Outreach Core

摘要：外展计划的总体目标有两个方面：1）为U 54提供核心支持，以培训基于社区的参与性研究（CBPR），直接社区外展和教育，以及实施和维持循证癌症控制计划的能力建设; 2）开展外展研究项目，以减轻波多黎各人的结肠直肠癌负担。该提案描述了外展核心活动（目标1）和所需的外展研究项目（目标2），具体如下：目标1：扩大现有的CCCOP，为U 54基础设施、临床研究项目和培训人员提供核心支持，包括直接社区外展、研究人员和社区能力建设、CBPR培训以及参与者招募和保留。目标2：制定和评估定制干预措施的有效性、成本溢出性和预算影响，以增加CRCS在PR患者中的应用。 降低PR中与癌症相关的发病率和死亡率需要不断努力解决与癌症相关的行为和环境条件，如医疗保健的获得。例如，尽管结直肠癌（CRC）是女性癌症相关死亡的第二大原因，男性癌症相关死亡的第三大原因，并且通过筛查和治疗癌前息肉在很大程度上是可以预防的，但与美国同行相比，结直肠癌筛查（CRCS）在符合年龄条件的患者中的PR中明显利用不足。 拟议的外展方案是波多黎各癌症控制社区外展方案的延续和延伸，该方案于2006年开始作为试点项目，并在当前供资周期扩大为完整的U 54外展核心。CCCOP将利用现有的社区合作伙伴关系、基础设施、数据和计划，1）为研究人员、受训人员和社区合作伙伴提供基于社区的参与性研究（CBPR）培训，2）开展直接的社区外展和教育，3）建设在社区和初级保健环境中实施和维持循证癌症控制计划的能力，4）利用现有数据，（a）建立伙伴关系并取得进展，以扩大在确定的优先领域的研究和干预活动;（b）开展外联研究项目，以减轻波多黎各人的结直肠癌负担。 通过与社区合作伙伴的合作，U 54外联核心将继续确定创新的外联战略，以接触最脆弱和得不到充分服务的人口。这些战略包括使用社区卫生教育者、互动和移动的技术，以及与联邦合格卫生中心合作。我们将为社区合作伙伴、受训人员和研究人员提供培训和技术援助，帮助他们确定癌症控制需求、制定或调整循证干预措施、实施和评估。我们还将重点关注增加社区对PR临床试验和生物库的参与，以促进有效的癌症预防，诊断和治疗方法 CCCOP充分记录了PR中的癌症负担，并且非常需要持续的社区外展工作和研究来减少它。CCCOP致力于继续在多个癌症控制主题方面开展工作，作为其外展核心的一部分，并通过优先考虑研究来加强这些外展活动。因此，通过外联努力和社区参与性活动制定了干预措施， 因此，可以严格评估、采用、实施和维持CBPR方法，以尽可能对波多黎各人的健康产生最大的影响。

Abstract: The overarching goals of the Outreach Program are twofold: 1) to provide core support to the U54 for training on community-based participatory research (CBPR), direct community outreach and education, and capacity building for implementation and sustainment of evidence-based cancer control programs, and; 2) to conduct an outreach research project to reduce the burden of colorectal cancer among Puerto Ricans. This proposal describes both outreach core activities (under Aim 1) and the required outreach research project (Aim 2) as follows: AIM 1: Expand the existing CCCOP to provide core support to the U54 infrastructure, clinical research projects, and trainees with respect to direct community outreach, researcher and community capacity building, CBPR training, and participant recruitment and retention. AIM 2: Develop and evaluate the effectiveness, cost effusiveness, and budget impact of a tailored intervention to increase CRCS in PR among patients of FQHCs. Reducing morbidity and mortality associated with cancer in PR requires continuous efforts to address cancer-related behaviors and environmental conditions such as health care access. For example, although colorectal cancer (CRC) is the second leading cause of cancer-related mortality in women and the third in men,^ and is largely preventable through screening and treatment of precancerous polyps, colorectal cancer screening (CRCS) is significantly underutilized in PR among age-eligible patients compared to their U.S. counterparts. The proposed Outreach Program represents a continuation and extension of the Puerto Rico Cancer Control Community Outreach Program (CCCOP) which began as a pilot project in 2006 and expanded to a full U54 Outreach Core in the current funding cycle. The CCCOP will use existing community partnerships, infrastructure, data, and programs to 1) provide training on community-based participatory research (CBPR) to researcher, trainees and community partners, 2) conduct direct community outreach and education, 3) build capacity for implementation and sustainment of evidence-based cancer control programs in communities and primary care settings, 4) leverage existing data, partnerships and progress to expand research and intervention activities in the identified priority areas, and; 5) conduct an outreach research project to reduce the burden of colorectal cancer among Puerto Ricans. Through collaboration with community partners, the U54 Outreach Core will continue to identify innovative outreach strategies to reach the most vulnerable and underserved populations. These strategies include the use of community health educators, interactive and mobile technologies, and collaboration with Federally Qualified Health Centers (FQHCs). We will provide training and technical assistance to community partners, trainees and researchers on issues such as identifying cancer control needs, developing or adapting evidence based interventions, implementation, and evaluation. We will also focus on increasing community participation in clinical trials and biobanking in PR in order to promote effective prevention, diagnostic, and treatment methods for cancer The cancer burden in PR is well documented by the CCCOP, and there is a significant need for continued community outreach efforts and research to reduce it. The CCCOP is committed to continue work in multiple cancer control topics as part of its Outreach Core, and to strengthen these outreach activities by prioritizing research. As a result, interventions developed through outreach efforts and community-based participatory research (CBPR) approaches can be rigorously evaluated, adopted, implemented and maintained to have the greatest possible impact on the health of Puerto Ricans.