OUTREACH CORE ABSTRACT Hispanics/Latinos are at higher risk for late stage cancer, and worse survival after diagnosis, compared to non- Latino whites. Reducing cancer disparities among Hispanics/Latinos requires dissemination of evidence-based strategies for cancer prevention and control and developing evidence to support novel strategies. We postulate that one effective and culturally sensitive approach for reducing cancer burden among Hispanics/Latinos is to link National Cancer Institute (NCI)-designated Cancer Centers and institutions serving underserved populations with Federally Qualified Health Centers (FQHCs). Accordingly, we propose a trilateral partnership among University of California San Diego (UCSD) Moores Cancer Center, San Diego State University (SDSU), and Family Health Centers of San Diego (FHCSD), a FQHC serving over 130,000 individuals annually in San Diego County. We propose to increase screening and diagnostic follow up for breast, cervical, and colorectal cancer among primarily Hispanic/Latino communities through the following aims. First, we will link a community health worker (promotor)-led cancer screening intervention with patient navigation to improve screening rates. The promotora cancer screening intervention builds on findings from a randomized controlled trial aimed to increase cancer screening rates in churchgoing Latinas, and will be extended by including a wide range of community organizations serving Hispanic/Latino communities, as well as Hispanic/Latino men, in outreach efforts. Second, we will optimize complete diagnostic evaluation of abnormal breast, cervical, and colorectal cancer screening tests through implementation of evidence-based best practices. Specifically, in partnership with FHCSD, we will use patient navigation strategies to build upon an existing case management infrastructure to promote complete diagnostic evaluation of abnormal test results. Third, we propose to disseminate best practices for cancer prevention and control through a certified Community Health Educator (CHE). The CHE will interface with patients and healthcare providers in the 19 FHCSD clinics using various dissemination strategies to for cancer prevention and control. We are using the Quality in the Continuum of Cancer Care framework to guide our intervention and evaluation Outreach Core activities. This framework effectively addresses the complexity of steps required for cancer screening and diagnostic resolution of a cancer-related abnormality. To ensure success, we assembled a multidisciplinary team including physician- scientists, behavioral scientists, healthcare providers, and public health advocates with expertise in the development of multi-level community and clinic-based interventions that promote cancer prevention and control in Hispanic/Latino communities.
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