Building research capacity for cancer disparities research with community-clinic partnerships in rural African American impoverished counties

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Arkansas is one of the most rural and impoverished states in the U.S., with rural, African Americans (AA) bearing a disproportionate burden of cancer and related outcomes. Due to the fact that rural AA are more likely to live in persistent poverty and experience poverty's adverse effects, the mortality and incidence rates for the four major cancers and all cancers combined in Arkansan AA are among the highest in the nation. These disparities in cancer-relevant outcomes are further compounded by decades of discrimination and racism. Despite the state's obvious need to advance cancer prevention and control efforts, there are no NCI- designated cancer centers that serve the state, nor a strategic plan to address cancer disparities among communities in rural persistent poverty counties. Without a formal, systematic plan for cancer research engaging communities in this high-need area of Arkansas, cancer prevention and control efforts will continue to be stymied in communities who desperately need treatment now. Our goal through this P30 supplement is to form a cross-cancer center partnership that leverages the infrastructure of Roswell Park Comprehensive Cancer Center (Roswell Park) and the University of Arkansas for Medical Sciences Winthrop P. Rockefeller Cancer Institute (UAMS/WPRCI) to programmatically advance a cancer control agenda to reduce cancer disparities experienced by rural AA communities in the highest need areas of the U.S. This study will simultaneously 1) gather clinic-, community-, and participant-level data to inform a strategic plan for cancer prevention and control; and 2) build sufficient capacity within institutions currently serving Arkansas rural persistent poverty areas to implement a systematic program of cancer research. We will use mixed methodology to characterize cancer-related factors in rural AA communities, ascertain the current cancer research capacity of healthcare clinics that serve the target area, and determine assets and gaps within institutions who serve these communities to implement cancer research. We will collect standardized survey data from 240 AA residing in rural persistent poverty counties, electronic medical records (EMR) data from three clinics that serve all 12 rural poverty persistent counties, and qualitative data from 12 in-depth interviews with clinic leaders and administrators. To build the area's capacity for cancer research in the target area, we will construct a Community Advisory Board (CAB) consisting of healthcare clinic and community leaders. Through engaging the CAB in all aspects of the study, we will build relationships between healthcare, community, and academic stakeholders to conduct rigorous cancer prevention and control research. This collaboration will be developed from already long-standing relationships with the healthcare system and rural AA community within our team, in addition to Roswell Park's innovative partnership with WPRCI/UAMS. This study will provide the necessary evidence base and partnership capacity to develop organized efforts (that have not yet been implemented) for cancer prevention and control in a high-risk population.