Project Title: Redes En Acción: The National Latino Cancer Research Network

Abstract:

Redes En Acción: The National Latino Cancer Research Network, is a major Community Networks Program (CNP) initiative funded by the NCI in 2005. It is a continuation of the Redes En Acción program originally funded in 2000 under the NCI's Special Populations Networks (SPN) initiative. The new NCI CNP initiative is aimed at reducing cancer deaths among minority and underserved populations through community-based cancer prevention and control activities in geographically and culturally diverse areas of the country. Redes En Acción is one of about 25 projects funded by the initiative targeting cancer disparities in Hispanics/Latinos, African Americans, American Indians and Alaska Natives, Asians, Hawaiian Natives and other Pacific Islanders, and the rural poor. Of the CNP programs funded, Redes En Acción is one of only six with a nationwide focus. Other funded programs have either a local or regional scope of activities.

Under the five year CNP initiative, Redes En Acción continues the work of bringing together the most extensive collection of organizations ever assembled nationwide to collaborate in the fight against cancer among this country's Hispanic/Latino populations.redes imgSince 2000, under the SPN initiative, the program has developed a broad-based coalition of cancer research centers, community-based organizations and federal partners to foster a national infrastructure for Hispanic/Latino cancer prevention and control activities. Redes En Acción has created a national and regional infrastructure for collaboration among grassroots leaders, local communities, researchers and public health professionals to stimulate cancer control research, training and awareness. Through network activities, the program established training and research opportunities for Latino students and researchers, generating research projects on key cancer issues impacting Latinos and supporting cancer awareness activities. (For more information about Redes En Acción, click on the logo to visit our Web site.)

As a result of these efforts, the program has addressed Latino cancer disparities on several fronts. For example, from 2000 to 2006, 18 pilot cancer research projects were funded by NCI through Redes En Acción with grants totaling >$900,000. In all, Redes-related cancer research projects at both the national and regional levels surpassed $70 million in leveraged funding from public and private sources. In the program's training component, 166 young Latinos throughout the U.S. were provided opportunities to train with cancer researchers and receive invaluable mentorship. In addition, regional network staffs raised cancer awareness in the public through hundreds of community events conducted across the country.

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Redes En Acción is utilizing the nationwide organizational framework originally formed in 1992-99 under the National Hispanic Leadership Initiative on Cancer (NHLIC): En Acción program and continued with the Redes En Acción SPN program during 2000-05. The national coordinating center is in San Antonio, and regional coordinating centers are in New York, Miami, San Francisco, San Diego and Houston. The Regional Network Centers are linked together through common goals, objectives and synergies. Their cancer research, training and awareness activities are overseen and coordinated by the National Network Center under the direction of Principal Investigator, Amelie G. Ramirez, DrPH, to reduce the disparate impact of cancer on this nation's 42 million Latinos.

PI:

  • Amelie G. Ramirez, DrPH, Professor of Epidemiology and Biostatistics, Director of the Institute for Health Promotion Research at the University of Texas Health Science Center at San Antonio: San Antonio, TX

Co-PI's:

  • J. Emilio Carrillo, MD, MPH, Associate Professor, Weill Medical College of Cornell University, President and Chief Medical Officer of the New York-Presbyterian Community Health Plan (Northeast Regional Network Center: New York City)
  • Maria E. Fernández, PhD, Assistant Professor and Director of Diversity Programs, University of Texas Health Science Center at Houston School of Public Health (Central Regional Network Center: Houston)
  • Frank J. Penedo, PhD, Assistant Professor, Sylvester Comprehensive Cancer Center, University of Miami (Southeast Regional Network Center: Miami).
  • Eliseo J. Pérez-Stable, MD, Professor of Medicine and Chief of the Division of General Internal Medicine at University of California, San Francisco (Northwest Regional Network Center: San Francisco)
  • Gregory A. Talavera, MD, MPH, Assistant Professor, Graduate School of Public Health, San Diego State University (Southwest Regional Network Center: San Diego)

Funding Institution:

  • National Cancer Institute
    • Center to Reduce Cancer Health Disparities,
      Community Networks Program (CNP)

Funding Period:

5yrs.– 2005-2010

Location/Service Area:

  • National Network Center: San Antonio, TX
  • Regional Sites: San Francisco, CA; San Diego, CA; Houston, TX; Miami, FL; New York, NY; Washington, D.C. (NHMA partnership)

Collaborators/Co-sponsors:

