University of Washington Member Center Alliance for Reducing Cancer, Northwest (ARC NW) This presentation is a product of the University of Washington Health Promotion Research Center, a Centers for Disease Control and Prevention (CDC) Prevention Research Center (PRC), and was supported by Cooperative Agreement (CA) number U48-DP from the CDC. The CA includes funding from the National Cancer Institute (NCI) through the PRC Program's Cancer Prevention and Control Research Network (CPCRN). The findings presented are those of the authors and do not necessarily represent CDC's or NCI's official positions.

Overview ARC NW Brief history & partners National projects Proposed pilot projects for Q&A

ARC NW Overview CPCRN member since 2002 Principal Investigators Jeff Harris10/02–03/07 Vicky Taylor04/07–09/13 Peggy Hannon10/13–present Project Director: Thuy Vu Puget Sound, and other areas of WA, Pacific Northwest

ARC NW Goals Conduct and disseminate community-based cancer research that will: Build upon existing knowledge of cancer prevention and control Address critical gaps in the Guide to Community Preventive Services Lead to the adoption, implementation, and dissemination of successful programs

Partner Organizations & Investigator Expertise, OrganizationsInvestigatorsExpertise American Cancer SocietyAudrey FineHealth systems collaborations Cornerstone Medical ServicesSuzanne PakCBPR w/ community health centers Fred Hutchinson Cancer Research Center Linda Ko, Vicky TaylorHealth communication, health disparities, CBPR w/ Latino + Asian populations Group Health Research InstituteBev GreenClinic-based interventions, patient-centered medical home Kaiser Permanente Center for Health Research Gloria CoronadoHealth disparities, Latino populations, community-health clinic collaborations Public Health-Seattle & King CountyJodi OlsonCancer screening un/under-insured University of WashingtonLaura-Mae Baldwin, Peggy Hannon, Jeff Harris, Mei-Po Yip D&I research, rural populations, workplace health promotion, state and local DOH collaborations, Asian populations Veterans Affairs Puget SoundSteve ZeliadtHealth economics, cancer decision-making WA Association of Community and Migrant Health Centers Mary Beth BrownLinkages w/ community health centers WA Department of HealthMegan Celedonia, Emily ButlerState cancer screening programs

National Activities with CPCRN, Participated in CPCRN activities in both leadership and supportive roles Chaired or co-chaired three workgroups Colorectal cancer control program (CRCCP) Federally qualified health centers (FQHCs) HPV vaccination Actively participated in all other work groups 2–1–1 Capacity building-technical assistance and training Community Guide Economics Survivorship

CRCCP Collaborators, CPCRN Sites Emory Harvard UCLA U Colorado UNC U S. Carolina U Texas Washington U-St. Louis U Washington Thuy Vu, MPH Marlana Kohn, MPH Caitlin Mason, PhD CDC Amy DeGroff Lindsay Gressard Ketra Rice Vicki Benard CRCCP Evaluation Team NCI Russ Glasgow Mike Sanchez Cynthia Vinson

Colorectal Cancer Control Program (CRCCP) Goal: Increase CRC screening to 80% by 2014 Provide screening to un/underinsured Promote screening population-wide

Opportunity for CPCRN Mission: Accelerate evidence-based intervention (EBI) adoption Shift in CDC’s approach from NBCCEDP to CRCCP Grantees urged to use Guide-recommended EBIs

Community Guide Strategies (2009) 5 strategies to promote CRC screening: Client-oriented Small media Client reminders Reducing structural barriers Provider-oriented Provider reminders Provider assessment and feedback

CRCCP Workgroup Goals Study EBI adoption, implementation, maintenance Implement Annual Grantee Survey Develop additional studies Comparison of grantees and unfunded sites, 2012 In-depth interviews,

Papers Grantees’ use of EBIs, AJPM, 2013 Patient navigation, JPHMP, 2014 Comparison of grantees and unfunded sites, Prev Chronic Dis 2014 Training and technical assistance, under review

ARC NW Pilot Projects Pilot 1: Peggy Hannon Pilot 2: Linda Ko Proposed Pilot Projects

Pilot 1: Implementation of Evidence-Based Interventions in WA Breast, Cervical, and Colon Health Program GRANTEE Washington State Health Department PRIME CONTRACTOR Public Health-Seattle & King County Serves 4 Counties PARTNER Community Health Centers PARTNER Local Hospitals PARTNER Small Local Health Departments PARTNER Community-based Organizations PRIME CONTRACTOR Citrine Health Serves 6 Counties PRIME CONTRACTOR Spokane Regional Health District Serves 9 Counties

Pilot 1 Aims & Activities Aim: Increase BCCHP partners’ use of evidence-based interventions Activities 1.Identify all BCCHP partners 2.Conduct mixed-methods needs assessment with partners EBI use, barriers and facilitators Impact of Affordable Care Act on program implementation, EBI needs Satisfaction with reach to eligible clients, newly insured, and population served by the partner organization

Pilot 2: Building Community Health Center Capacity to Promote CRC screening to Limited English Proficient Patients US LEP population increasing, particularly Hispanics and Asians ~79% of Spanish, Chinese, Korean, Vietnamese speakers report LEP LEPs have low CRC screening rates (LEP: 33% vs. overall US: 59%) Our approach with a community health center can be adopted/ adapted by other CPCRN member centers

Pilot 2 Aims and Activities Aims: to increase CRC screening among LEPs by building capacity of CHCs to select, adapt, and implement evidence-based interventions Partner CHC serves a large LEP patient population Two Activities 1.Collaborate with a CHC to build capacity to select and adapt EBIs to promote CRC screening using the Cultural and Linguistic Adaptation Framework (CLAF) 2.Assist a CHC to select, adapt, and implement 2 EBIs and conduct an evaluation of the impact of the selected EBIs on CRC screening.

Thank you! Questions?