Important yet surmountable barriers to achieving dramatic reductions in cancer-related morbidity, mortality, and inequities include little research on: 1) changeable factors that influence health disparities, 2) effective interventions to address those factors, and 3) how best to accelerate the use of effective cancer control programs and policies in communities. To reduce the cancer burden, we need research that fills the evidence gaps in both knowing what interventions work to change cancer-related behaviors and environmental conditions and how best to disseminate and implement them. New researchers interested in pursuing these important areas of inquiry will require training on how to design and test interventions with a keen eye toward reach (dissemination, implementation, and sustainability in communities experiencing the greatest burden of disease). This training includes community-based participatory research, planning approaches for the development of multilevel interventions, problem analysis including GIS mapping, innovative data collection methods, robust design and analysis, and dissemination and implementation frameworks and methods. Additional ly, researchers will need to embrace collaborative "team science" approaches so that experts in the fields of psychology, anthropology, political and organizational science, economics, statistics, health education, clinical medicine, and epidemiology can bring their expertise to bear on the complexities of cancer control at multiple levels, settings, and population groups. We incorporated these approaches early and have built a specialized curriculum, with strong community relationships and mentors and grant support that can fully incorporate dissemination and implementation science to address the challenges. Our success in training 57 pre-post docs from all disciplines in population sciences counts 1/3 from underrepresented groups;85% conduct research in cancer prevention. We are currently on target to exceed our goal of advancing 19 trainees to the next career stages, 36% of whom are African American or Hispanic/Latino. We will also build on transformational changes in our school: 45% of the faculty have been recruited in the past 4 years, with clear emphasis on external funding and scientific productivity;doctoral programs have been expanded across a re-energized 6-campus system that is interlinked for video conferencing and distance learning;courses are available in multiple formats in intervention development, systematic review, cancer epidemiology, and community-based participatory research;and health disparities and leadership concentrations (doctoral students)/certificates (postdocs) are now well established. Because our strength is preparing qualified doctoral students to enter NCI R25T post-doctoral CECDPs, we requested and received a waiver to continue with 4 predoc slots/year;we reduced post-doc slots to 3/year to free up funds for trainee research and for honoraria for external reviews of postdocs'proposals. The hallmark of our plan for years 21-25 is to continue emphasis on disparities and add explicit focus on dissemination and implementation science.
Preventing cancer and finding it early, when it can be treated easily, is an important priority in the U.S., where cancer is the second leading cause of death. The Cancer Education and Career Development Program at the University of Texas School of Public Health is applying for an additional 5 years of funding to continue a training program for doctoral students and medical doctors and PhDs. This program accepts trainees from multiple disciplines who learn to work together on programs to reduce the number of people in the U.S. who get cancer or who die from cancer.
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