2C-1: Collaboratively Developed, Culturally Responsive, Online Cancer Education Inspires Cancer Risk Reduction For Alaska’s Community Health Aides/Practitioners

Katie Cueva¹, Laura Revels², Melany Cueva², Reggie Kuhnley², Anne Lanier², Mark Dignan^3
1University of Alaska Anchorage, Boston, MA, USA; ²Alaska Native Tribal Health Consortium, Anchorage, AK, USA; ³University of Kentucky Department of Internal Medicine, Lexington, KY, USA

Abstract: Background: Alaska’s village-based primary care providers— community health aides and practitioners (CHA/Ps)—requested additional information about cancer for themselves and their communities. However, Alaska’s geographic challenges (large distances, expensive airfare, and harsh weather patterns) restrict the amount of in-person education that can be made available. In response, a research team at the Alaska Native Tribal Health Consortium developed a successful application to the National Cancer Institute to co-create a culturally respectful distance-delivered cancer education course with, and for, Alaska’s CHA/Ps. Description: Seven culturally relevant, interactive, online cancer education modules were created by the project team on topics including men’s health, colorectal cancer, and cancer basics. Each module was reviewed by CHA/Ps and partners prior to being published online through the Alaska Community Health Aide Program Distance Learning Network as continuing medical education. While evaluation is ongoing and iterative, approximately 150 module evaluations were collected between March 2015 and March 2016. Evaluation: Similar to the population of Alaska’s CHA/Ps, evaluation respondents were predominantly female (85 %) and Alaska Native/American Indian (78 %). Almost all (99 %) reported that they learned what they hoped to learn, and 97 % shared that the modules were respectful of their culture. Respondents indicated they would use the information they learned in the modules with their patients (81 %), family (60 %), friends (47 %), and in their communities (59 %). Almost all (96 %) reported they were motivated by the cancer education modules to reduce their own cancer risk, including 67 % planning to increase their physical activity, 54 % intending to eat healthier, and 29 % planning to get a cancer screening. Usefulness: This project overcomes barriers to providing timely, medically accurate, cancer education to Alaska’s CHA/Ps, while creating a model for effective, culturally relevant online education that could be adapted to diverse populations and health promotion initiatives. Learning Objectives: The participant shall be able to describe evaluation responses to culturally relevant online cancer education modules developed with and for Alaska’s CHA/Ps and list a variety of modifiable outcomes that learners shared they were inspired to change to reduce their cancer risk as a result of interactive, culturally relevant, online cancer education modules. References: Kelly, J., Schade, T., Starkey, M., Ashokkumar, R., & Lanier, AP. (2012). Cancer in Alaska Native People 1969-2008 40-Year report. Anchorage: Alaska Native Tumor Registry Alaska Native Epidemiology Center Division of Community Health Services Alaska Native Tribal Health Consortium. Golnick, C., Asay, E., Provost, E., Van Liere, D., Bosshart, C., Rounds-Riley, J., Cueva, K., & Hennessy, T. (2012). Innovative primary care delivery in rural Alaska: a review of patient encounters seen by community health aides. International Journal of Circumpolar Health. 71.

2C-2: Anal Cancer and the Internet: the Bottom Line

Michelle Snow¹, Janet Papadakos¹, Jordana Winegust^2
1Princess Margaret Cancer Centre, Toronto, ON, Canada; ²Faculty of Information, University of Toronto, Toronto, ON, Canada

Abstract: Background/Purpose: The Princess Margaret Cancer Centre, Patient and Family Library houses a significant consumer health collection of over 1,000 pamphlets on various cancer-related topics. Despite efforts to develop and maintain a comprehensive collection, gaps exist in information about rare cancers or those less commonly treated at Princess Margaret. Every year, 600 Canadians are diagnosed with anal cancer and at least 50 of these individuals are treated at Princess Margaret. The library does not have resources on this topic and as such when a patron requests information about anal cancer, library staff search the Internet for information. Since the Internet is largely unregulated, the quality of consumer health resources retrieved from it is questionable. This paper describes the systematic retrieval and quality assessment of anal cancer websites. Methods: Search terms were developed from (MeSH) based on the alternative entry terms for “anal cancer.” The top 20 websites from each search term were identified and assessed by two independent reviewers using a modified Patient Education Materials Assessment Tool (PEMAT). When disagreement was found among reviewers, triangulation was used to reach consensus. Results/Findings: PEMAT scores were tabulated for each website and a readability assessment done. Following this, websites were evaluated using the Princess Margaret Library Collection Development Policy. Analysis of the websites found common themes: the majority of websites analyzed did not include actionable information, many sites lumped anal cancer together with colon and rectal cancers, and the understandability score of the websites was extremely variable with the highest scores being from health organizations and from government organizations. Discussion: Developing an understanding of the quality of anal cancer information available on the Internet will help library staff build confidence in certain websites and will inform future resource development projects that fill gaps and meet the specialized needs of patients and families with anal cancer. Learning Objectives: The participant shall be able to identify at least three higher quality anal cancer websites and also recognize a need for a reliable national anal cancer organization. References: Sium A, Guiliani M, Papadakos, J. The persistence of the pamphlet: On the continued relevance of the health information pamphlet in the Digital Age. J Cancer Educ. 2015:1-4. Fahy E, Hardikar R, Fox A et al. Quality of patient health information on the Internet: reviewing a complex and evolving landscape. Australas Med J 2014; 7(1):24-28. 

