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Cancer Control Research

Messias, Deanne Karen Hilfinger


DESCRIPTION (provided by applicant): Hispanics are the fastest growing population group in the southeastern United States, and South Carolina (SC) is among four states with the most rapidly growing Hispanic population (300% increase from 1990-2005). Cancer is a leading cause of morbidity and mortality among Latinos, many of whom in SC are uninsured, delay seeking medical care, and tend not to engage in preventive health behaviors. Cancer prevention and control is a critical issue with implications that extend beyond the individual and have multiple repercussions at the community, healthcare system, and policy levels. Ongoing challenges to conducting cancer research with the emerging Hispanic populations in SC include the lack of internal research capabilities of primary care providers and the lack of accessible systems-level data. In partnership, the University of South Carolina and SC Hispanic/Latino Health Coalition will engage with three practice-based primary health care partners in a project to increase the organizational capacity of primary health care organizations to participate in Hispanic health research, while better serving the cancer screening needs of the local Latino community. The specific research aims are to: 1) enhance existing community-academic research partnerships by actively engaging professionals and support staff of local primary care practices in the formation of a Hispanic health research network (HHRN) to address health care disparities research among the emerging Latino population; 2) assess the organizational Hispanic health research capacity of primary care practices that provide breast and cervical cancer (BCC) screening to Latinas; and 3) build the Hispanic health research capacity of primary care providers, staff, and organizations. The HHRN Project Model developed to guide the methodology includes four essential phases of the participatory research process: 1) engaging partners; 2) assessing research capacity and priority-setting; 3) building research capacity; and 4) launching the HHRN by implementing a collaborative research project. Community-based participatory research approaches will be used to engage partners in Phase 1. In Phase 2, an organizational assessment of each practice-based partner will be conducted, including key informant interviews of administrators and clinical directors (n=15) and surveys of clinical and administrative personnel (n=45). Phase 3 will involve planning and implementing specific activities to increase the Hispanic research capacity of each practice-based partner. In Phase 4, to launch the HHRN, we will conceptualize, develop, and implement a research project to test the capacity to conduct Hispanic health research on BCC screening. The efforts of the HHRN are expected to result in enhanced community- academic research partnerships, improved health care experiences for Hispanic patients, and specific strategies for engaging community-based and primary care organizations in research. This research addresses the public health need for increased capacity of practice-based research focusing on issues of health disparities, access to healthcare, and appropriate utilization of services, specifically among limited English proficient Hispanics seeking breast and cervical cancer screening services. The study addresses a recognized need for practice-based research networks to address research questions related to cancer prevention care experiences among underserved populations. In addition to generating research evidence for practice, the research outcomes include building practice-based research capacity by engaging clinic staff in research, utilizing the organizational infrastructure of primary care clinics to support research, the recognition of available technical and funding support; and the identification of research questions to be explored through future practice-based research.

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