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What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
What is Cancer Equity?
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What is Cancer Equity?

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  • 1. SmartState Center for Cancer Equity Chanita Hughes Halbert, Ph.D. Medical University of South Carolina Endowed Chair, SmartState Center for Cancer Equity Department of Psychiatry and Behavioral Sciences Hollings Cancer Center
  • 2. What is Cancer? Cancer is defined as a group of diseases that are characterized by the uncontrolled growth and spread of abnormal cells within the body.
  • 3. Cancer Facts and Figures • 1,660,290 new cancer cases will be diagnosed in 2014 • Cancer is the 2nd leading cause of death • Cost for cancer care is $201.5 billion dollars • Relative survival has increased to about 68%
  • 4. Cancer Death Rates* by Race and Ethnicity, US, 2005-2009
  • 5. Cancer Death Rates* by Sex and Race, US, 1975-2009
  • 6. Health Disparities Differences in the quality of health care that are not due to access-related factors or clinical needs, preferences and appropriateness of intervention Differences in the incidence, prevalence, mortality, and burden of cancer that exist among specific population groups in the US Disparities are often characterized by race and ethnicity.
  • 7. Social Determinants of Health and Racial Disparities
  • 8. SmartState Center for Cancer Equity • Enhance minority participation in clinical research on health promotion and disease prevention and control. • Increase access to and utilization of emerging technologies for health promotion and prevention and control. • Develop culturally tailored assessments and interventions to improve health outcomes. • Develop sustainable infrastructure for health promotion and disease prevention and control in clinic and community settings. Percent
  • 9. PPRNet August 22-24, 2013 ©PPRNet 2013 OBESITY AMONG ADULTS
  • 10. • Engage in moderate intensity physical activity at least 30 minutes on five or more days of the week (walking, stretching) • Participate in more intense physical activity for at least 20 minutes on three or more days of the week (jogging, swimming)
  • 11. Regular physical activity Decreases risk for: • CVD • Stroke • Colon cancer • Diabetes • High blood pressure • Obesity • Breast Cancer
  • 12. • No time • Too tired • Can’t afford it • Afraid friends and family will laugh • Don’t have the will power • Afraid of getting hurt • Too many family obligations • Too old Barriers to PHYSICAL ACTIVITY
  • 13. • Find times of day that you can use for PA. • Start a walking program with friends and family • Exercise in 10-minute bouts • Choose activities that fit your age, fitness level, skill level, and health status. WAYS TO OVERCOME PHYSICAL ACTIVITY BARRIERS
  • 14. • Eat at least 5 servings of fruits and vegetables each day. • Reduce sodium intake • Reduce fat intake
  • 15. • Affordability • Access • Ability • Knowledge • Resources Barriers to EATING HEALTHY
  • 16. • Make a daily meal plan • Use your meal plan to direct your grocery shopping. • Use MyPlate to inform your meal plan. • Control your portions Strategies to EATING HEALTHIER
  • 17. Community Concerns & Priorities Comparative Effectiveness Research Dissemination & Implementation Research Triumphant Living Collaborative MUSC HPC Penn NBLIC ENGAGING CLINIC AND COMMUNITY STAKEHOLDERS Community-Based Participatory Research to Address Disparities
  • 18. COMPARATIVE EFFECTIVENSS TRIAL • Session 1: Risk Factors – Disease facts and figures for African Americans • Session 2: Dietary Behaviors – Recommendations for fruit and vegetable intake – Menu planning – Food diary – Label reading • Session 3: Physical Activity – Recommendations for physical activity – Starting a walking program – Making active choices – Exercising in short bouts • Session 4: Putting it Together – Anticipated barriers and facilitators to behavior change – Problem solving training
  • 19. Triumphant Living Collaborative Randomized Trial for Cancer Control
  • 20. COMPONENTES OF INTEGRATED RISK EDUCATION Construct Strategy Perceived Risk Perceived Severity Self-efficacy Cue to Action Information about cancer and cardiovascular disease Identify overlapping risk factors for disease Values clarification from motivational interviewing & provide information about behavioral change Participants develop individualized action plan
  • 21. INTERVENTION COMPONENTS • Delivered in a group setting by a health educator • Incorporated multiple modes of presenting information (e.g., video, slide presentation, written materials) • About 2-3 hours in length • Developed intervention to be a brief, but intensive program that could be disseminated to other settings
  • 22. Variable Level n (%) Gender Male Female 227 (43%) 303 (57%) Marital status Married Not married 62 (12%) 467 (88%) Education level ≥ Some college ≤ High school 260 (49%) 270 (51%) Employment status Employed Not employed 177 (34%) 349 (66%) Income level > $20,000 < $20,000 237 (48%) 254 (52%) Health insurance Yes No 414 (78%) 115 (22%) Age Mean (SD) 48.2 (10.7 Body mass index Mean (SD) 29.9 (6.6) SAMPLE CHARACTERISTICS (n=530)
  • 23. Changes in Physical Activity (n=523) 47 5253 48 0 20 40 60 80 100 Baseline 1-Month Adherent Not Adherent Percent McNemar=8.04, p=0.005
  • 24. Changes in Physical Activity by Study Group – Disease Specific (n=261) 49 5251 48 0 20 40 60 80 100 Baseline 1-Month Adherent Not Adherent Percent McNemar=2.27, p=0.13
  • 25. Changes in Physical Activity by Study Group – Integrated (n=262) 46 5254 48 0 20 40 60 80 100 Baseline 1-Month Adherent Not Adherent Percent McNemar=6.40, p=0.01
  • 26. Adoption of Evidence-Based Strategies (n=241) 71 69 65 60 0 20 40 60 80 100 Started walking program Made active choices Talked to HCP about concerns Exercise in short bouts % Yes
  • 27. Opportunities in South Carolina • Dissemination research to evaluate the effects of integrated and disease specific risk education • Implementation of interventions into clinical and community settings across the state • Translational research to understand interactions between biological factors, psychological characteristics, and the environment • Policy development and research to address macro- level factors

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