Reducing cancer disparities through community engagement in policy development: the role of cancer councils.
Ontology highlight
ABSTRACT:
SUBMITTER: Preston MA
PROVIDER: S-EPMC5553628 | biostudies-other | 2014 Feb
REPOSITORIES: biostudies-other
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Project description:During the regulatory drafting process, California considered allowing police officers to become licensed owners of cannabis businesses, an action that would have codified a conflict of interest (COI), allowing police to exert influence in two market strata, enforcement and licensure. Up until then, no state specifically excepted law enforcement from COI prohibitions, making California's proposed medical cannabis regulation unique. We performed two 50-state surveys and examined 298 public comments submitted to the Bureau of Cannabis Control during the initial medical cannabis rulemaking process in June 2017. After public comments, the Bureau withdrew this provision. However, that the exception was even considered is cause for concern in this new area of policy development. The progression from proposed medical cannabis rules to emergency rule adoption and now, into proposed final regulations, highlights the value of civic engagement with the rulemaking process. Jurisdictions should adopt bright-line COI rules within their cannabis codes that limit the relationships that law enforcement may have with the private cannabis markets.
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Project description:Reduction of cancer-related disparities requires strategies that link medically underserved communities to preventive care. In this community-based participatory research project, a public library system brought together stakeholders to plan and undertake programs to address cancer screening and risk behavior. This study was implemented over 48 months in 20 large urban neighborhoods, selected to reach diverse communities disconnected from care. In each neighborhood, Cancer Action Councils were organized to conduct a comprehensive dynamic trial, an iterative process of program planning, implementation and evaluation. This process was phased into neighborhoods in random, stepped-wedge sequence. Population-level outcomes included self-reported screening adherence and smoking cessation, based on street intercept interviews. Event-history regressions (n = 9374) demonstrated that adherence outcomes were associated with program implementation, as were mediators such as awareness of screening programs and cancer information seeking. Findings varied by ethnicity, and were strongest among respondents born outside the U.S. or least engaged in care. This intervention impacted health behavior in diverse, underserved and vulnerable neighborhoods. It has been sustained as a routine library system program for several years after conclusion of grant support. In sum, participatory research with the public library system offers a flexible, scalable approach to reduce cancer health disparities.
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Project description:BackgroundCommunity engagement is key to developing local and context-specific strategies for the prevention and control of COVID-19. However, expedited research design and approval in the early days of the pandemic may have limited the opportunities for community members to influence pandemic-related research. In this study, we sought to understand how a Community Engagement Group (CEG) could impact a large longitudinal COVID-19 research project (Optimise), when involved solely in the interpretation and knowledge translation phases of the research.MethodsSeven community members were recruited for the CEG, representing a diverse range of groups. Each month, Optimise data of topical importance were compiled into a draft report. The CEG discussed the draft report at their monthly meeting and members' contributions were incorporated into the final report for distribution to policy-makers. In this study, a document analysis was undertaken of ten consecutive reports produced between February and November 2021. Each report was compared pre- and post- the inclusion of CEG contributions, which were then analysed using thematic analysis.ResultsCommunity engagement in the interpretation and knowledge translation phases of Optimise had positive impacts on reports for policy-makers, including grounding the empirical findings in broader community perspectives, identifying policy issues affecting different groups and contributing unique insights beyond the empirical findings. Overall, the CEG contributions demonstrated the complexity of lived experience lying beneath the empirical data.ConclusionCommunity engagement in the translation of the Optimise findings resulted in research reports to policy-makers that were reflective of a broader range of community perspectives, and that provided potential solutions to emerging policy issues related to COVID-19. This study adds to the evidence base about the impact of community engagement in the later interpretation and knowledge translation phases of research, particularly in the context of reporting to policy-makers during a public health emergency.
