The mission of the Partnership Community Outreach, Research and Education Core (PCORE) is promoting access to cancer services and to encourage and support health behaviors which enhance the quality of life for diverse underserved communities. PCORE accomplishes this by establishing, strengthening, supporting and sustaining relationships with key segments of the community. This work has direct impact with programs and research in our local area and beyond.
Over the past 10 years, the PCORE Core has implemented trailblazing community-engaged outreach and research, and addressed socioeconomic determinants of health and gaps in cancer outcomes and quality of care for large medically underserved communities, including the CCNY community, the Harlem community in which CCNY is embedded, and the broader NYC community. Through partnerships and model program dissemination, PCORE has also extended its outreach and research activities across the U.S. PCORE is a vital member of several National Cancer Institute (NCI) and American Cancer Society (ACS) Committees addressing the inclusion of diverse populations in research, including the NCI’s National Outreach Network and Screen to Save (S2S) Initiative, the ACS National HPV Roundtable, and the Geographic Management of Cancer Health Disparities Program (GMaP). PCORE specifically addresses the NCI Cancer Moonshot Blue Ribbon Panel recommendation to reduce cancer risk and cancer health disparities through the expansion of proven cancer prevention and early detection strategies.
To build upon and strengthen PCORE’s community-academic partnership assets to further develop, implement, and disseminate robust community-engaged cancer disparities reduction outreach, community and provider education, service, policy, and research activities to address socioeconomic determinants (centering on health care access) of cancer outcomes and decrease disparities in five priority areas, determined by community-engaged needs assessments and guided by the NCI Blue Ribbon Panel:
- Colorectal cancer screening, and treatment access and completion
- HPV prevention, and screening for HPV-associated cancers
- Prostate cancer screening, treatment access and completion
- Cancer risk factors including tobacco, obesity, diet, physical activity, and occupation
- Precision medicine/precision prevention
To build the capacity of researchers and community members to engage the community in the conduct of translational research to reduce cancer disparities, working in concert with the Linguistic and Cultural Responsiveness Shared Resource Core:
PCORE provides assistance to investigators from CCNY and MSKCC who are interested in developing and/or are currently engaged in community-based projects.
Types of assistance offered include:
- Identifying and establishing relationships with community partners
- Defining the collaboration with community partners by creating goals, expectations, and outcomes for both groups
- Consultation in community-based participatory research methodology
To request assistance: please contact Jeralyn Cortez-Weir, Community Outreach Coordinator, at firstname.lastname@example.org or 646-888-0082.
PCORE provides resources to the community by helping community-based organizations and individuals to address unmet cancer-related health needs. Resources provided speak to cancer-related health information, guidance, and technical assistance:
- Audience-tailored presentations on cancer screening, healthy lifestyle options, and smoking cessation
- Identifying best-practices in cancer-related programming
- Conducting community needs assessments to establish or evaluate cancer-related programmatic services
- Partnering or assisting with disparities research including community needs assessments in order to increase service capacity
- Hosting capacity building workshops including grant development and program management
- Providing public service awareness campaigns
- Creating linkages to print and web-based resources resource of local cancer-related programs and service available in multiple languages
To request a consultation for any of the services mentioned or for more information: please contact Jeralyn Cortez-Weir, Community Outreach Coordinator, at email@example.com or 646-888-0082.
Devika Jutagir, Ph.D., Adriana Espinosa, Ph.D. and Bert Peterson Jr., MD are the leaders of this Working Group. Their associated project, Redressing Access to and Disparities in Immunotherapy (READI), is the first study to examine breast cancer immunotherapy disparities. This study is examining breast cancer immunotherapy implementation at cancer treatment facilities that have varied access to resources, and that vary in the patient populations they treat. The researchers will conduct and analyze audio recorded semi-structured interviews with key stakeholders within New York City metropolitan area cancer clinics to develop a taxonomy of metastatic triple-negative breast cancer immunotherapy use barriers/facilitators. Results will be used to guide interventions to facilitate the equitable provision of breast cancer immunotherapy for Black and Hispanic women.
