Multi-sector, multi-level interventions for improving cancer prevention and control addressing persistent poverty

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OVERALL: PROJECT SUMMARY The overall, long-term goal of “HOPE & CAIRHE 2gether (HC2)” is to increase the reach of evidence-based cancer prevention and control interventions (EBIs) in areas of persistent poverty (PP). HC2 brings together the expertise, infrastructure, partnerships, and resources of the Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute, and University of Utah, with the Center for American Indian and Rural Health Equity (CAIRHE) and Montana State University. HC2’s community level, translational research programs align with communities’ cultural beliefs, resources, and priorities; reach across the lifespan; and, strategically partner with key “anchor organizations,” public health agencies, healthcare systems, American Indian communities, and community organizations across five states. The HC2 Network brings together the robust community partnerships across institutions to create a unique resource for advancing cancer prevention in PP areas in the Mountain West, and HC2 is guided by a Community and Scientific Advisory Board. Projects 1 and 2 address the major drivers of the disproportionate burden of cancer among PP areas and populations. Project 1 partners with Community Health Centers (CHCs) to address tobacco cessation and mitigate the negative impacts of the social determinants of health (SDOH) among CHC patients in Utah who use tobacco and live in PP census tracts (majority Latino). Project 2 partners with Cooperative Extension Systems (CES) to address obesity prevention and SDOH among American Indian communities located in PP census tracts in Montana, Oregon, South Dakota, and Wisconsin (all census tracts are rural/frontier). Both Projects include Project Steering Committees and Project 2 includes Local Community Advisory Boards in each community. An overarching theme creating synergy across HC2 activities and research is increasing “Reach through Equitable Implementation.” As such, HC2 implementation strategies are specifically tailored to local and community contexts. HC2’s structure and function creates substantial synergy to advance cancer prevention research in areas and populations experiencing persistent poverty via: Complementary areas of expertise, experience, community engagement, and leadership across institutions; Innovative, comprehensive, multi- level, conceptual framework targeting Reach through Equitable Implementation, with shared research foci that drive the research programs; Multi-faceted, cross-institutional training program that leverages the complementary strengths and access to trainee populations across Utah and Montana; and, Combining deep and extensive community engagement and robust partnerships across institutions to create the HC2 Network, which will help bridge the gap between scientific discovery and the implementation of EBIs in areas of PP. In sum, HC2 will build on existing expertise, research infrastructures, and longstanding partnerships to serve as a regional and national leader in community-engaged cancer prevention and control research in areas of PP.