CPCRN WORKGROUP & INTEREST GROUP PROJECTS

The CPCRN Scholars Workgroup strives to educate students, postdoctoral fellows, junior faculty, practitioners, and other health professionals in dissemination and implementation (D&I) science focused on cancer prevention and control and health equity. Scholars will be provided with opportunities to engage in mentored projects with workgroups that most align with their interests. Scholars will have different tracks to follow, but an educational component covering core competencies is required. Through a formalized process, it is our hope that we can increase: the depth and breadth of the Scholars’ connectedness within the CPCRN, a diverse cancer research pipeline, and applied D&I work in academic and clinical settings. Workgroup products are a D&I curriculum, evaluation of curricula, and Scholars’ productivity after the training.

For more information about the CPCRN Scholars Workgroup, please contact Project Directors, Sam Noblet (noblet@mailbox.sc.edu) & Courtney Petagna (cpetagn@emory.edu).

The goal of the CPCRN Health Behaviors Workgroup is to examine and characterize the complex relationships among social, structural, and commercial determinants of health, individual characteristics and experiences, and cancer outcomes, including survivorship and mortality. The primary objective of the Workgroup is to advance what is known about how determinants interact to influence cancer-related outcomes and disparities, and provide information that can be used by researchers and public health practitioners to inform the design of strategies and interventions intended to mitigate the health impacts of cancer.

For more information about the Health Behaviors Workgroup, please contact Project Chair, Dr. Christine Kava (ckava@uw.edu).

Research has shown that rural communities in the United States are often at increased risk of cancer incidence, morbidity, and mortality compared to their urban counterparts. Similarly, declines in the overall cancer burden seen nationally have not yet been observed in rural communities. The primary objective of the CPCRN Rural Cancer Workgroup is to leverage the resources, expertise, and relationships of the diverse CPCRN to conduct impactful and innovative rural cancer research to improve outcomes for rural residents and capacity for rural health care providers/organizations.

For more information about the Rural Cancer Workgroup, please contact Project Director, Heidi Haines (heidi-haines@uiowa.edu).

The CPCRN Cancer Survivorship Workgroup seeks to advance interdisciplinary research collaborations that support cancer survivorship science and outreach with the goal of promoting  health equity among cancer survivors. Workgroup members define a cancer survivors and survivorship as follows: An individual is considered a cancer survivor from the time of diagnosis, through the balance of their life. This also includes secondary survivors, such as caregivers and family members of those diagnosed with cancer. Survivorship research encompasses the physical, psychological, social, economic and spiritual health of survivors across the cancer continuum, with special emphasis on long-term well-being, including disease prevention and health promotion over the life course.

Numerous gaps remain in Workgroup members' effort to optimize the health of all cancer survivors. Further, there are several underserved and/or vulnerable groups of survivors whose unique needs for health promotion after a diagnosis are not being met. This Workgroup is charged with filling gaps in current knowledge and advancing the evidence base to cancer survivorship care as well as conducting dissemination and implementation (D&I) research, engaging in policy, and supporting clinical guidelines to promote health after a cancer diagnosis.

For more information about the Cancer Survivorship Workgroup, please contact Project Director, Rosi Vogel (rosimvogel@arizona.edu).

The CPCRN Health Equity Workgroup (previously Health Equity & Social Determinants of Health (SDOH) Interest Group) advances health equity in cancer prevention and control research and provides the CPCRN and Network Centers with: guiding principles for health and racial equity; tools for measurement and evaluation of health and racial equity principles; case studies intended to serve as examples of the equity principles in action and guidance around implementing them; and technical assistance to support the integration of health and racial equity into research.