The goals for this group include:
- Contributing to the conceptualization, design, and implementation of future studies to characterize and reduce breast cancer immunotherapy disparities, including through the leveraging of electronic medical records, interviewing patients with metastatic breast cancer, and conducting a systematic review
- Developing educational materials about breast cancer immunotherapy for use with patients with low health literacy and limited English proficiency
Biodesign through Clinical Immersion (BCI) Program
Hedvik Hricak, M.D., Ph.D. and Jeff Garanich, Ph.D are the leaders of this working group.
This group aims to promote visibility of engineering and its roles in addressing cancer health disparities, enhance collaboration and integration of engineering in research and education programs of this partnership and increase the overall impact of multi-disciplinary group to understand and address cancer health disparities.
The goal of this program is to attract and retain students in cancer research and it is designed to provide both clinically centered experiences (clinical immersion) and training in bio-design. Students recruited to this program will be trained and exposed to a combination of integrated science, technology and business expertise to promote scientific discoveries into health care utilization for improvement of cancer health care.
Nicole Roberts-Eversley, MPH, Francesca Gany, M.D, M.S. and Erica Lubetkin, M.D., MPH are the leaders of this working group.
This Working Group is newly developed and seeks to elucidate racial and ethnic-related health inequities and develop a reservoir of training resources, interventions, and tools that reduce the detrimental effects of racial discrimination.
This group focuses on identifying and developing proposals that:
- Investigate the underlying causes and conditions of racial health disparities and discrimination
- Inform or pilot interventions addressing causal factors (social, economic, environmental and structural) that contribute to racial health disparities and discrimination
- Implement interventions addressing the health inequities resulting from racial and ethnic discrimination
- Provide mentorship to Junior investigators that work in this area
- Nicole Roberts-Eversley, Drs. Francesca Gany and Erica Lubetkin’s exploratory project: “The SOLACE project, Supportive interventions to Overcome grief and Loss through Advocacy and Community Engagement: Mental Health Conversations with Brooklyn and Harlem Church Leaders.”
- This study seeks to conduct in-depth interviews with church leaders in Brooklyn and Harlem, New York to understand the community mental health needs of Black Americans during these heightened times of grief and trauma.
- The information gathered will inform a culturally sensitive Community-based Service Delivery Model for mental health resources and to increase the community’s capacity to support mental health concerns, that may ultimately lead to de-stigmatization and uptake in utilization of professional mental health services.
- Drs. Deidre Anglin, Tashuna Albritton, and Rosario Costas-Muñiz’s pre-pilot proposal: “Collective trauma of the Coronavirus Pandemic: Implications for Health Risk Behaviors and Mental Health among Youth and Families in the Bronx, NY.”
- This proposal was submitted for U54’s August 2020 call for funding, and scored quite well. It was awarded funding in the fall of 2020 from MSK institutional funds dedicated to the Partnership.
PCORE Ongoing Initiatives
PCORE’s work to promote HPV vaccination at CCNY is informed by a Fall 2016 CCNY student health needs assessment that PCORE conducted in partnership with CCNY Student Health Services (SHS), using the American College Health Association (ACHA)’s validated student health survey. The survey was administered digitally to approximately 10,000 current CCNY undergraduate/graduate students. We created a fact sheet for the CCNY SHS that highlighted these risk factors, and shared evidence-based interventions (based on a literature review) to address them. We are working with the CCNY SHS to develop and implement new interventions that target the behavioral risk factors commonly reported in the survey, including the promotion of PA (e.g. campus-wide promotion of Walk with a Future Doc (see further below); circulating educational information on PA and the availability of exercise facilities on campus via social media, online through SHS, and in print via SHS; SHS counseling on PA, and increasing access to fresh fruits/vegetables on campus. In addition, the data from the survey were used in a funded NYS Office of Alcohol and Substance Abuse Services proposal ($125,000/year for 5 years beginning July 2017) to further enable CCNY to target tobacco, alcohol and other substance use. PCORE is currently adapting the evidence-based interventions document for use as a ‘toolkit’/template by other campuses (by populating the cancer risk data with their own ACHA survey results). We have started the process of re-administering the ACHA survey at CCNY using multiple approaches to increase the participation rate.