  • NCI's Center for Strategic Dissemination
  • Cancer Information Service (CIS)
  • Office of Cancer Survivorship
  • Epidemiology and Genetics Research Program, Division of Cancer Control and Population Sciences
  • Center for Cancer Research
  • Behavioral Research Program, Division of Cancer Control and Population Sciences
  • Continuing Umbrella of Research Experience (CURE)
  • Minority Institution Cancer Control Program (MICCP)
  • National Coalition for Health Professional Education in Genetics (NCHPEG)
  • National Hispanic Medical Association
  • Hispanic Centers of Excellence
  • Hispanic Serving Health Professions Schools (HSHPS)
  • Latinos in a Network to Control Cancer (LINCC)
  • Susan G. Komen Breast Cancer Foundation
  • Lance Armstrong Foundation
  • Latino Council on Alcohol and Tobacco (LCAT)
  • Tobacco-Free Kids
  • National Council of La Raza
  • National Association of Community Health Centers
  • Hispanic Radio Network
  • National Center for Farmworker Health, Inc.
  • Dia de la Mujer
  • Toburcio Vasquez Health Center, Union City, CA
  • San Ysidro Health Centre, San Diego, CA
  • Su Clinica Familiar, Harlingen, TX
  • Brooklyn Hospital Center, Brooklyn, NY
  • Abriendo Caminos, Casselberry, FL
  • American Cancer Society
  • Centers for Disease Control and Prevention (CDC)
  • Health Resources and Services Administration (HRSA)
  • Centers for Medicare & Medicaid Services (CMS)
  • National Institute of General Medicine Sciences
  • National Human Genome Research Institute
  • NCI Specialized Programs of Research Excellence
  • NCI Cancer Genetics Network
  • NCI Special Populations Networks
  • Women’s Health Initiative
  • M. D. Anderson Cancer Center
  • San Antonio Cancer Institute
  • Cancer Therapy and Research Center

Goals:

  • Expand existing Redes En Acción organizational infrastructure into a sustainable network that will reduce cancer health disparities through cancer education, research, and training within and among the diverse Latino communities in the U.S. and Puerto Rico, with research on policy and organizational change and on the effects of innovative interventions to reduce disparities.
  • Enhance existing public and professional education through various strategies and venues, including national and local media, program communication channels and professional presentations, and collaboration with local providers to increase awareness of disparities in cancer prevention and control and of the need for policy and organizational changes that will 1) improve access to cancer screening and treatment services and 2) increase utilization of beneficial interventions to reduce disparities (including enrollment in clinical trials).
  • Conduct 3 primary research activities:
    • Pilot projects involving reducing health disparities in underserved and minority communities
    • Policy research relating to cancer disparity reduction and access to screening and care for Latino populations
    • Community-based participatory research aimed at increasing utilization of beneficial interventions to reduce disparities (e.g., screening and follow-up services for cervical and breast cancers)
  • Promote cancer training opportunities for Latino researchers and students.
  • Develop, with community-based partners, competing independent grant applications stemming from the pilot projects and other resources to reduce cancer health disparities, and provide technical assistance for community-based organizations and Latino researchers to submit successful proposals for federal or other funding.

Results:

  • Having satisfied all of the requirements outlined in the Community Networks Program RFA, Redes En Acción applied for transition from Phase I to Phase II with its CNP application.
  • Develop national and regional infrastructure.
    • - The National Network Center and 5 regional network centers were established during the Redes Special Populations Network initiative (2000-05).
    • - A database of over 2,000 partners has been established and is continually growing.
  • Establish research opportunities for early career Hispanic scientists.
    • - 4 proposals reviewed through Redes process, 4 pilot applications submitted to NCI, and 2 proposals funded by the NCI for the first CNP pilot cycle.
    • - Policy studies relating to cancer disparity reduction and access to screening and care for Latino populations to be organized.
    • - A two-part study to assess the need for a patient navigation intervention to improve access to timely and quality follow-up of abnormal cancer test results to be conducted.
      • The first phase chart review for "Follow-up of Abnormal Cancer Screening Tests: A Needs Assessment" should be completed by June 2007.
    • - 4 new or ongoing research projects directly generated as a result of Redes have been funded that explore genetics, breast cancer, Latino health disparities, and clinical trial recruitment, totaling almost $1 million in funding.
    • - Over $38 million leveraged funding research dollars were generated by the Redes network through 38 regional and national new and/or ongoing projects that Redes researchers are leading or participating in through subcontracts and shared resources.
  • Establish training opportunities for early career Hispanic scientists.
    • - 35 individuals have received training through the network for the CNP initiative.
    • - Junior Faculty: We have had 12 funded and 3 unfunded positions.
    • - Internships: We have 13 funded and 4 unfunded internships.
    • - Pre/Post Doctoral: 3 pre- and post-doctoral positions were paired with ongoing research and awareness or outreach activities.
    • - Increase the number of Latinos in cancer research and in biomedical fields through special training projects and collaborations with NIH agencies and other organizations.
  • Enhance existing public and professional education through various strategies and venues, including national and local media, program communication channels and professional presentations, and collaborations with local providers.
    • - Quarterly e-newsletters disseminated to Redes national network.
    • - Monthly E-Alerts offer timely information on a range of topics (e.g., new RFAs, reports, publications, training opportunities, etc.).
    • - The redesenaccion.org Web site is operational and includes new enhancements such as a Latino Cancer Experts Directory and interactive "Join the Network" Web form.
    • - Six Public Service Announcements on improving access to cancer screening and treatment services among Latinos are being developed to distribute nationally in 2007 to over 700 English and Spanish TV, radio and print channels.
    • - Approximately 550 cancer education events have been conducted (e.g., health fairs, cancer screening Webinars, tobacco prevention TV and radio interviews, policy briefings, etc.).
    • - Over 400 professional education presentations have been given nationally at conferences, seminars and workshops.
  • Develop independent grant applications.
    • - 15 Redes SPN pilot investigators have already been awarded subsequent competing grants following completion of their pilot studies, including R01, R25, R03, CMS, DOD, etc., totaling $19.5 million, and we expect similar results from CNP pilot investigators.
    • - Submit one research project (such as R01, R03, or K awards) per regional center (5) to a funding source other than the Center to Reduce Cancer Health Disparities.