The overall objective of the Modeling Evidence-Based Intervention (EBI) Impact Workgroup is to inform the implementation of EBIs through modeling, systems mapping, and other systems science tools, including how to select and prioritize EBIs, appropriately plan for implementation, costs, and allocation of resources, and adapt EBIs for specific contexts. Workgroup members are interested in supporting increased cancer screening overall, as well as addressing observed disparities. In order to guide cancer screening-focused intervention planning, practice-level change, improvement at the health system-level, and policy at the state and national level, members integrate best available evidence into decision support models, which they use to conduct virtual comparative and cost effectiveness research. Using EBI models, they simulate and compare the impact of alternate “what if” scenarios on screening rates in a given year and over time, the percent of subpopulations up-to-date with routine screening, cancer incidence, cancer stage at diagnosis, and cancer deaths and/or life-years lost due to cancer. Workgroup members engage diverse stakeholders in discussions regarding the appropriate outcomes of focus, motivating research questions, target populations, and resource considerations. The Workgroup also aims to serve as a resource for others interested in applying a systems lens to their research and implementation studies (for example, by providing guidance on how to conduct simulation studies and systems mapping activities, and use the findings to improve cancer screening).

For more information about the Modeling EBI Impact Workgroup, please contact Project Chair, Dr. Stephanie Wheeler (stephanie_wheeler@unc.edu).

The Multiple Cancer Screening Workgroup grew out of the question:  how can we make cancer preventive services easier for people to access and use? Thus we are looking at a cancer screening(s) paired with any kind of preventive service, be it gynecologic or flu vaccine, etc. Our Workgroup has been focused on a conducting a scoping review to answer the research question, ‘What is the structure, content, and impact of bundled cancer screening programs?’

Adolescent and young adult (AYA) cancer survivors face unique challenges in the diagnosis, treatment and follow up of cancer which translates into higher morbidity and mortality. These challenges include unique concerns regarding late/long-term effects and higher prevalence of certain cancer types. Our experience (and I think supported by literature) is that it is challenging to capture long-term follow up on the AYA population due to mobility/competing life demands. This creates challenges for doing studies and building an evidence base. There are newer therapies for which we don’t yet understand the full range of late/long-term toxicities. The CPCRN has demonstrated interest in cancer survivorship, with AYA being a subset and representing a small(er) proportion of cancer survivors. Having multiple sites increases power for any intervention, and we would be able to focus in on specific questions (e.g. cardiotoxicity, reproductive late effects, psychosocial). Project ideas include:

• Gathering data on preferences/strategies for contact/follow up/recruitment in this population;
• Observational studies or secondary database analysis to describe late/long-term effects of newer therapies (biologics), late/long-term effects for potentially understudied, and strategies to reduce cardiovascular morbidity.

For more information about the AYA Cancer Interest Group, please contact Project Chair, Dr. Linda Overholser (linda.overholser@cuanschutz.edu).

For more information about the Organizational Readiness Interest Group, please contact Project Coordinator, Derek Craig (derek.w.craig@uth.tmc.edu).

For more information about the Social Deprivation Interest Group, please contact Project Director, Julie Kranick (julie.kranick@nyulangone.org).

Results of the National Lung Cancer Screening Trial have informed the development of favorable guidelines and policies to support implementation of lung cancer screening using low-dose computed tomography (LDCT); however, uptake and maintenance of screening remain suboptimal. To maximize the individual and population health benefits of lung cancer screening, there is an urgent need for efforts to raise clinician and candidate engagement with lung cancer screening, support informed consideration of uptake, and facilitate adherence. While there has been some early attention to addressing disparities and inequity, there are a host of opportunities for developing, testing, and implementing targeted and tailored strategies to support appropriate and informed lung cancer screening in a number of underserved communities that are likely to experience higher rates of eligibility for screening due to tobacco use history. The CPCRN Lung Cancer Screening Interest Group will consider these opportunities and work toward generating ideas and collaborations to develop an evidence base to support equity in lung cancer screening implementation.

For more information about the Lung Cancer Screening Interest Group, please contact Project Directors, Mary Wangen (wange062@live.unc.edu) & Emily Bilenduke (emily.bilenduke@ucdenver.edu).

UPDATE [1/5/21]: Formerly  participating as an Interest Group, the Cancer & COVID-19 project has since folded under the Cancer Survivorship Workgroup, effective 2022. For more information on previous work completed by the Cancer & COVID-19 Interest Group, please refer to the description below, or contact past Co-Chairs, Drs. Betsy Risendal (betsy.risendal@cuanschutz.edu) & Cynthia Thomson (cthomson@arizona.edu).

