Ongoing Global Health Projects
The International Consortium for Action and Research on Tobacco
On December 5, 2014, at the World Cancer Congress in Melbourne, Australia, NCI joined with other cancer research funding organizations to launch a collaborative effort to enhance tobacco control research capacity in low- and middle-income countries. The International Consortium for Action and Research on Tobacco will work to increase coordination and collaboration across research funders, to develop and promote a joint research agenda, and to increase investment in the evidence-base for tobacco control. While the Framework Convention for Tobacco Control and funding efforts from the Bloomberg Philanthropies and the Bill and Melinda Gates Foundation have greatly strengthened international tobacco control advocacy and policies, ongoing research is needed to provide continued support for effective tobacco control efforts and evaluate their impact. Along with NCI, partners include Cancer Research UK, the UICC, Cancer Council Australia and Cancer Council Victoria, The McCabe Centre for Law and Cancer, Irish Cancer Society, the French Institut National du Cancer, Norwegian Cancer Society, The Campaign for Tobacco Free Kids, and Latin American & Caribbean Society of Medical Oncology
Global Smoking Attributable Mortality
Currently, tobacco use contributes to 6 million deaths every year and is predicted to increase to 8 million deaths every year by 2030, with 80% of these deaths occurring in low- and middle-income countries (LMICs). The existing methodology has been used to generate accurate estimates in the United States, but without country-specific data for other regions, it is currently not accurately transferable to generate estimates for other countries. The purpose of this initiative, led by the US CDC, is to bring together a wide range of international partners and experts to develop a direct method that estimates smoking-attributable mortality, by using existing national (high-income) smoking-attributable mortality (SAM) methodologies and translating them onto a global scale, by country, starting in select middle-income countries and continuing worldwide. Eleven middle-income countries have been tentatively identified for the initial stage of the project, including Brazil, China, India, Indonesia, Mexico, Poland, Russia, South Africa, Thailand, Turkey and Egypt. Mark Parascandola joined the planning committee for this initiative and participated in a kick-off meeting in Toronto, Canada, October 8-10, 2014.
China-US Smokefree Workplace Initiative
The US Department of Health and Human Services and the China CDC launched the China-US Smokefree Workplace (CUSW) initiative 2 years ago as a public-private partnership to assist companies in creating healthy, smokefree workplaces for their employees. NCI provides technical and staff support to the CUSW and is currently participating in planning for a series of cessation training workshops for physicians in Beijing, Shenzhen, and Qingdao in 2015. The workshops are supported by a grant from Global Bridges and the Pfizer Foundation. Additionally, NCI is leading an evaluation of the CUSW initiative for future publication.
Emory University’s Collaboration with NCI on Reducing the Secondhand Smoke Exposure in Newborns in China
Emory University is using NCI-developed mHealth smoking cessation resources as one element of a multi-layered project. The project recruited participants and launched in October 2014. It consists of a three-arm trial investigating strategies to reduce infants’ exposure to secondhand smoke within the home. The primary goal is to help create smoke-free homes through 1) standard education taught in group prenatal classes, 2) individual education with women and their partners about the health risks of secondhand smoke, and 3) enhanced education plus smoking cessation support via the SmokefreeTXT China program. One of the goals of the project is to assess the potential added benefit of the enhanced treatments.
USAID and NIH Partnerships for Enhanced Engagement in Research (PEER) Health
The USAID and NIH Partnerships for Enhanced Engagement in Research (PEER) Health supports developing-country researchers in low- and middle-income countries (LMICs) with the primary focus on “implementation science.” NCI participated in the Cycle 2 (2014) solicitations for Philippines and Indonesia (See August issue of the Newsletter). The USAID missions will fund several awards in the two countries. Additionally, three highly ranked proposals were identified for NCI support, two in Indonesia and one in the Philippines:
- Prabandari (Indonesia) - Impact of reduced in-home secondhand smoke exposure on low birth weight prevalence and neonate health
- Sablan (Philippines) - Effect of a Smoking Cessation Intervention Program for Families of Children Diagnosed with TB
- Idris (Indonesia) - Effects of air pollution in early life on infant and maternal health
Both DCCPS and CGH have committed funds for the first year of these awards. NCI will continue to provide technical assistance to this initiative. Mark Parascandola will participate in the protocol review process for funded projects in December 2014.
