This renewal application proposes to continue the cancer prevention programs of the University of Kentucky PRC, the only PRC dedicated to cancer prevention in rural Appalachia. Known locally as the Rural Cancer Prevention Center (RCPC), our past focus has been on the prevention (through vaccination) and early detection of cervical cancer. Through social marketing and planned outreach the RCPC has successfully leveraged the trust of rural people residing in the most economically depressed area of Appalachia (southeastern, KY). The proposed renewal offers plans to continue our community-based cancer prevention research, and to extend our programs to other regions of Appalachia, using sustainable models. Moreover, the previous research pertaining to cervical cancer prevention created a strong basis for testing a novel approach to community-based screening for colorectal cancer (CRC). Based on new screening technology, this approach will be effective and accessible to medically disenfranchised and under-served rural residents. The proposed plan has 5 general aims (A-E) and a specific research aim (F): A) Provide infrastructure and administrative services that support cancer prevention; B) Build community capacity and actively engage the community in partnerships for cancer prevention; C) Provide an efficient and effective communications network that ties cancer prevention activities together and disseminates health communication; D) Offer training and technical support to state and local agencies; E) Evaluate (process and outcome) all planned activities related to aims A-D; and F) Conduct an applied prevention research project that demonstrates the value of using community change agents to foster widespread adoption of annual colorectal cancer (CRC) screening with Fecal Immunochemical Test (FIT), followed by navigation to colonoscopy for those screening FIT-positive, and by an intervention program that promote annual repeat use of FIT. All six aims are inter-related; however, the final aim is a highly focused set of activities that occur in two phases: 1) the programs supporting this aim will be tested in Years 1-3, and 2) to benefit other rural Appalachian states, dissemination and implementation activities will be conducted in Years 4-5. Programs to be tested in Years 1-3 include 1) a community-based intervention featuring a Diffusion of Innovations model, standard RCPC outreach methods, and academic detailing for health care providers tested using a non-equivalent comparison design; this trial will end when 500 FIT specimens have been returned in the intervention health district, 2) a social network analysis (N = 64) used to provide interim feedback regarding key characteristics of effective change agents used in the diffusion model, 3) a navigation program (based on current RCPC practices for cervical cancer) that will be applied to people testing FIT-positive (N = 60), and 4) an internet-based program designed to foster annual repeat FIT screening tested using a randomized, controlled trial design (N = 220). Programs will be designed for optimal sustainability and dissemination/implementation potential.

Public Health Relevance

This renewal application proposes to continue the cancer prevention programs of the University of Kentucky PRC, the only PRC dedicated to cancer prevention in rural Appalachia. The proposed renewal offers plans to continue our community-based cancer prevention research and to extend our programs to other regions of Appalachia using sustainable dissemination and implementation models.

Agency
National Institute of Health (NIH)
Institute
National Center for Chronic Disease Prev and Health Promo (NCCDPHP)
Type
Health Promotion and Disease Prevention Research Centers (U48)
Project #
5U48DP005014-05
Application #
9543818
Study Section
Special Emphasis Panel (ZDP1)
Project Start
2014-09-30
Project End
2019-09-29
Budget Start
2018-09-30
Budget End
2019-09-29
Support Year
5
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Kentucky
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
939017877
City
Lexington
State
KY
Country
United States
Zip Code
40526
Mark, Kristen P; Crosby, Richard A; Vanderpool, Robin C (2018) Psychosocial Correlates of Ever Having a Pap Test and Abnormal Pap Results in a Sample of Rural Appalachian Women. J Rural Health 34:148-154
Crosby, Richard A; Stradtman, Lindsay; Collins, Tom et al. (2017) Community-Based Colorectal Cancer Screening in a Rural Population: Who Returns Fecal Immunochemical Test (FIT) Kits? J Rural Health 33:371-374
Crosby, Richard A; Collins, Tom (2017) Correlates of Community-Based Colorectal Cancer Screening in a Rural Population: The Role of Fatalism. J Rural Health 33:402-405
Akahane, Koshi; Li, Zhaodong; Etchin, Julia et al. (2017) Anti-leukaemic activity of the TYK2 selective inhibitor NDI-031301 in T-cell acute lymphoblastic leukaemia. Br J Haematol 177:271-282
Crosby, Richard A; Hagensee, Michael E; Fisher, Rebecca et al. (2017) Self-collected vaginal swabs for HPV screening: An exploratory study of rural Black Mississippi women. Prev Med Rep 7:227-231
Akahane, K; Sanda, T; Mansour, M R et al. (2016) HSP90 inhibition leads to degradation of the TYK2 kinase and apoptotic cell death in T-cell acute lymphoblastic leukemia. Leukemia 30:219-28
Vanderpool, Robin C; Moore, Stephanie C; Stradtman, Lindsay R et al. (2016) Adaptation of an Evidence-Based Intervention to Improve Preventive Care Practices in a Federally Qualified Health Center in Appalachian Kentucky. J Health Care Poor Underserved 27:46-52
Crosby, Richard A; Hagensee, Michael E; Vanderpool, Robin et al. (2015) Community-Based Screening for Cervical Cancer: A Feasibility Study of Rural Appalachian Women. Sex Transm Dis 42:607-11