The goal of SIUBID is to reduce the prevalence of obesity among children in Harlem by teaching them about the benefits of PA and a healthy diet. Students from the CUNY School of Medicine/Sophie Davis Biomedical Education Program, together with CCNY students in other disciplines, teach a school-based healthy lifestyle program. SIUBID was implemented at PS 153, an elementary school in the heart of West Harlem. Program activities were geared towards addressing obesity, PA and an unhealthy diet. The focus was on identifying and understanding the importance of foods in each of five food groups highlighted in MyPlate.gov. Students were taught how to make healthy dietary choices and a variety of ways in which to be physically active. The students completed six monthly (~50 minute) workshops, from November 2015 to April 2016. Approximately 150 1st and 2nd grade students took part in the first SIUBID cohort. To promote program sustainability, an ongoing process was instituted to train the CCNY student educators to become future project directors. The new project directors and the PS153 staff have been able to incorporate the SIUBID program into the school’s curriculum, obviating the need for ongoing PCORE funding.
Our longstanding CRC screening program has educated 656 individuals over the past 5 years, and has evolved to additionally target the Spanish-speaking population and the large NYC taxi driving population. SCOPED provides community-engaged CRC screening outreach, education, referrals and access to health care, and navigation, and includes program outcomes evaluation (See Planning and Evaluation Core). We have expanded SCOPED to include several additional CBOs and community-embedded initiatives in our CRC screening capacity-building, outreach, and navigation services. We have partnered with the VDS program, Union Fouta (serving Fulani-speakers), the Mexican Coalition, and Make the Road New York (MTRNY), to build their organizational capacity. The communities served by these organizations have among the lowest CRC screening rates in NYC. We train their outreach staff, promotoras, and community health workers (CHWs) through CBO capacity building training workshops that include the following topics: 1. CRC Screening: The Basics; 2. CRC Screening Education Strategies and Materials; 3. CRC Screening Referrals; 4. CRC Screening Results: Follow-up and Navigation. We also continue to co-lead the Disparities Committee for the NYC Department of Health and Mental Hygiene’s Citywide Colon Cancer Control Coalition (C5), where our data inform policy.
- SCOPED-Spanish was developed in 2016 in partnership with the NY VDS program, which works with over twenty Mexican-serving organizations to increase access to health care and promote healthy lifestyle choices for Mexican Americans in the NY metropolitan area, and has sister programs at 50 national sites.
- SCOPED-Taxi is our newest tailored CRC education program. It targets the at-risk NYC taxi driver community. SCOPED program materials that had been previously developed were modified through cognitive interviews and focus groups to make them linguistically and culturally responsive to the taxi driver community.
We have partnered with the Fred Hutchinson Cancer Research Center/New Mexico State University U54 Partnership to add an additional education/research component to SCOPED: the inflatable colon (with its polyps and cancers) tour, which their U54 pioneered. We piloted the colon with 17 West African American participants eligible for CRC screening at the Union Fouta CBO in the Bronx. Participants completed a pre-test, received a tour of the colon, and then completed a post-test. There was an overall increase in knowledge in several areas. Since the pilot, the colon has additionally been utilized at several other community health events: CUNY School of Medicine at CCNY Health Fair and Health Professions Mentorship Program; Communities of Harlem Health Revival Walk /Health Fair; Immaculate Conception Church 2017 Family Health Fair; Consulate General of Mexico La Semana Binational de Salud 2017; Hispanic Federation: Vive tu Vida! Get up Get Moving!; Church of the Revelation & Parkchester; Jame Masjid 7th Annual Health & Wellness Event; WHEC/NYPD National Night Out.
PCORE participates in Screen to Save (S2S), an NCI Colorectal Cancer Outreach and Screening Initiative, which complements SCOPED activities. The initiative’s goal is to increase CRC screening rates among those ages 50–75 from racially and ethnically diverse communities and in rural areas. We implemented S2S CRC outreach and education activities through our existing outreach infrastructure, using the standardized, national S2S materials (English and Spanish surveys, Powerpoint presentation, flip charts), and the inflatable colon with bilingual signage. S2S includes a pre- and post-intervention knowledge assessment, along with a 3-month follow-up survey to assess screening uptake (currently ongoing). In 2017, a total of 56 participants were recruited into the initiative at community health fairs and events held in conjunction with CBO partners. At the 3-month follow-up time point, 25 participants had already received CRC screening (colonoscopy or annual FIT).
