Abstract
The NCI and NIH awarded $50 million over 5 years to five university-based centers to conduct research and implement programs aimed at improving how people with cancer fare in low-income areas. Centers participating in the Persistent Poverty Initiative will expand research in high-poverty areas and engage patients in cancer prevention through lifestyle changes, such as smoking cessation, healthy eating, and physical activity.
Five university-based centers will study the effects of poverty on how people with cancer fare under a $50 million initiative coordinated by the NIH and NCI. The newly established centers will expand existing programs in low-income communities and launch anticancer efforts, such as reducing tobacco use, improving access to healthy food, and promoting physical activity.
The initiative targets persistent poverty areas, defined as communities where 20% or more of the population has lived below the federal poverty line for the past 30 years. Such areas are associated with delays in cancer diagnosis and treatment, as well as higher incidences of cancer deaths, compared with people in higher-income regions, according to the NCI.
“Persistent poverty is a place-based and community phenomenon,” says Shobha Srinivasan, PhD, senior advisor for health disparities and health equity in the NCI's Division of Cancer Control and Population Sciences. “This research will help us assess interventions aimed at addressing some of the failures of institutions to drive improvements in overall health, cancer control, and cancer outcomes.”
The centers, selected through a competitive grant process, will each receive approximately $2 million per year for 5 years. In addition to community-based interventions, funding will support training early career investigators to work with underserved communities across the country.
Participating centers include the HOPE & CAIRHE 2gether Center, co-led by the Huntsman Cancer Institute at the University of Utah in Salt Lake City and Montana State University in Bozeman, which works with Hispanic and American Indian communities to prevent obesity and encourage quitting tobacco. For example, the center's researchers partner with community health centers in Utah to enroll patients in tobacco cessation programs and offer access to evidence-based tools, such as counseling and FDA-approved medications, says project lead Chelsey Schlechter, MPH, PhD, of the Huntsman Cancer Institute.
“Electronic health record–based interventions prompt clinic staff to ask about patients’ tobacco use and connect them with available interventions and resources to help them address social and economic hardships, such as lack of insurance or housing instability,” says Schlechter. “We provide repeated opportunities for patients to enroll in programs and engage with community health workers employed by our primary care association.”
Another center, the Acres Homes Cancer Prevention Collaboration, housed at The University of Texas MD Anderson Cancer Center in Houston, works with Black/African American and Hispanic communities to promote nutrition and physical activity. The new funding will help expand a 3-year-old partnership with Acres Homes, a low-income neighborhood in Northwest Houston, says Ruth Rechis, PhD, of MD Anderson.
“One program combines nutrition education for elementary students and families with distribution of healthy food,” says Rechis. “Our other main project helps cancer survivors be more physically active and connects them with resources to exercise safely, such as classes at neighborhood recreation centers and walking clubs at local parks.”
The other three centers to receive funding are the UPSTREAM Research Center, led by Stanford University in Palo Alto, CA; the Center for Cancer Control in Persistent Poverty Areas, led by the University of Alabama at Birmingham; and the Center for Social Capital, led by Weill Cornell Medicine and Columbia University in New York, NY.
An overarching goal is tailoring cancer prevention and survivorship programs to people living in disadvantaged communities, which have unique barriers to adopting healthy habits, says Karen Basen-Engquist, PhD, MPH, of MD Anderson.
“Sometimes the behavior changes that we ask people to do, such as exercising or walking more, are not as accessible for people living in neighborhoods that have no sidewalks or where it's not safe to walk,” notes Basen-Engquist. “We want to adapt programs to be helpful to people across the socioeconomic spectrum.” –Janet Colwell
For more news on cancer research, visit Cancer Discovery online at http://cancerdiscovery.aacrjournals.org/CDNews.
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