The overarching goals ofthe Outreach Program are twofold: 1) to provide core support to the U54 for training on community-based participatory research (CBPR), direct community outreach and education, and capacity building for implementation and sustainment of evidence-based cancer control programs, and;2) to conduct an outreach research project to reduce the burden of colorectal cancer among Puerto Ricans. This proposal describes both outreach core activities (under Aim 1) and the required outreach research project (Aim 2) as follows:
AIM 1 : Expand the existing CCCOP to provide core support to the U54 infrastructure, clinical research projects, and trainees with respect to direct community outreach, researcher and community capacity building, CBPR training, and participant recruitment and retention.
AIM 2 : Develop and evaluate the effectiveness, cost effectiveness, and budget impact of a tailored intervention to increase CRCS in PR among patients of FQHCs. Reducing morbidity and mortality associated with cancer in PR requires continuous efforts to address cancer-related behaviors and environmental conditions such as health care access. For example, although colorectal cancer (CRC) is the second leading cause of cancer-related mortality in women and the third in men,^ and is largely preventable through screening and treatment of precancerous polyps, colorectal cancer screening (CRCS) is significantly underutilized in PR among age-eligible patients compared to their U.S. counterparts. The proposed Outreach Program represents a continuation and extension of the Puerto Rico Cancer Control Community Outreach Program (CCCOP) which began as a pilot project in 2006 and expanded to a full U54 Outreach Core in the current funding cycle. The CCCOP will use existing community partnerships, infrastructure, data, and programs to 1) provide training on community-based participatory research (CBPR) to researcher, trainees and community partners, 2) conduct direct community outreach and education, 3) build capacity for implementation and sustainment of evidence-based cancer control programs in communities and primary care settings, 4) leverage existing data, partnerships and progress to expand research and intervention activities in the identified priority areas, and;5) conduct an outreach research project to reduce the burden of colorectal cancer among Puerto Ricans. Through collaboration with community partners, the U54 Outreach Core will continue to identify innovative outreach strategies to reach the most vulnerable and underserved populations. These strategies include the use of community health educators, interactive and mobile technologies, and collaboration with Federally Qualified Health Centers (FQHCs). We will provide training and technical assistance to community partners, trainees and researchers on issues such as identifying cancer control needs, developing or adapting evidence based interventions, implementation, and evaluation. We will also focus on increasing community participation in clinical trials and biobanking in PR in order to promote effective prevention, diagnostic, and treatment methods for cancer. The cancer burden in PR is well documented by the CCCOP, and there is a significant need for continued community outreach efforts and research to reduce it. The CCCOP is committed to continue work in multiple cancer control topics as part of its Outreach Core, and to strengthen these outreach activities by prioritizing research. As a result, interventions developed through outreach efforts and community-based participatory research (CBPR) approaches can be rigorously evaluated, adopted, implemented and maintained to have the greatest possible impact on the health of Puerto Ricans.
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