This presentation was supported by Cooperative Agreement number U48DP from the Centers for Disease Control and Prevention, Prevention Research Centers program. The findings and conclusions in this presentations are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. OPPORTUNITIES TO PREVENT CANCER & IMPROVE CANCER SURVIVORSHIP Kerri Winters-StoneJackilen Shannon OHSU School of NursingOHSU Department of Public Health & Preventive Medicine

Thank You Northwest Portland Area Indian Health Board Chairman Andy Joseph Executive Committee Delegates Our Collaborating Partners: Kerri Lopez Eric Vinson Northwest Tribal Comprehensive Cancer Control Project

OVERVIEW Building on successful accomplishments We recognize the successful, ongoing work aimed at addressing cancer prevention and education in tribal people. Our goal is to collaborate and see how those efforts could be expanded given newly available resources and opportunities. Collaborating partners: Kerri Lopez & Eric Vinson Northwest Tribal Comprehensive Cancer Control Project CDC-funded Prevention Research Center -called- OHSU Center for Healthy Communities (Tom Becker’s center) Cancer Prevention and Control Research Network (CPCRN)

We, as representatives of this National Cancer Prevention & Control Network: Are committed to: 1. Building long-standing relationships 2. Gauging interest in cancer-related efforts 3. Identifying available resources that may support tribal community needs 4. Linking tribal communities to programmatic opportunities for addressing cancer-related concerns

What is the Cancer Prevention and Control Research Network? The CPCRN is a national network of academic, public health, and community partners who work together to reduce the burden of cancer. Its members conduct community-based participatory interventions across its ten network centers, crossing academic affiliations and geographic boundaries. __________ CDC  PRC (CDC’s flagship program for preventing and controlling chronic diseases) Under the PRC umbrella sits CPCRNs.

The efforts behind Cancer Prevention and Control encompass the full, broad spectrum of the topic, needs and demands on communities Cancer Prevention; Healthy communities Cancer Screening Cancer Treatment; Care delivery Survivorship End of life Survivorship End of life

New Opportunities to address Cancer Prevention & Control in Tribal Communities National resources; Cancer Prevention and Control Research Network Local resources; OHSU Knight Cancer Institute Integration of both with Tom’s OHSU Center for Healthy Communities (PRC)

We call ourselves the Oregon Cancer Community Research Collaborative (OR-CCRC) Our primary mission is to address prevention, early detection, and cancer survivorship while emphasizing dietary and physical activity interventions for primary and tertiary prevention. Guiding principle: assure proposed projects are culturally appropriate and valuable to community participants

Involved OR-CCRC Faculty Tom Becker – health promotion in tribal communities; provider training programs Jackilen Shannon – diet & cancer prevention; community research; education programs for youth Kerri Winters-Stone – cancer survivorship--exercise and long-term/late effects; bringing evidence-based into the community Cynthia Perry – physical activity in communities, with a focus on youth Nancy Findholt – nutrition in rural schools; school policy; engaging with communities around healthy eating Frances Lee-Lin – breast and colorectal cancer screening and creating education programs for communities

OR-CCRC Tribal & Rural Advisory Board Kerri Lopez helped identify interested tribal members willing to join the board. Judy Charley Twila Teeman Kerri Lopez First meeting = February 2, 2015 Goal: To discover commonalities between tribal and rural community needs in order to match OR-CCRC expertise, national and local resources.

Building upon established & successful programs designed to address the cancer- related needs of tribal communities The OR-CCRC provides an opportunity to offer resources that could expand or build upon current successes. In particular, OR-CCRC faculty have expertise in physical activity and nutrition programs to reduce the risk of cancer and improve outcomes for cancer survivors and their families. The Knight Community Partnership program may provide additional support to actualize plans to reduce the burden of cancer in tribal communities.

Example Projects: Cancer Screening At the national CPCRN level, several “cross-center” (nationwide) projects are under development and consideration for implementation across multiple sites. Current areas of discussion around screening: Cervical cancer screening Colorectal cancer screening Lung cancer screening Other areas HPV vaccination Training programs to guide communities toward implementation of evidence-based interventions

Example projects: Community Cancer Prevention & Education o Science, education and outreach tool designed for use in communities  Tool can be used to promote awareness, educate and/or collect data on large #’s of people - ANONYMOUSLY  Health-fair style community education and engagement program  Teacher professional development and integrated lesson plans for student engagement  Multiple, engaging health-related stations, including cancer risk and prevention

Cancer Risk Skin cancer, lung cancer, and breast cancer risk assessment Blood Pressure and Chemistry Blood pressure. For adults: Fingerstick test for glucose, cholesterol, HDL, LDL, triglycerides, other lipids Diet Computerized assessment with tailored feedback. Bitter taste sensitivity Sleep Computerized assessment of sleep quality, morningness / eveningness, and daytime sleepiness with tailored feedback Genetics Salivary sample for anonymous DNA Body Composition Height, weight, waist circumference, body mass index, body fat percentage Communities Schools Data linked anonymously to each participant by scanning their random wristband barcode Automatically added to database at OHSU Researchers Memory Computerized assessment of short-term visuospatial memory

Example projects: Cancer Survivorship Evidence-based exercise programs (Winters-Stone; Perry): Community exercise programs to reduce symptoms and side effects of cancer treatment Effective programs that are medically appropriate Tested in community setting; Instructor training model Exercising Together – partnered strength training for couples coping with cancer Improves health and well being of patient and spouse/caregiver Couples stick with the program long term.  Other areas in cancer survivorship  Understanding the impact of cancer treatment on patients and families  Helping families address decisions, particularly around end of life

Supporting Communities in their Fight Against Cancer; The OHSU Knight Cancer Institute The Knight Community Partnership Program; designed to build sustainable collaborations with Oregon communities by: providing grants, links to academic partners and other resources to foster development of cancer prevention, early detection, treatment and survivorship projects based on community-identified needs. The OHSU Knight Cancer Institute has made a decade- long commitment to Oregonians to invest $1 million dollars through this program every year. Early Stage grants of up to $10,000 Developmental grants of up to $25,000 Program Advancement grants of up to $50,000.

Questions? Comments? PRC-related: Tom Becker – Tosha Zaback – (program director) CPCRN/ OR-CCRC/ Knight Ca Institute-related: Jackie Shannon – Kerri Winters-Stone – Paige Farris – (program manager)

Thank you. We greatly appreciate your time.