Scientific Advisory Committee for the Provincial Integrated Cancer Survivorship Program
Julia Rowland was recently recruited to serve as one of the international members of the Scientific Advisory Committee for the Provincial Integrated Cancer Survivorship Program (PICSP) in Alberta, Canada. The PICSP is one component of the Alberta Cancer Action Plan.
Cancer Research in the Caribbean
NCI’s Center for Global Health, in collaboration with the Caribbean Public Health Agency, is supporting a funding opportunity for cancer research in the Caribbean. The objective of this FOA is to support research of cancers that are of a significant burden within a population or community, in a Caribbean country, or throughout the Caribbean. NCI Center for Global Health will support up to six awards at $25K per year over 2 years. Damali Martin is the program contact for NCI.
Cancer Registries and Surveillance Research Initiatives in Low- and Middle-Income Countries
Brenda Edwards was an invited speaker at the Indo-US Joint Workshop on Epidemiology and Prevention of Cancer held at the Cancer Institute (WIA) in Chennai, India, October 7-9, 2014. The US co-lead was Ernie Hawk of MD Anderson Cancer Center. Invited participants represented US and Indian researchers who discussed their initiatives and engaged in discussions on research priorities and possible future collaborative studies. Dr. Edwards conducted informational visits with the cancer registry leaders in Chennai and attended their stakeholders meeting, the regional cancer registry and Global Initiative for Cancer Registry Development (GICR) hub in Mumbai, and the regional registry in Trivandrum. All three registry leaders received training from the SEER Program directors many years ago and continue to rely on their resource materials for current operations.
In collaboration with the NCI Center for Global Health (CGH), Dr. Edwards was a faculty member for the 2-day training course held in Ankara, Turkey, which was followed by a meeting of the Middle East Cancer Consortium (MECC) cancer registry advisory committee. These MECC registry activities are in transition to becoming part of the GICR regional hub in Izmir, Turkey. In collaboration with CGH and the International Agency for Research on Cancer (IARC), Dr. Edwards worked with Ann Chao to conduct a 3.5-day cancer registry course for South East Asia that was held in Shanghai, China. Faculty were from the NCI SEER Program and a DCCPS grantee. Dr. Edwards also participated in the NCI and China annual meeting of cancer institute leaders (Beijing, China) and met with leaders for a briefing and discussion of emerging changes in the Japanese mandate for reporting of cancer registry data.
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Global Health Research and Training Initiatives
Data to Action in Tobacco Control Workshop
NCI Tobacco Control Research Branch and the Center for Global Heath organized a one-day workshop prior to the World Cancer Congress in Melbourne, Australia, on December 2, 2014.Faculty included members from Cancer Council Victoria, Cancer Research UK, Public Health Foundation of India, and NCI. Participants represented a variety of countries including Argentina, Indonesia, Kenya, Malaysia, Papua New Guinea, Ethiopia, Turkey, and Zambia. The primary goals of the workshop were to 1) highlight the important role surveillance and investigation have in policy change; 2) discuss ways to link data and research with advocacy action; and 3) provide tools for developing capacity for data analysis, research, and dissemination in tobacco control. This data-to-action training focused on using existing data and building research capacity to support local and national tobacco control policies and programs consistent with the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) and MPOWER strategies. The workshop also provided an opportunity for networking among national and international tobacco control experts.
WHO-International Telecommunication Union (ITU) Workshop
Erik Augustson provided content and facilitated a mHealth trainingfor the workshop in Manila, Philippines, on November 25-27, 2014. The goal of the workshop was to provide training to members of the Philippines Department of Health, as well as representatives from the island of Tonga in order to develop the necessary skills and planning to develop and implement behavioral mHealth programs. This WHO- ITU mHealth initiative aims to broaden the use of mHealth-based interventions as a means to manage and prevent non-communicable diseases.