Potential Impact:

This study will potentially lead to the development of a sustainable national Latino network that will reduce cancer health disparities through cancer education, research, and training within and among the diverse Latino communities in the U.S. and Puerto Rico, with research on policy and organizational change and on the effects of innovative interventions to reduce disparities.

Publications:

Published Manuscripts:

  • Ramirez AG, Gallion K, Miller A, San Miguel de Majors SL. Testing Three Different Cancer Genetics Registry Recruitment Methods with Hispanic Cancer Patients and Their Family Members. Community Genetics (2007); in press.
  • Ramirez AG, Gallion K, Pérez-Stable EJ, Talavera G, Marti J, Penedo F, Trapido E, Giachello A, Medrano M. Redes En Acción: Increasing Hispanic Participation in Cancer Research. Journal of the National Cancer Institute; submitted.
  • Ramirez AG, Gomez J. Genetics and Latinos: Proceedings of a National Summit. Cancer Res, 2005; 68(8): 2996, April 2005.
  • Ramirez AG, Gallion K, Suarez L, Giachello AL, Marti J, Medrano MA, Pérez-Stable EJ, Talavera GA, Trapido EJ. A national Agenda for Latino Cancer Prevention and Control. Cancer 2005; 103(11): 2209-15, Jun 1, 2005.

Manuscripts Under Development:

  • Ramirez AG, Wildes K, Nápoles-Springer A, Pérez-Stable EJ, Talavera G, Rios E. Physician Gender Differences in General and Cancer-Specific Prevention Attitudes and Practices.
  • Hughes C, Peterson SK, Ramirez AG, Gallion K, McDonald P, Skinner S, Bowen D. Minority Recruitment in Hereditary Breast Cancer Research; in review.
  • Scarinci IC, Garces IC. Cervical Cancer Primary Prevention Among Latino Immigrants: Knowledge and Beliefs Regarding Sexual Risk Reduction; in preparation. [Pilot: Cervical Cancer Primary Prevention in Latina Immigrants.]
  • Perez MA, Thornton AA, Otis-Green S. Denial-type Coping Mediates the Relationship Between Culture-Related Variables and Health-Related Quality of Life in Latinos with Cancer; in preparation. [Pilot: Coping and Quality of Life in Latino Cancer Patients.]
  • Ramirez AG, Chalela P, Velez LF, Gallion K. Energy Balance Feasibility Study for Latinas in Texas: A Qualitative Assessment.
  • Ma F, Collado-Mesa F, Hu S, Kirsner RS. Skin Cancer Awareness in White Hispanic and White Non-Hispanic High School Students in Miami, Florida, U.S.; in preparation. [Pilot: Perception of Risk of Skin Cancer in Hispanic Students.]
  • Wildes K, Gallion K, Ramirez AG. Physician Gender Differences in General and Cancer-Specific Prevention Attitudes and Practices.
  • Ramirez AG, Wildes K. Comparison of Minority and Non-Minority Physicians and Clinical Trial Recruitment.
  • Mamani D, San Miguel de Majors SL, Ramirez AG. Barriers to Breast Cancer Care Among Hispanic Women in South Texas.
  • Web site: http://www.redesenaccion.org