The JWI incorporates research into its mission and activities several ways.
- Funded studies conducted by the JWI Director and Co-Director
- Research services for University of Miami investigators engaged in, or planning, community-based or disparities-focused studies – provided by the Cancer Center Shared Resource, the Disparities and Community Outreach (DCO) Core
- Educating UM medical, public health and other students about community research
Funded Research Projects
Patnè en Aksyon
Partners in Action (Patnè en Aksyon in Haitian Creole), was the first funded campus-community partnership established between the Sylvester Comprehensive Cancer Center and South Florida’s Haitian community. It introduced Community-Based Participatory Research (CBPR) methods to studies to address cancer disparities in Miami’s Haitian community. The first initiatives, starting in 2004, focused on breast cancer, and expanded to in include cervical cancer and colorectal cancer screening.
South Florida Center for Reducing Cancer Disparities (SUCCESS)
The South Florida Center for Reducing Cancer Disparities (SUCCESS) was established in 2010 with funding from a National Cancer Institute (NCI) Cooperative Agreement (Grant No. 1U54CA153705). It is part of the NCI Center to Reduce Cancer Disparities’ Community Network Program.
Reducing Cervical Cancer Disparities
The first SUCCESS study (2010-2015) involved community partners in medically-underserved Haitian and Hispanic communities in Miami Dade County to reduce the high rates of cervical cancer. The study utilized principals of CBPR and involves Community Health Workers (CHWs) to address the unique needs of each community. A Community Advisory Group was involved in the project since its planning, and guided the development of study materials, recruitment strategies, and study implementation. We recruited 200 women over three years in each of the three study sites. Women in the control group received NCI-approved culturally and linguistically appropriate outreach and educational materials on cervical cancer screening. The other groups received either home-based education by a CHW and referrals to a Federally Qualified Health Center for a Pap test, or a home-based self-sampling device to screen for the Human Papilloma Virus (HPV), the major cause of cervical cancer. We evaluated the cost of the interventions, and the acceptability of self-sampling.
Reducing Colorectal Cancer Disparities
PBuilding on the cervical cancer study, Drs. Kobetz and Carrasquillo, along with a team of UM researchers, were awarded a Bankhead Coley Florida Team Science grant in 2012 (Grant No. 2BT02).
This project adapted strategies from the cervical cancer project to reduce disparities in colorectal cancer in Miami Dade County’s Hispanic and Haitian communities. Three inter-related studies were part of this grant. The team included Cancer Center researchers Drs. Daniel Sussman (gastroenterologist), David Lee (epidemiologist), Tulay Koru-Sengul (statistician).
- Project 1 involved analysis of data from the Florida Cancer Data System (FCDS) to identify communities with high rates of late-stage colorectal cancer. FCDS data was linked with hospital discharge data from the Florida Agency for Health Care Administration to examine treatment and outcome disparities.
- Project 2 tested the acceptability and feasibility of using Spanish and Haitian Creole-speaking CHWs to provide individual or group education about colorectal cancer and to provide free Fecal Immunochemical Test (FIT) test kits. The FIT has been shown to be an effective and sensitive tool for screening average-risk adults who may not have access to screening colonoscopies. Our project, called “FIT for Life,” include educational material developed in conjunction with community members in Spanish and Haitian Creole. A total of 485 women have been screened to date. Compliance with returning the FIT kit to the UM laboratory was very high.
- Project 3 explored the molecular mechanisms that underlie the differences in tumor behavior between Hispanics and Haitians versus non-Hispanic whites.
Addressing Cervical Cancer Disparity in South Florida: CBPR in Action
In July 2014, Dr. Kobetz and Dr. Carrasquillo received a NCI RO1 award (Grant No. 1R01CA183612-01) to compare cervical cancer screening interventions tested in their previous studies. The project is called “Health in Your Hands.” As in their previous work, Community Advisory Groups are involved in developing study materials and study methods. The study will be conducted in Hispanic and Haitian communities in Miami Dade County. Women will be randomized into a control group that receives a CHW intervention or a study group that receives a mailed a HPV selfsampler. Analysis will include comparative effectiveness by ethnic group and acculturation level, as well as knowledge, attitudes, and beliefs about cervical cancer and the importance of early detection of disease, access to care, and the relative cost of the two intervention strategies. Recruitment began in January 2015.
Geographic Management of Cancer Health Disparities Program for Region 3 (GMaP3) In September 2014, Dr. Carrasquillo and Dr. Kobetz were awarded an administrative supplement from the National Cancer Institute’s Center to Reduce Cancer Health Disparities for Strengthening Research, Training and Outreach Capacity to support the Geographic Management of Cancer Health Disparities Program for Region 3 of the US (GMaP3). Region 3 includes Florida, Puerto Rico, Georgia, Alabama, Mississippi, Louisiana, Arkansas and Missouri. GMaP3 has two components: (1) Communication and Dissemination – to disseminate information about best practices, resources and tools through a ListServ, webinars, newsletters and an online repository of health education resources related to cancer disparities research. (2) Recruitment and Job Placement – to NCI-funded cancer researcher trainees and early stage investigators to regional experts in cancer health disparities research. Trainee will be linked with mentors and there will be an online repository of information to help with professional development, grant-writing and resources for job searches.
Cervical Cancer Screening Program
Dr. Kobetz continues her research to reduce cervical cancer rates with funding from the GE Foundation. The new study will replicate the aforementioned HPV self-sampling interventions in two demographically-diverse communities: rural Palm Beach County and Liberty City, a predominately African American urban community in Miami Dade County. Using CHWs from each community, they will recruit 750 women who have not been screened for HPV and/or cervical cancer within the last the years. We are partnering with Health Choice Network of Florida, Inc., that has Federally-Qualified Health Centers in these communities.