Communication in American Indians thru Strategies for Equity 4 Cancer (CASE4Cancer)

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PROJECT SUMMARY: Cancer continues to be the top cause of death for American Indians (AIs) in North Carolina. With higher rates of colorectal cancer (CRC) late-stage diagnosis and mortality and the highest smoking rate among all race/ethnic groups in the state, there remains a critical need to reduce the use of tobacco among AIs while also improving early detection of lung and CRC cancers in order to improve disparities and outcomes. The Atrium Health Wake Forest Baptist Comprehensive Cancer Center’s (AHWFBCCC) Community Outreach and Engagement (COE) efforts are focused on addressing the disproportionate burden of cancer in the catchment area. NC has the largest AI population east of the Mississippi River, making addressing the cancer-related health needs of AI communities critical to this mission. Our recent integration with Atrium Health presents a unique opportunity to leverage complementary strengths across both cancer campuses to expand our reach by building on existing foundational collaborations and activities. Together, we propose to apply an innovative, multi-channel outreach and educational campaign to increase cancer awareness, preventive behaviors, and lifesaving screenings, to help address cultural and demographic issues contributing to disparities in health literacy and cancer in AIs. To accomplish this, we have two Specific Aims: 1) Implement a culturally tailored communication campaign tailored to tribal communities in the catchment area and region to improve health literacy, increase awareness about cancer screenings, and promote preventive lifestyle behaviors focused on lung, colorectal, and head and neck cancers, and 2) develop a tribal liaison program for continued local cancer education and screening support that will increase cancer awareness, preventive behaviors, and screenings by linking underserved AI communities to state-of-the-art evidence-based cancer screening and tobacco cessation. By employing a framework for equity-centered health communication, we will partner with our tribal communities in an iterative process to create, implement, and evaluate culturally tailored educational cancer communication messaging to increase cancer awareness, preventive behaviors, and lifesaving screenings. Leveraging established infrastructure and foundational collaborations will facilitate development of a community outreach and education intervention that is sustainable and can disseminate best practice for future adaptation and implementation.