Proposed is a Regional CNP located in Alameda County, California the home to one and a half million people and the most diverse county in the San Francisco Bay Area. It has large populations of Asian American (25%), Hispanic Americans (22%), African Americans (17%), and a decreasing Euro-American population (37%), and is the home of the largest group of Afghan refugees in the US. This county not only has diversity in its ethnic/racial composition but also a large population of persons who are uninsured or underinsured and of limited English proficiency. This is a population that is not reached through medical service settings. Therefore, we propose to reach them through their diverse faith communities.
Aims : Using CBPR methods: 1) Develop and implement an Outreach Program based on updating assets/needs of the community through socio-demographic and health assessments, existing resources. 2) Conduct a full research project and pilot project (as a training tool). 3) Develop a Training Program to develop a cadre of community researchers using CBPR methods. Methods: 1) We will conduct an assets/needs assessment working with the community members through diverse faith communities by using existing data from the census, cancer registry, county surveys and will collect information on community resources (both educational materials and services) and will coordinate our efforts with the NCI. Using CBPR methods, we will involve community in deciding the directions for the Outreach Program. Two new programs are envisioned: Church socials &other events that focus on family history and the importance of biospecimen collection/clinical trials, and a faith based colorectal screening program to reduce the burden of cancer. 2) The Full Research proposed focuses on issues of literacy, low language proficiency, and cultural/religious issues in breast health among Afghan refugee women while the pilot focuses on use of churches for recruiting African American women and training them in advocacy skills to better navigate the health care system. 3) Our faculty for training are experienced in teaching about disparities at both the population and service level, CBPR, and grants writing. We are also experienced mentoring young researchers to become skilled in developing independent programs of CBPR research. Outcomes: Finally, both process and outcome evaluation will be used for all of the programs to improve them and to meet productivity benchmarks consistent with academic achievement.

Public Health Relevance

At a time of reduced resources, low income populations who are uninsured and of limited English proficiency bear a disproportionate share of the burden of cancer. This CNP will provide the opportunity to increase collaboration between communities of color, academic institutions and health serving organizations to make more efficient use of existing resources.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZCA1-PCRB-G (M1))
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Farhat, Tilda
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University of California Berkeley
Public Health & Prev Medicine
Schools of Public Health
United States
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Shirazi, Mehra (2017) Reflections on Cultivating Community-based Participatory Research Partnerships with the Afghan Immigrant Community. Narrat Inq Bioeth 7:21-24
Hébert, James R; Satariano, William A; Friedman, Daniela B et al. (2015) Fulfilling Ethical Responsibility: Moving Beyond the Minimal Standards of Protecting Human Subjects from Research Harm. Prog Community Health Partnersh 9 Suppl:41-50
Shirazi, Mehra; Shirazi, Aida; Bloom, Joan (2015) Developing a culturally competent faith-based framework to promote breast cancer screening among Afghan immigrant women. J Relig Health 54:153-9
Hébert, James R; Braun, Kathryn L; Meade, Cathy D et al. (2015) Community-Based Participatory Research Adds Value to the National Cancer Institute's Research Portfolio. Prog Community Health Partnersh 9 Suppl:1-4
Shirazi, Mehra; Bloom, Joan; Shirazi, Aida et al. (2013) Afghan immigrant women's knowledge and behaviors around breast cancer screening. Psychooncology 22:1705-17