2C-3: Leveraging Virtual Communities of Practice (VCoPs) to Maximize Collaboration and Improve Practice

Margaret Farrell, Jordan Tompkins, David Chambers
National Cancer Institute, Bethesda, MD, USA

Abstract: Background/Purpose: Web 2.0 technologies have driven a paradigm shift from static websites to dynamic online communities that allow for two-way dialogue and enhanced learning opportunities. In few areas is this need greater than that of the emerging field of implementation science. The field has exploded over the last several years. More communities and researchers are collaborating around cost-efficient, evidence-based methods to enhance cancer screening and prevention efforts. Description: The National Cancer Institute (NCI)’s Research-to-Reality (R2R) community of practice helps translate research into practice by maximizing opportunities for collaboration. On R2R, researchers, practitioners, and decision-makers discuss evidence-based interventions (EBIs). Through interactive features and targeted learning communities, members learn how to select, adapt, and implement EBIs while maintaining fidelity to achieve desired cancer health outcomes. Evaluation: Measuring and tracking Web analytics alone do not capture the growth or vitality of the community of practice. Therefore, NCI adapted the Macuarium Set of Community Practice Measurements and collects data to measure each of the dimensions. In 2015, the R2R website had 42,000 page views with an average monthly page view of 3200. Registration and membership have grown steadily. A mixed-method content analysis evaluate the level of engagement with R2R discussions and the types of content or cues that prompted R2R members to post and interact with one another. Program data demonstrate a 62 % increase in communitygenerated discussions since 2011. Usefulness: R2R has attracted a robust membership from many disciplines. Members are eager to showcase their work. Anecdotal stories and posted discussions demonstrate its potential to conduct capacity-building activities, especially around technically difficult topics such as precision medicine and public health genomics. VCoPs can be an invaluable venue to support research translation within and between organizations and share research findings on the feasibility of uptake as well as best practices for program implementation. Learning Objectives: The participant will be able to discuss how virtual communities of practice support research translation within and between organizations and discuss how public health agencies and organizations, research institutions, and cancer registries can collaborate to design and implement evidence-based interventions. References: Bernhardt JM, Mays D, Kreuter MW. Dissemination 2.0: closing the gap between knowledge and practice with new media and marketing. J Health Commun 2011;16(Suppl 1):32–44. Purcell EP, Mitchell C, Celestin MD, Evans KR, Haynes V, McFall A, et al. Research to reality (R2R) mentorship program: building partnership, capacity, and evidence. Health Promot Pract 2013;14(3):321–7. 

2C-4: Using the RE-AIM Framework to Develop and Implement a Colorectal Cancer Screening Educational Tool

Maria Jibaja-Weiss¹, Jane Montealegre¹, Loretta Hanser², Roshanda Chenier¹, Ivan Valverde¹, Glori Chauca¹, Maria Daheri², Brian Reed¹, Milena Gould-Suarez¹, Benjamin Musher¹, Larry Scott^3
1Baylor College of Medicine, Houston, TX, USA; ²Harris Health System, Houston, TX, USA; ³The University of Texas Health Science Center Houston, Houston, TX, USA

