partnerships aimed at reducing cancer health disparities," concluded the authors.