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Noteworthy Reports
‘Smokeless Tobacco and Public Health: A Global Perspective’ Report
This first-ever report on the global use and impact of smokeless tobacco finds that more than 300 million people in at least 70 countries use these products. The report, Smokeless Tobacco and Public Health: A Global Perspective, was released by the CDC and NCI at the National Conference on Smoking or Health in Mumbai, India, on December 15, 2014. Representatives from the Government of India and the World Health Organization participated in the release and accompanying scientific symposium. Thirty-two leading experts from around the world contributed to the report. In addition to detailing the serious and well-documented health effects of smokeless tobacco products, the report also examines the distinct challenges and policy solutions in reducing the burden of smokeless tobacco use. For example, a wide range of smokeless tobacco products with different characteristics are in use around the world, yet limited data is available detailing the contents of these products, how they’re used, and their prevalence within different population groups. The report identifies key research gaps and makes recommendations for capacity building in research and surveillance of smokeless tobacco use, with the aim of reducing the burden of smokeless tobacco use worldwide.
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Meeting Reports
UICC World Cancer Congress
Several DCCPS staff participated in the World Cancer Congress held in Melbourne, Australia, December 3-6, 2014. Staff were involved in organizing special sessions, workshops, and satellite meetings. Brenda Edwards co-moderated a special session on the IARC’s Global Initiative on Cancer Registry (GICR) development. The five presentations covered development of the regional hubs, with special emphasis on the African Regional Cancer Network (Max Parkin, UK), announcement of the Pacific Island Regional Hub (David Roder and David Ellis, Australia), use of cancer registry data for the Global Cancer Burden (Freddie Bray, IARC), and the Center for Global Health’s (CGH’s) partnership activities for building cancer surveillance capacity in low- and middle-income countries (Lisa Stevens, CGH NCI). Rajesh Dikshit, the PI for the regional hub in Southeast Asia, was co-moderator of the session and contributed to the discussion period. Dr. Edwards also attended in the special session cancer in indigenous people and contributed to the breakout discussion groups. Presentations on the activities in North America related to American Indians and Alaska Natives were part of several special sessions at the Congress, with Linda Burhansstipanov of the Native Network as one of their experts.
Health Information National Trends Survey - China
In November 2014, results from the Health Information National Trends Survey (HINTS)-China Pilot Project were presented at the 100th annual Convention for the National Communication Association, in Chicago, Illinois. Wen-ying Sylvia Chou represented the HINTS-China collaborative group by giving two presentations: the first was entitled "Overview of the HINTS-China Research Program: Expanding and Internationalizing the National Cancer Institute’s U.S.-Based HINTS Research Program" and the second, led by Grace Huang (SRTB) and Alexander Persoskie (formerly of BRP, now FDA-CTP), was entitled "Media Use, Health Information Seeking, and Cancer Cognitions in China." The HINTS-China Pilot was fielded in Beijing and Hefei in November 2013.
Third Biennial Science of Global Prostate Cancer Disparities in Black Men Conference
Damali Martin (EGRP) and Antoinette Percy-Laurry (SRP) participated in the Third Biennial Science of Global Prostate Cancer Disparities in Black Men Conference in Montego Bay, Jamaica, November 5-8, 2014. Other NCI participants included Ted Trimble and Makeda Williams of the Center for Global Health, and Stefan Ambs of the Center for Cancer Research. The meeting was planned by three consortia: the Prostate Cancer Trans-Atlantic Consortium (CaPTC), the Men of African Descent and Carcinoma of the Prostate (MADCaP), and the African Caribbean Cancer Consortium (AC3). The objectives of the meeting were 1) to provide opportunities for mutual learning, knowledge transfer, and collaborations among CaP scientists, clinicians, survivors, and advocates; 2)to promote transdisciplinary and multidisciplinary CaP research globally; 3)to facilitate networking among individuals involved in all aspects of CaP control, education, and research in black men; 4) to facilitate the development of a global community of practice to address common challenges in CaP, including prevention, detection, diagnosis, treatment, and survivorship; and 5) to contribute to a global impact against CaP through research, training, education, and advocacy programs for low-resource countries. Drs. Martin and Percy-Laurry facilitated the Tri-Consortia deliberation session on data collection and research methodology standardization, data pooling for genetic and epidemiological data, and research collaborations. Dr. Martin presented on “Developing and Managing an Effective Cancer Epidemiology Consortium” and participated in an interview to discuss NCI’s activities in the Caribbean.