Funded by an Administrative Supplement to the CCNY-MSKCC U54 Partnership, COMIDA is a diet and lifestyle counseling and healthy behavior text messaging initiative that addresses obesity among Mexican immigrants visiting the VDS. The COMIDA curriculum is based on the USDA MyPlate program (which is available in Spanish), tailored to the Mexican population’s commonly eaten foods. Individuals participate in an initial, one-time 45-minutes counseling session on diet and PA, receive written materials, and then receive thrice weekly healthy behavior text message tips for 3 months. Satisfaction with the program was high: 74% rated the overall program as good/excellent, 73% felt the counseling enhanced their ability to select affordable healthy food options, and 82% rated the weekly text message tips as very helpful.
Tobacco use remains extremely high in many immigrant and low-income NYC communities. Yet, there is very low adherence with the USPSTF lung cancer screening guidelines. To address this, PCORE assessed the knowledge and beliefs related to lung cancer screening and the recent USPSTF guidelines among PCPs. A 10-15 minutes survey was administered to PCPs in NYC neighborhoods with high numbers of at-risk smokers or former smokers (Central/East Harlem, the South Bronx, Flushing/Chinatown, Manhattan Chinatown and Sunset Park, Brooklyn). Findings will help shape planned PCP and patient education interventions related to USPSTF guidelines, eligibility requirements, insurance coverage, and availability of low cost facilities for uninsured patients. Patients will also be educated on how to discuss screening with their doctor, and about smoking cessation.
PCORE’s work to address the high cervical cancer risk in the Hispanic community leverages our longstanding partnership with the VDS program; was informed by a qualitative and quantitative community needs assessment; provides cervical cancer screening and HPV vaccination outreach, education, referrals, and access to care; navigates community members into primary care; and includes program outcomes evaluation. Findings led PCORE to develop a Pap/HPV screening assessment, referral, and navigation program at our weekly VDS health education and screening programs. In addition, Drs. Abraham Aragones (MSKCC) and Gerardo Blumenkrantz (CCNY) implemented a U54 full research project to develop and assess the effectiveness of a social marketing campaign in raising HPV and HPV vaccination awareness and uptake. PCORE is currently utilizing these social marketing and educational materials to provide HPV vaccination outreach, education, referrals, and navigation at the VDS. In addition, the Aragones/Blumenkrantz project is utilizing an Randomized Control Trial to evaluate the impact of the social marketing campaign with and without the addition of a text messaging intervention. From the groundwork laid by the U54 project, Dr. Aragones received an R01 (R01 CA204379 01A1) for EdTech HPV: A Community Approach using Education and Technology to Increase HPV Vaccination. This is a national study to assess the effectiveness of a Mexican American community-based HPV vaccination completion education program in NY, Chicago, Las Vegas, and Texas.
This program offers a series of free community health education sessions, to increase capacity among community members to actively take part in their health and healthcare To inform the educational session development, we distributed a needs and interest survey in both English and Spanish to local businesses and CBOs, health centers, police precincts, the Harlem YMCA and on the CCNY campus. There was interest in learning about key cancer risk factors, including diet, PA, diabetes, tobacco cessation and stress. In Fall 2017, 3 monthly sessions were held on diet, PA, diabetes, and mental health, on available related research studies and how to address participation barriers. At least 60 individuals participated in each session. All participants who completed an exit evaluation described being satisfied or very satisfied and were very likely to return for another session and to recommend MMS to their friends and family. Read More....
The World Health Organization defines food security (FI) as having access to sufficient, safe, nutritious food to maintain a healthy and active life. We are collaborating with the Green Bronx Machine (GBM), a CBO whose school-based model uses urban agriculture to support healthy students and schools in marginalized communities. We are working with GBM to provide a supplement of fresh produce for FI cancer patients utilizing cancer clinic-based food pantries. CCNY student interns are assisting with a Bronx school summer camp focused on community gardening and harvesting, and in the daily operation and evaluation activities of the clinic food pantry. Staff and interns track use of the pantry, including frequency of visits, and use of the fresh produce; participants are also surveyed to assess their preferences for food items, feedback, impact of the pantry on diet, health, treatment adherence, quality of life, and satisfaction. To date, GBM has provided fresh produce to 59 low income cancer patients at our safety net community partners.