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Project description:The health and education departments of government share a responsibility for promoting the health of children through policies in the school setting. These policies can be enhanced through the involvement of such stakeholders as school personnel, students, parents or caregivers, health professionals, the non-profit sector and industry. Although there is little evidence-based literature on the roles of stakeholders in school policy development and implementation, stakeholder involvement appears to be critical throughout the policy process. This article discusses stakeholder involvement in the development and implementation of school policies that promote and support healthy eating and physical activity. Canadian examples illustrate stakeholder engagement in this context.Electronic Supplementary MaterialSupplementary material is available for this article at 10.1007/BF03405621 and is accessible for authorized users.
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Project description:It is well known that health disparities exist and that a significant majority of patients who suffer disproportionately from them are lower income, non-white residents of dense, and diverse urban neighborhoods. It is our belief that factors hindering the reduction of health disparities in these neighborhoods are a lack of a framework and preparation needed to engage these communities in identifying specific health care needs. This paper describes one curricular intervention, a graduate level community engagement course, developed within an academic medical center located in an urban setting, that demonstrates promise in effecting change in the extent to which clinicians are able to engage communities and practice "neighborhood-engaged care" with the central goal of mitigating disparities.
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Project description:Researchers generally engage in few interactions with policymakers, which limits the extent to which empirical evidence is used to guide public policy and, consequently, the potential effectiveness of public policies in improving societal wellbeing. Although many researchers wish to see their work used for social impact, several factors contribute to researchers' limited policy engagement, including a lack of opportunities for developing policy competencies (i.e., knowledge, skills, and self-efficacy that support effective policy engagement) and limited support or incentives from research, training, and philanthropic institutions. Moreover, despite work that shows that researchers are more likely to engage in policy when they report greater policy competencies, little descriptive or evaluative research has explored the effectiveness of policy training. The current work seeks to expand the limited empirical base by drawing connections between training approaches and conditions that support policymakers' use of research evidence. Policy training approaches that combine direct instruction (i.e., information-based, often didactic teaching via classes) and experiential learning (i.e., skills and knowledge obtained through active engagement, hands-on application) appear most promising. Various pathways for policy training are described, and one specific policy training and engagement strategy is further described alongside evaluation data regarding benefits associated with direct instruction and experiential learning approaches. We conclude with recommendations to strengthen researchers' policy competency development and engagement. These recommendations range from increasing access to training opportunities to adjusting institutional incentive systems that currently hinder researchers' policy engagement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Project description:Educational attainment is one lever that can increase opportunity for economically disadvantaged families-especially in Science, Technology, Engineering, and Math (STEM). Unfortunately, students from lower-income backgrounds often perform poorly and fail high school STEM courses, which are a necessary step in pursuing fast-growing and lucrative STEM careers, graduating high school, and matriculating to college. We reasoned that, because high school STEM courses often use high-stakes tests to gauge performance, and such tests can be especially stressful for lower-income students, interventions that help students regulate their negative emotions during tests should reduce the achievement gap between higher- and lower-income students. In a large-scale (n = 1,175) field experiment conducted in ninth grade science classrooms, students were asked to complete a control exercise, or they were given the opportunity to complete an exercise to help them regulate their worries and reinterpret their anxious arousal before their tests. We found significant benefits of emotion regulation activities for lower-income students in terms of their science examination scores, science course passing rate, and students' attitudes toward examination stress, suggesting that students' emotions are one factor that impacts performance. For example, 39% of lower-income students failed the course in the control group compared with only 18% of students failing the course if they participated in the emotion regulation interventions-a reduction in course failure rate by half. Our work underscores the crucial importance of targeting students' emotions during impactful points in their academic trajectories for improving STEM preparedness and enhancing overall academic success.