45th Union World Conference on Lung Health
The 45th Union World Conference on Lung Health took place in Barcelona, Spain, October 28 - November 1, 2014. Mark Parascandola co-organized and presented at a symposium on "Integrating Community-based Tobacco Control Activities in TB Programs" and participated in the TB, HIV, Tobacco Scientific Working Group. The symposium drew approximately 100 participants and highlighted the need to address multiple health threats in a coordinated way and to take advantage of existing TB and HIV treatment infrastructure to intervene around tobacco smoking. The working group is finalizing a joint paper for publication.
2nd International Conference on Waterpipe Smoking Research: A Collision of Two Epidemics Waterpipe and Cigarettes
Mirjana Djordjevic was invited to the 2nd International Conference on Waterpipe Smoking Research to present the NIH-funded research on waterpipe tobacco smoking, as well as to participate in the pre-conference workshop on “How to Write Summary or Abstract for a Scientific Study Proposal.” The conference took place in Doha, Qatar, October 25-27, 2014, and was supported by Hamad Medical Corporation, Weill Cornell Medical College Qatar, and Director General of the Executive Board of the Health Ministers Council for Cooperation Council. The goal of the conference was to review the state of the science on waterpipe tobacco smoking. It covered a wide range of topics including product characteristics and marketing strategies, prevalence of use, initiation and cessation interventions, perception and quitting intentions, regulation and media, health warning labels, secondhand exposure, health effects, as well as building tobacco control research capacity in the Middle East. At the end of the meeting, the Doha Declaration was issued to inform policy and regulation and aid implementation of the Framework Convention on Tobacco Control (FCTC).
Annual Asia-Pacific Quitline Network Meeting
The Annual Asia-Pacific Quitline Network (APQN) Meeting took place in Beijing, China, on October 25-26, 2014. Erik Augustson presented on “The Potential of Integrating mHealth into Quit Lines.” AQPN membership includes representatives from China, Korea, Thailand, Mongolia, the Philippines, Tonga, Taiwan, Australia, New Zealand, and the United States. The focus of APQN is to expand the needed expertise to effectively develop and implement smoking cessation Quitline services.
16th Congress of the International Psychosocial Oncology Society
At the 16th Congress of the International Psychosocial Oncology Society (IPOS), held in Lisbon, Portugal, October 21-24, Julia Rowland was the recipient of the 2014 Bernard Fox Memorial Lecture Award. The award was established to honor an IPOS or community member who has made an outstanding contribution in education, research or leadership to the field of psycho-oncology.
Conferences of the International Society of Quality of Life Leadership
Kristin Litzelman attended the 21st Annual Conference of the International Society of Quality of Life Leadership, October 15-18, 2014, in Berlin, Germany. Dr. Litzelman was selected for an oral platform presentation of her current research, entitled “Quality of Life and Depression Spillover among Spouses with and without Cancer,” attended a methodological training addressing response shift in self-reported quality of life, and participated in the New Investigator Special Interest Group.
International Society of Quality of Life Meeting
Sandra Mitchell attended the annual research meeting of the International Society of Quality of Life (ISOQOL) in Berlin, Germany, October 15-18, 2014. Dr. Mitchell and the research team developing the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) delivered three podium presentations and two posters. PRO-CTCAE study findings disseminated in the ISOQOL presentations included the results of a linguistic validation of the Spanish language version of the PRO-CTCAE, results of an analysis examining the responsiveness of PRO-CTCAE items to detect between-group differences, and an analysis of the patterns of PRO-CTCAE alerts for severe symptoms that were generated in a randomized cancer treatment trial. One of the two poster presentations focused on the feasibility of implementing PRO-CTCAE in a multi-site randomized trial in radiation therapy, while the other compared various PRO-CTCAE recall periods (7 days vs. 14 days vs. 28 days). Dr. Mitchell also co-authored a presentation with Bill Wood and Antonia Bennett, who are PRO-CTCAE early adopters at the University of North Carolina. The presentation examined the association between symptomatic toxicities, pedometry values, and patient self-reports of physical activity, self-assessed health, and quality of life.