Investigators from the Cancer & COVID-19 Interest Group published two "sister" articles focused on identifying and addressing public health and clinical challenges under COVID-19:

• "Addressing COVID-19 Using a Public Health Approach: Perspectives from the Cancer Prevention and Control Research Network." The authors provide recommendations, based on their collective experience in increasing the reach and impact of cancer prevention and control programs, for national response strategies to reduce the burden of COVID-19 and related disparities.
• "Addressing Cancer Survivorship Care Under COVID-19: Perspectives from the Cancer Prevention and Control Research Network." The authors also address the potential for health disparities associated with COVID-19 to amplify health concerns, with a focus on cancer survivorship care and strategies for adapting to the pandemic and optimizing clinical outcomes

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The goal of the CPCRN iCollab Workgroup is to create a cross-center implementation laboratory to study the use of both quality improvement (QI) practice and implementation science (IS) to improve cancer prevention and control.  We investigate implementation support strategies used in CPCRN projects that engage community and practice partners to implement evidence-based interventions (EBIs) into routine practice.  Using case studies from Collaborating Centers, we describe how our Network is advancing: 1) best practices in implementation support across a variety of funding types, cancer programs, and settings; 2) an understanding of the mechanisms through which implementation support strategies impact outcomes; 3) approaches for better integrating QI practice and IS; and 4) health equity through engaging stakeholders in the implementation strategy development process.

For more information about the iCollab Workgroup, please contact Project Directors, Dr. Catherine Rohweder (rohweder@email.unc.edu) & Emily Bilenduke (emily.bilenduke@ucdenver.edu).

There has not been a comprehensive assessment of patient navigators in NBCCEDP or CRCCP, especially with respect to cancer screening. Most of what we know is from the perspective of grantee program administrators. This workgroup aims to characterize patient navigators affiliated with program grantees, using a mixed-methods approach and disseminate findings to stakeholders, including to the CDC, grantees, and other researchers and practitioners.

The Centers for Disease Control and Prevention (CDC) supports two nationwide cancer screening programs, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer Control Program (CRCCP). The CPCRN has collaborated with CDC since 2010 to measure CRCCP grantees’ use of evidence-based interventions (EBIs) to promote colorectal cancer screening and evaluate program success.

Recent studies indicate that adherence to new (2009, 2012) Cervical Cancer Screening guidelines is low and patients and providers are reluctant to lengthen screening intervals. This workgroup identifies and evaluates methods to increase implementation of new and emerging guidelines – at the patient, provider, practice/organizational and policy levels. Specific aims include evaluating approaches and methods de-escalation as well as increasing adherence to guidelines and examining the current state of practice and key determinants.

The goal of this workgroup is to contribute to the science and evidence-base supporting innovative community-clinical linkages to increase Human Papillomavirus (HPV) vaccination initiation and completion among adolescents and young adults. Through applied prevention research, the HPV vaccination workgroup aims to accelerate the implementation of evidence-based cancer control through the systematic identification and dissemination of best practices, community/clinical stakeholders and vaccine champions, and community-clinical linkages needed to increase HPV vaccination rates among different populations in diverse settings.

Evidence-based interventions (EBIs) continue to be underused in community programs and practices. The purpose of this Workgroup is to develop, test, and refine training and technical assistance strategies with the goal of building community planners’ capacity to select, adapt, and implement evidence-based interventions. The training and technical assistance strategies will be tested with grantees of the Knight Cancer Institute’s Community Partnership Program, through which the Knight has made a 10-year commitment to provide $1 million annually for community-based cancer prevention in Oregon. Participating CPCRN centers also will have the opportunity to test the training and technical assistance strategies locally or in other cross-center projects.

This cross-CPCRN Center initiative aims to understand barriers and facilitators faced by community health centers related to implementing both: 1) tobacco assessment and cessation assistance/referral (USPSTF grade A recommendation); and 2) low dose computed tomographic (LDCT) scan for lung cancer screening (the USPSTF grade B recommendation). The first step was to develop a survey to assess current practices, resources and potential barriers to these preventive services.