Community Based Prevention Marketing for Systems Change: Reducing Disparities

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DESCRIPTION (provided by applicant): We propose a Prevention Research Center that uses community-based prevention marketing (CBPM) to adapt, implement, evaluate, and disseminate evidence-based approaches to strengthen state and local health departments' and community coalitions' capacity for sustained disease prevention and health promotion. The FPRC's health priority will be the reduction of cancer disparities, and the core research project for the next five years will focus on the promotion of colorectal cancer screening (CRCS). The FPRC's mission and core research are responsive to the Guide to Community Preventive Services' focus on multilevel interventions to increase screening for cancer. The core research project will focus on colorectal cancer (CRC), selected by our State partner - the Florida Department of Health (FDOH), because it is the second leading cause of cancer-related deaths among men and women in the U.S. While scientific cancer advances are occurring, racial ethnic minorities and the medically underserved have consistently experienced the highest CRC mortality rates. The aims of the core research project are to: 1) examine disparities in late stage colorectal cancer incidence and screening rates to identify priority populations; 2) identify appropriate and feasible evidence-based interventions (EBI) for the priority populations; 3) conduct formative research with priority populations and key stakeholders to assess the EBIs' acceptability and to tailor EBIs to better meet priority population(s)' preferences and needs; and 4) implement and evaluate the multilevel intervention and make recommendations for future programs and policies in the state of Florida. This proposal makes three significant contributions to prevention research. First, the FPRC will work with FDOH, a community committee and other stakeholders (e.g., American Cancer Society) to test the CBPM for Systems Change framework's ability to select, tailor, promote, monitor, evaluate, and disseminate EBIs to reduce colorectal cancer screening (CRCS) health disparities. This planning framework has the potential to equip prevention researchers, health department and community partners with an effective planning framework that accelerates the translation of research to practice. Lessons learned from this demonstration project will be used to enhance the FPRC's training website and provide technical assistance to other State health departments and community partners. Second, the FPRC and its partners will create a computer simulation model of the system in which CRCS disparities are embedded and identify evidence-based interventions appropriate for addressing determinants at multiple levels in that system. This model and formative research results will be used to design an integrated, multilevel intervention for reducing CRC disparities. The intervention will be evaluated and the feasibility of scaling it up to other communities assessed. A dissemination plan will be created for effective components. Third, the FPRC will use lessons learned from the new and previous demonstration projects to enhance the CBPM training website and mentor other public health agencies and community partners that adopt it.