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Project description:BackgroundThe National Cancer Institute Community Cancer Centers Program (NCCCP) pilot was designed to improve quality of cancer care and reduce disparities at community hospitals. The NCCCP's primary intervention was the implementation of the Commission on Cancer Rapid Quality Reporting System (RQRS). The RQRS is a hospital-based data collection and evaluation system allowing near real-time assessment of selected breast and colon cancer quality of care measures. Building on previous NCCCP analyses, this study examined whether improvements in quality cancer care within NCCCP hospitals early in the program were sustained and whether improvements were notable for minority or underserved populations.MethodsWe compared changes in concordance with three breast and two colon cancer quality measures approved by the National Quality Forum for patients diagnosed at NCCCP hospitals from 2006 to 2007 (pre-RQRS), 2008 to 2010 (early-RQRS), and 2011 to 2013 (later-RQRS). Data were obtained from NCCCP sites participating in the Commission on Cancer Rapid Quality Reporting System. Logistic regression analyses were performed to identify predictors of concordance with breast and colon cancer quality measures.ResultsThe sample included 13,893 breast and 5,546 colon cancer patients. After RQRS initiation, all five quality measures improved significantly and improvements were sustained through 2013. Quality of care measures showed sustained improvements for both breast and colon cancer patients and for vulnerable patient subgroups including black, uninsured, and Medicaid-covered patients.ConclusionsQuality improvements in NCCCP hospitals were sustained throughout the duration of the program, both overall and among minority and underserved patients. Because many individuals receive cancer treatment at community hospitals, facilitating high-quality care in these environments must be a priority.Implications for practiceQuality improvement programs often improve practice, but the methods are not maintained over time. The implementation of a real-time quality reporting system and a network focused on improving quality of care sustained quality improvement at select community cancer centers. The NCCCP pilot increased numbers of patients receiving guideline-concordant care for breast and colon cancer in community settings, and initial improvements noted in earlier years of RQRS were sustained into later years, both overall and among minority and underserved patients. National initiatives that improve care for diverse patient groups are important for reducing and eliminating barriers to care.
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Project description:Decrements in sleep health, including insufficient sleep duration, irregular timing of sleep, poor sleep quality, and sleep/circadian disorders, are widespread in modern society and are associated with an array of disease risks and outcomes, including those contributing to health disparities (eg, cardiovascular disease, obesity and diabetes, psychiatric illness, and cancer). Recent findings have uncovered racial/ethnic and socioeconomic position differences in sleep health; however, the contribution of sleep deficiency to health disparities remains largely unexplored, and understanding the underlying causes of disparities in sleep health is only beginning to emerge. In 2011, the National Heart, Lung, and Blood Institute (NHLBI) convened a workshop, bringing together sleep and health disparities investigators, to identify research gaps and opportunities to advance sleep and health disparities science. This article provides a brief background and rationale for the workshop, and it disseminates the research recommendations and priorities resulting from the working group discussions.
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Project description:The Southeastern United States has the lowest kidney transplant rates in the nation, and racial disparities in kidney transplant access are concentrated in this region. The Southeastern Kidney Transplant Coalition (SEKTC) of Georgia, North Carolina, and South Carolina is an academic and community partnership that was formed with the mission to improve access to kidney transplantation and reduce disparities among African American (AA) end stage renal disease (ESRD) patients in the Southeastern United States.We describe the community-based participatory research (CBPR) process utilized in planning the Reducing Disparities In Access to kidNey Transplantation (RaDIANT) Community Study, a trial developed by the SEKTC to reduce health disparities in access to kidney transplantation among AA ESRD patients in Georgia, the state with the lowest kidney transplant rates in the nation. The SEKTC Coalition conducted a needs assessment of the ESRD population in the Southeast and used results to develop a multicomponent, dialysis facility-randomized, quality improvement intervention to improve transplant access among dialysis facilities in GA. A total of 134 dialysis facilities are randomized to receive either: (1) standard of care or "usual" transplant education, or (2) the multicomponent intervention consisting of transplant education and engagement activities targeting dialysis facility leadership, staff, and patients within dialysis facilities. The primary outcome is change in facility-level referral for kidney transplantation from baseline to 12 months; the secondary outcome is reduction in racial disparity in transplant referral.The RaDIANT Community Study aims to improve equity in access to kidney transplantation for ESRD patients in the Southeast.Clinicaltrials.gov number NCT02092727.
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