Project Title: National Hispanic Leadership Initiative on Cancer (NHLIC): En Acción

Abstract:

The National Hispanic Leadership Initiative on Cancer: En Acción is a multi-risk cancer prevention and control research and community outreach program. Funded by the National Cancer Institute, the NHLIC: En Acción initiated the first comprehensive assessment of cancer risk factors among the major populations of Hispanic/Latino men and women and developed state-of-the-art cancer prevention and control strategies tailored to those diverse populations. Research questions compared cancer rates and behavioral risks before and after intervention strategies were implemented. Formative research was employed to develop local newsletters and test role model portrayals. The program focused on implementing a theory-based behavioral journalism (using community role models to relate personal examples of behavior modification) and community networker (peer) intervention model at each site. Combining national and regional health expertise with grassroots community leadership, the innovative outreach program integrated the latest advances in cancer research into health policy and practice among a substantial segment of this nation’s Hispanic population. As a result, NHLIC: En Acción has empowered Hispanic communities with the knowledge and the resources necessary to prevent and control cancer among their own people.

PI:

  • Amelie G. Ramirez, DrPH, Professor of Medicine and Deputy Director of the Chronic Disease Prevention and Control Research Center at Baylor College of Medicine

Co-PI's:

  • Jose R. Martí, MD, Brookdale Hospital Medical Center in Brooklyn, New York
  • Eliseo J. Pérez-Stable, MD, Chief of the Division of General Internal Medicine at U. of California, San Francisco
  • Gregory A. Talavera, MD, MPH, Faculty at School of Public Health, Division of Health Promotion at San Diego State U.
  • Edward J. Trapido, ScD, Associate Director of the U. of Miami Sylvester Comprehensive Cancer Center
  • Roberto Villarreal, MD, University of Texas Health Science Center at San Antonio, San Antonio, Texas
  • Lucina Suarez, PhD, Texas Department of Health, Austin, Texas

Funding Institution:

National Cancer Institute

Funding Period:

7 yrs.– 1992 – 1999 (including 2-year extension)

Funding Award:

$9,000,000 (estimated)

Location/Service Area:

  • The Coordinating Center is Baylor College of Medicine, Houston and San Antonio, TX
  • The program impacts 6 heavily Hispanic regions in the United States: Puerto Ricans in New York City, Cuban Americans in Miami, Central and South Americans in San Francisco, and Mexican Americans in San Diego, California, and in San Antonio and Brownsville, Texas.

Collaborators/Co-sponsors:

  • National Cancer Institute
  • Brookdale Hospital Medical Center, Brooklyn, NY
  • University of California at San Francisco
  • San Diego State University
  • The University of Miami
  • University of Texas Health Science Center at San Antonio
  • Texas Department of Health

Goals:

To initiate the first comprehensive assessment of cancer risk factors among the major populations of Hispanics: Mexican Americans, Puerto Ricans, Cuban Americans, and Central and South Americans, and develop and implement state-of-the-art cancer prevention and control strategies tailored to these diverse groups.

Results:

  • Networker Activities: In 4 years of full intervention at the 6 sites, program activities included recruiting 955 community networkers and 399 role models. Volunteers distributed 768,000 monthly newsletters a year.
  • Community Partnerships: Community partnerships for the purposes of disseminating materials and making presentations were developed with more than 750 community organizations, businesses, clinics, schools and churches.
  • Mass Media: Also during this period, 900 stories appeared in about 40 different media outlets (TV, radio and newspaper) at the sites. Combined media efforts reached more than 3.2 million men and women, nearly one-third of the U.S. Hispanic population at risk for cancer.
  • Expanding Knowledge: To help fill the gaps in available Hispanic/Latino health information, the NHLIC: En Acción initiated the first comprehensive assessment of cancer risk factors in diverse populations and obtained preliminary research results.

Potential Impact:

NHLIC: En Acción is unique in its multi-risk-factor approach to cancer prevention and control among diverse Hispanic populations. This was the first time such a study has been undertaken, and it is considered the most extensive campaign ever waged to combat cancer in Hispanics. This historic research effort is one of the first studies to utilize the same survey instrument to collect baseline, panel and follow-up data on all of the major U.S. Hispanic population groups. The study will help determine if the intervention model can be successfully applied to diverse Hispanic populations and settings around the country to improve screening rates and other cancer risk-reduction behaviors.

Future plans:

Determine if the intervention model can be successfully applied to diverse Hispanic populations and settings around the country to improve screening rates and other cancer risk-reduction behaviors.

Publications:

  • Ramirez AG, Villarreal R, Suarez L, Flores E. The Emerging Hispanic Population: A Foundation for Cancer Prevention and Control. Monograph, Journal of National Cancer Institute, 18: 1-9, 1995.
  • Ramirez AG, McAlister AL, Gallion KJ, Ramirez V, Garza IR, Stamm K, de la Torre J, Chalela P. Community level cancer control in a Texas barrio: Part I, Theoretical basis, implementation and process evaluation. Monograph, Journal of National Cancer Institute, 18: 117-122, 1995.
  • McAlister AL, Fernandez-Esquire ME, Ramirez AG, Gallion KJ, Trevino F, Villarreal R, Community level cancer control in a Texas barrio: Part II, Baseline and preliminary outcome findings. Monograph, Journal of National Cancer Institute, 18: 123-126, 1995.
  • Ramirez AG, McAlister A, Villarreal R, Suarez L, Talavera GA, Pérez-Stable EJ, Marti J, Trapido EJ. Prevention and Control in Diverse Hispanic Populations: A National Initiative for Research and Action. Submitted and accepted, Cancer, 1998.
  • Ramirez AG, Villarreal R, McAlister A, Gallion K, Suarez L, Gomez P. Advancing the Role of Participatory Communication in the Diffusion of Cancer Screening among Hispanics. Submitted and accepted, Journal of Health Communications, 1998.
  • Iammarino NK, Laufman L, Ramirez AG, Phillips JL. Mentoring in the Sciences and the Health Professions. Submitted and accepted, Cancer, 1998.
  • Fulgoni VL, Ramirez AG. Cancer: The Role of Diet, Nutrition and Fitness. Submitted and accepted, Cancer, 1998.
  • Web site: http://www.nhlic-enaccion.org