In 2014, students and faculty of the CUNY School of Medicine initiated WWFD (https://www.ccny.cuny.edu/calendar/walk-future-doc), a leadership/professional development program designed to encourage community PA while training medical school students to gain knowledge of and confidence in talking about PA with future patients. The first of its kind in US medical schools, this program is affiliated with the National initiative known as Walk with a Doc (http://walkwithadoc.org/). WWFD has capitalized on existing partnerships with PCORE organizations such as the LCCC, and developed relationships with new community organizations including the Harlem YMCA, local NYC police department precincts, the Community of Harlem Health Revival, and our own CCNY community, including staff from Public Safety, Social Media and Communications and summer high school pipeline programs. In 2016-17, over 1400 people walked with WWFD. We are in the process of analyzing data from a student led (PURT Fellow) evaluation that queried walkers and medical students to examine changes in motivation for and participation in PA, and medical students’ knowledge and confidence in talking to community members about the benefits of PA on cancer prevention and treatment. We have also extended our reach beyond NYC: our WWFD program has inspired 8 additional nationwide WWFD chapters.
There are over 300,000 taxi drivers in the U.S. and more than 160,000 in NYC. The Taxi Network, co-led with SACSS, engages in community based participatory research (CBPR), service delivery, community capacity building, and policy support to reduce health disparities among NYC taxi drivers. The Taxi Network has worked closely with its taxi driver Community Advisory Board, key community partners, and an external advisory committee to assess drivers’ health priorities and identify barriers to healthcare (750 health and needs assessment surveys, 40 in-depth interviews, and 7 focus groups have been administered), and to use these data to tailor cancer risk reduction and screening services for drivers. The Taxi Network uses a health fair model to provide an important gateway to the healthcare system. Health fairs provide hundreds of drivers with counseling about how to prevent and manage cancer and chronic diseases, and offer free referrals and navigation into affordable healthcare services. We have a robust follow-up protocol for all participants in need of further counseling. Our PCORE-linked studies include: 1) A 4-arm RCT, Taxi STEP (Social networks, Technology, and Exercise through Pedometers) (U01-MD010648), which is assessing pedometer use effectiveness in combination with mobile technology and social network support to increase PA in taxi drivers; 2) A U54-funded community-engaged T1-T4 translational research study entitled, “TaxI Particulate matter (PM) Study (TIPS)” (U54-CA137788), assessing whether excess in-vehicle PM exposure is associated with changes in intermediate physiologic and biochemical markers associated with increased risk of lung cancer and/or CVD; 3) An NCI-funded R03 entitled, “Informing the Adaptation of a CHW Model to Facilitate Lung Cancer Screening for Chinese Taxi Drivers” (1R03CA202515-01), addressing the high lung cancer risk in Chinese livery drivers secondary to occupational air pollution exposure and high smoking rates (70% in our preliminary work).
Erica Lubetkin, MD, MPH
Erica Lubetkin an associate medical professor in the Department of Community Health and Social Medicine at the CUNY School of Medicine. Her background is in neuroscience (B.S.), internal medicine (M.D.) and public health (M.P.H./health policy and management, effectiveness and outcomes). The majority of her research has examined the performance of patient-reported outcome measures, and she has a strong track-record in measuring health-related quality of life and quantifying the burden of disease due to chronic diseases and health risk behaviors. She also have worked on numerous projects assessing cancer risk beliefs, patient activation, and health literacy in inner-city primary care patients. In terms of teaching, she is the course director for Evidence-Based Medicine, a longitudinal first- and second-year medical student course.
Jennifer Leng is a member of the research faculty of the Immigrant Health and Cancer Disparities laboratory, which facilitates linguistically and culturally sensitive health care services for newcomer populations through research, education, training, program development, policy, and advocacy. Her research interests include developing and testing support and survivorship interventions for Chinese cancer patients; targeting social and economic barriers to cancer care, and studying interventions to address food insecurity among immigrant and minority cancer patients; and community-based cardiovascular disease and cancer risk screening for underserved populations.