Integrating Multiple Sources of Data to Inform Cancer Interventions: a Case Study with Arab Americans

This dissertation engaged multiple Arab American (ArA) community stakeholders to define cancer-related needs and barriers in the ArA community in Chicago, and in turn guide the development of acceptable, culturally-congruent cancer interventions. First, I conducted a scoping review of the cancer intervention literature with ArAs to examine outcome and implementation characteristics and identify gaps and opportunities for future research. I also engaged in community-based participatory research (CBPR) with a community-based organization to assess their community’s cancer-related priorities through focus groups, and subsequently develop a responsive cancer intervention. Finally, I conducted interviews with ArA community stakeholders to explore their perceptions of ArA cancer survivors’ needs and acceptable interventions. As a whole, this dissertation revealed that although multilevel cancer interventions across the cancer control continuum are needed to effectively address cancer disparities with ArAs, existing cancer interventions have disproportionality focused on individual-level determinants of cancer detection. Findings also suggest that a community-academic partnership grounded in CBPR was a feasible and acceptable approach to generate and integrate locally-relevant community and academic data to inform a multi-component cancer intervention. Finally, perspectives of multiple ArA stakeholders (e.g., cancer survivors, caregivers, healthcare providers, community leaders, faith-based leaders) captured the multilevel needs experienced by ArA cancer survivors, as well as acceptable multilevel interventions to address these needs. Overall, this dissertation generated opportunities to develop and test acceptable cancer interventions with the ArA community in Chicago. Addressing the cancer needs of ArAs will require tackling fundamental research barriers unique to this population, including funding and community engagement challenges. For example, ArAs should be considered a health disparity population by the National Institutes of Health to increase funding availability and incentivize research with this understudied population. To achieve this long-term goal, academic researchers should engage in equitable partnerships with local ArA communities to generate nuanced, locally-relevant data, as well help make the case for funding allocation to address their unique needs. Simultaneously, the dynamics and successes of these partnerships should be documented. Additionally, academic researchers should support community-based advocacy efforts to recognize ArAs as separate from Whites, to achieve the mutually beneficial goal of visibility and representation

From study plans to capacity building: a journey towards health equity in cancer survivorship

This article highlights the importance of pausing and reflecting on one's motivation, capacity, and positionality when engaging in health equity research and encourages researchers to engage in critical self-reflection and contribute to the ongoing dialogue on the ethical conduct of health equity-focused cancer research. In response to the urgent need to address health disparities and improve health equity in cancer survivorship care, the Cancer Prevention and Control Research Network (CPCRN) Survivorship workgroup discussed developing a study focused on understanding how racism impacts patient engagement in cancer survivorship care. However, during the study's development, the workgroup recognized limitations in research team composition and infrastructure. The workgroup engaged in critical self-reflections, individually and collectively, leading to the halting of the research study. Consequently, they redirected their efforts towards strengthening the necessary infrastructure for conducting such research, including diverse investigator representation and equitable partnerships with cancer survivors. The description of this process, along with suggestions for reflection, may be helpful and informative to other researchers and research networks seeking to center marginalized voices and work in partnership to address healthcare and health equity.Open access articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected] copyright statement above the abstract on the PDF file is incorrect; this article is not US government work with no copyright protection

A Culturally Adapted Breast and Cervical Cancer Screening Intervention Among Muslim Women in New York City: Results from the MARHABA Trial.

We examine the efficacy of MARHABA, a social marketing-informed, lay health worker (LHW) intervention with patient navigation (PN), to increase breast and cervical cancer screening among Muslim women in New York City. Muslim women were eligible if they were overdue for a mammogram and/or a Pap test. All participants attended a 1-h educational seminar with distribution of small media health education materials, after which randomization occurred. Women in the Education + Media + PN arm received planned follow-ups from a LHW. Women in the Education + Media arm received no further contact. A total of 428 women were randomized into the intervention (214 into each arm). Between baseline and 4-month follow-up, mammogram screening increased from 16.0 to 49.0% in the Education + Media + PN arm (p < 0.001), and from 14.7 to 44.6% in the Education + Media arm (p < 0.001). Pap test screening increased from 16.9 to 42.3% in the Education + Media + PN arm (p < 0.001) and from 17.3 to 37.1% in the Education + Media arm (p < 0.001). Cancer screening knowledge increased in both groups. Between group differences were not statistically significant for screening and knowledge outcomes. A longer follow-up period may have resulted in a greater proportion of up-to-date screenings, given that many women had not yet received their scheduled screenings. Findings suggest that the educational session and small media materials were perhaps sufficient to increase breast and cervical cancer screening among Muslim American women. ClinicalTrials.gov NCT03081507

Six phases for building sustainable impact through policy, systems, and environmental change

This second installment in the Action Learning Brief series provides practical guidance on defining and applying the six phases of policy, systems, and environmental change that can help organizations and their technical assistance providers expand their efforts and build sustainable impact. Policy, systems, and environmental changes influence laws, shape physical landscapes, and help to improve institutions to make healthy living easier and to tackle the root causes of health inequities

Key drivers of success: What catalyzes lasting change in your organization or community?

This third installment in the Action Learning Brief series provides practical guidance on what factors support and sustain momentum through each stage of the policy, systems, and environmental change process. Policy, systems, and environmental changes influence laws, shape physical landscapes, and help to improve institutions to make healthy living easier and to tackle the root causes of health inequities

What are action steps and resources to help your organization apply the six phases of policy, systems, and environmental change?

This fifth installment in the Action Learning Brief series provides simple action steps and resources to help organizations and technical assistance providers learn how to adopt policy, systems, and environmental change during each phase of the policy, systems, and environmental change process. Policy, systems, and environmental changes influence laws, shape physical landscapes, and help to improve institutions to make healthy living easier and to tackle the root causes of health inequities

Technical assistance types: What support do you need to catalyze policy, systems, and environmental change?

This fourth installment in the Action Learning Brief series discusses how distinct forms of technical assistance can support policy, systems, and environmental change and highlights types of technical assistance that might be needed at each phase of the policy, systems, and environmental change process. Policy, systems, and environmental changes influence laws, shape physical landscapes, and help to improve institutions to make healthy living easier and to tackle the root causes of health inequities