Dr. Mitchell also met with several early adopters of PRO-CTCAE, including collaborators who are implementing PRO-CTCAE in cancer clinical trials and routine practice in the United Kingdom, representatives from the Danish Cancer Society who are translating PRO-CTCAE into Danish and conducting a linguistic validation, and a team from Germany who are planning to use PRO-CTCAE to characterize symptomatic treatment toxicity in women receiving treatment for metastatic breast cancer.
A key step in promoting widespread implementation of PRO-CTCAE in both international and US trials is the availability of translated and linguistically and culturally adapted instrument versions. In addition, feasibility trials using varied study designs and in diverse contexts of use will provide important information to enhance adoption of PRO-CTCAE around the world. These collaborations are structured under the terms of Material Transfer Agreements negotiated with investigators through the NCI Office of Technology Transfer. Robert Wagner (NCI Office of Technology Transfer) and Kate Castro (ORB) work closely with Dr. Mitchell to establish these agreements and to coordinate the work conducted by these early adopters. For more information about the presentations delivered at the ISOQOL meeting, please contact Sandra Mitchell at mitchlls@mail.nih.gov
5th International African Caribbean Cancer Consortium
Damali Martin attended the 5th International African Caribbean Cancer Consortium (AC3) Scientific and Training meeting in Schoelcher, Martinique, October 9-11, 2014. The meeting was planned by the EGRP-supported AC3 consortia, in collaboration with the Cancer Registry of Martinique (AMREC). The theme for this meeting was “Advancing Cancer Health Equity in Populations of African Descent” and the specific objectives were 1) to facilitate knowledge-transfer related to cancer risk and outcomes in African-descended populations, and promote the development and coordination of research studies involving African-American, African-Caribbean, and African populations and 2) to promote diversity in health disparities research by providing a forum for training and career development for under-represented minority investigators and students. Dr. Martin presented on NCI’s activities for the Caribbean and also served as a judge for an oral presentation session for junior investigators.
European Association for Communication in Health
Bradford Hesse and Neeraj Arora attended the biennial meeting of the European Association for Communication in Health (EACH), September 28 to October 1, 2014, in Amsterdam, the Netherlands. The two participated on a panel entitled “Monitoring the Quality of Patient-Centered Communication in Cancer Care: Methods, Measures, and Population Surveillance.” Drs. Arora and Hesse highlighted findings from the Health Information National Trends Survey and put the findings presented by the speakers within the larger context of DCCPS research priorities related to patient-centered cancer communication and care coordination. The conference panel was created to promote discussions among relevant international scientists related to the task of engineering health systems in patient-centered communication. Building on the NCI monograph Patient-Centered Communication, the panel discussed a functional outcomes approach emphasizing patient support in six areas: (1) exchange of information; (2) decision making; (3) healing relationships; (4) patient self-management; (5) management of uncertainty; and (6) responding to, and coping with, emotions. Panel presenters included Richard Street from Baylor University and Kathy Mazor from the University of Massachusetts Medical School.
Visiting Researcher at the Federal University of Juiz de Fora, Brazil
In October 2014, Joan Warren was sponsored by the Brazilian government to spend 3 weeks as a Visiting Researcher at the Federal University of Juiz de Fora, Brazil. Dr. Warren taught a short course, ”Use of Population-based Public Health Data,” to 15 graduate students in addition to meeting with faculty from the Public Health Program to discuss their current projects as well as existing health data and potential linkages. While in Brazil, she had an opportunity to visit two cancer centers and to give a lecture on breast cancer treatment at a regional seminar organized by the Federal University.
Canadian Provincial Symptom Management Rounds
The Canadian September Provincial Symptom Management Rounds focused on the new ASCO guidelines on Anxiety and Depression Management in Cancer Survivors. A guidance was developed as an adaptation of Pan-Canadian guidelines. Julia Rowland, the senior author of the ASCO guidelines, provided an overview of how these were developed and the expectation for their implementation in the US.
Scientific Review of the Division of Psychosocial Research and Epidemiology, the Netherlands Cancer Institute
Julia Rowland participated in a four-member site visit committee that included Patricia Ganz (Chair), Peggy Tucker (NCI), and Scott Ramsey (Fred Hutchinson Cancer Center) and was tasked with providing a scientific review of the Division of Psychosocial Research and Epidemiology of the Netherlands Cancer Institute, August 27, 2014. This program has been one of most generative leaders in cancer control research in Europe.
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