Abstract: Background: Cancer screening to detect precancerous or early stage lesions is a fundamental process within the Continuum of Cancer Care. However, health clinics often face budgetary constraints and competing health issues that impede their ability to deliver cancer screening education to their patients. As part of a comprehensive system design intervention, we developed and implemented linguistically and culturally targeted educational videos to promote the uptake of colorectal cancer screening within a high-volume public healthcare system. Methods: The Reach, Effectiveness, Adoption, Implementation, Maintenance (REAIM) framework was used to develop and implement a multimedia tool to facilitate patient education. The intervention used all factors in the REAIM model. Reach considerations included harnessing the electronic medical record (EMR) to identify patients due for a screening test. Effectiveness considerations included using an evidence-based intervention and theory-based messaging to encourage screening utilization and foster effective patient–provider communication. Adoption considerations included in-service trainings of clinical staff to incorporate the intervention within the clinic workflow. Implementation considerations included administrative reporting features to evaluate clinic-level performance and outcomes. Maintenance considerations included integration within clinic workflow and features to promote its use as a quality measure. Findings: To date, the videos have been implemented at 16 community health centers, 10 homeless clinics, and 3 outpatient and specialty clinics. Video watching for the colorectal cancer screening videos is documented for an average of 424 patients per month. This represents 21 % of those who obtain the screening test. Interview with clinic staff indicate that documentation occurs for only a fraction of patients who watch the videos. Discussion: This education tool has become an integral aspect of colorectal cancer screening in a high-volume safety net healthcare system. Employing the RE-AIM framework ensured the integration of key features for effective patient–provider communication at the point of care. Learning Objectives: The participant will be able to identify components of the RE-AIM framework to facilitate translation of research into practice. The participant will be able to explain why individual and institutional levels of impact are important within the RE-AIM framework. References: Gaglio B, Shoup JA, Glasgow RE. The RE-AIM Framework: A Systematic Review of Use Over Time. American Journal of Public Health 2013, 103 (6): e38-e46. Yip M, Chun A, Edelson J, Feng X, Tu S. Contexts for Sustainable Implementation of a Colorectal Cancer Screening Program at a Community Health Center. Health Promotion Practice 2016, 17:48-56. James A, Richardson V, Wang JS, Proctor EK, Colditz GA. Systems Intervention to Promote Colon Screening in Safety Net Settings: Protocol for a Community-based Participatory Randomized Controlled Trial. Implementation Science 2013, 8:58

2C-5: Wired for Health: User Preferences for Social Media Health Interventions

Vivekka Suppiah¹, Stacy N. Davis¹, Liliana Gutierrez¹, Daniel Schadrac², Alexis Koskan³, Martine Dorvil⁴, Clement Gwede¹, Cathy Meade^1
1Moffitt Cancer Center, Tampa, FL, USA; ²University of South Florida, Tampa, FL, USA; ³University of Miami, Coral Gables, FL, USA; ⁴University Area Community Development Center, Tampa, FL, USA

Abstract: Background/Purpose: Social media is a promising new platform for the delivery of cancer education interventions. Yet, little information exists about its usage among diverse community members. Therefore, we explored receptivity of social media in cancer education interventions. Methods: Eighty participants were recruited from community settings using active, passive, and snowball methods. Participants completed the 40-item Wired for Health survey, which included use of social media, receptivity of social media in cancer interventions, and demographics. Results/Findings: Participants were 36 % Black, 32 % White, 51 % female, and 49 % 50 years of age and older. Majority of participants owned a computer (83 %), a smartphone (80 %), and used the Internet (93 %). Sixty-nine (86 %) participants had heard of and used social media over the past 12 months. The most commonly used social media was social networking (e.g., Facebook) with 54 % using it daily. Participants (50 and older) were less likely to use social media daily (p = 0.01) and to believe social media could be useful to discuss health issues (p = 0.03). The 69 participants that had used social media were asked if they would join a private group within a social media platform as part of a cancer education intervention. Majority participants (83 %) said they would be receptive to joining a private group within social media for reasons such as accessibility and opportunity to connect with others. Older participants were less receptive to join (p = 0.01). Major reasons for not joining were privacy concerns and time constraints. Discussion: The frequency of social media use varied by age. Individuals 50 years and older were less receptive to cancer interventions with a social media component. When creating social media-based cancer education interventions, it is essential to recognize that these interventions may not reach everyone. Other communication platforms may be needed to increase equity in access to critical cancer education. Learning Objectives: The participant shall be able to identify facilitators and barriers in social media cancer education interventions. The participant shall be able to maximize receptivity of social media cancer health interventions in a targeted, community population. References: Broderick, A., & Haque, F. (2015). Mobile Health and Patient Engagement in the Safety Net: A Survey of Community Health Centers and Clinics. Commonwealth Fund. Fox S, Jones S. The Social Life of Health Information. Pew Internet & American Life Project. 2009. Kontos, E., Blake, K. D., Chou, W. Y. S., & Prestin, A. (2014). Predictors of eHealth usage: insights on the digital divide from the Health Information National Trends Survey 2012. Journal of medical Internet research, 16(7), e172. Zickuhr K. Who’s not online and why. Washington, DC: Pew Internet & American Life Project; 2013 Sep 25.