3C-1: A Pilot Study in a Midwestern High School in the USA

Ana Barros¹, Denise H. Britigan², Luís Moreira³, Filipe Santos-Silva^4
1College of Public Health – UNMC/i3S – Instituto de Investigação e Inovação em Saúde da Universidade do Porto – Portugal, Omaha, NE, USA; ²Maurer Center for Public Health, Omaha, NE, USA; ³Health School of Vila Nova de Gaia – Piaget Institute, Vila Nova de Gaia, Portugal; ⁴IPATIMUP, Porto, Portugal

Abstract: Background/Purpose: Adolescents are in a critical stage regarding the development of health-risk behaviors. So as research shows prevention is the best strategy to reduce the cancer burden, and new approaches regarding cancer prevention are of utmost importance. School is one of the most important arenas during this adolescence to learn about healthier choices and lifestyles. Despite its importance, health education is not a required subject in all US schools, and even if it is, parents can opt out of their child taking it. The aim of this study is to evaluate the feasibility of a teacher-based cancer education model in a Midwest High School providing to the teachers the appropriate skills for the implementation of their own activities about cancer education, aiming to increase students’ knowledge on cancer prevention and risk factors. Methods: In this pilot project, teachers were trained before their interventions that are taking place during school year 2015–2016. We will assess students perceived and actual cancer knowledge through questionnaires, both before (pre-test) and after (post-test) the teachers’ intervention. The activities and materials developed and implemented by teachers will be also evaluated regarding the intervention design, the educational contents, and the impact on the students’ knowledge about cancer. Results/ Findings: Twenty-two teachers were efficiently trained and able to develop their own cancer education activities, engaging 300 high school students. The results collected from the pre-test survey show an overall level of cancer knowledge below 50 %, indicating a low understanding about cancer. Discussion: The reduced knowledge and awareness about cancer among students encloses a great potential for improvement. This is one of the necessary tools to design, target, and adapt future curriculum and campaigns in order to achieve two major goals: (i) provide adequate information to increase knowledge about cancer and (ii) improve skills and decision-making capacity to enable beneficial behavior changes for reducing cancer risk. Learning Objectives: The participant shall be able to identify that cancer prevention education promoted in a school context is a more effective way to educate adolescents about cancer and identify that adolescents are an ideal audience for reducing cancer risk through the adoption of healthier choices. References: 1. Barros A, Moreira L, Santos H, Ribeiro N, Carvalho L, et al. (2014) “Cancer—Educate to Prevent”— High-School Teachers, the New Promoters of Cancer Prevention Education Campaigns. PLoS ONE 9(5): e96672. 2. Morse, L. L. (2013). Let schools do it! Helping schools find a role in cancer prevention. Journal of Adolescent Health, 52(5), S89-S92. 3. Mayer AB, Smith BJ, McDermott RJ (2011) Health Education: Always Approved but Still Not Always on Schools’ Radar. Am J Health Educ, 42(6):349-359.

3C-2: Making Cancer Health Text on the Internet Easier to Read for Deaf College Students Who Use American Sign Language

Poorna Kushalnagar, Raja Kushalnagar
Gallaudet University, Washington, DC, USA

Abstract: Background: Deaf consumers with relatively low English proficiency might find existing cancer health information on the Internet to have unfamiliar words or grammatically complex, which reduces access and understanding of the information. The current state of art does not support low cost and quick translation of online materials to American Sign Language; the state of art is relatively more advanced in simplifying text information. Methods: We worked together to develop a two-step approach to simplifying cancer health text and tested this with 36 deaf and 38 hearing college students in a crossover design. Findings: Results indicated that hearing college students did well on both original and simplified text conditions. However, deaf college students greatly benefitted from the simplified text condition. Discussion: In the above study, we used two steps to simplify the text materials taken from a cancer education website. This process has been proven to be beneficial for both deaf and hearing college students. Replicating this method with endless text on the Internet can be quite time consuming and expensive. We offer recommendations to improve Internet accessibility in future work. Learning Objectives: The participant should be able to (1) recognize that current online health information on the Internet continue to be higher than the fourth to sixth grade reading level as recommended by the National Institute of Health and (2) identify steps used to simplify existing cancer health text on the Internet. References: Pascual, A., et al. (2014). Impact of web accessibility barriers on users with hearing impairment. Proceedings of the XV International Conference on Human Computer Interaction. Puerto de la Cruz, Tenerife, Spain, ACM: 1-2. Štajner, S., Mitkov, R., & Saggion, H. (2014). One step closer to automatic evaluation of text simplification systems. In Proceedings of the 3rd Workshop on Predicting and Improving Text Readability for Target Reader Populations (PITR)@ EACL (pp. 1-10).

3C-3: Oncology Training Outcomes for the Deaf Community’s Interpreters

Georgia Robins Sadler¹, Melanie Nakaji¹, Amy Ustjanuskas^2
1UCSD Moores Cancer Center, San Diego, CA, USA; ²San Diego State University/UCSD Joint Doctoral Program in ClinicalPsychology, UCSD Moores Cancer Center, La Jolla, CA, USA

Abstract: Background: The deaf community experiences multiple barriers to accessing health information and health care, including language and literacy barriers, limited availability of interpreters with appropriate levels of translation skills, dearth of culturally competent providers and institutions, distrust, educational attainment, economic barriers, and a limited breadth and depth of social networks. A two-decade long community–campus partnership scientifically tested a variety of strategies to help reduce these barriers, along with the subsequent health disparities they help create. The most recent intervention evolved from the partnership’s recognition that the limited scientific coursework undertaken by most American Sign Language (ASL) interpreters and Certified Deaf Interpreters (CDIs) creates opportunities for suboptimal interpreting in medical settings. Courses related to the scientific process, anatomy and physiology, and the basic sciences are rarely taken. The ASL vocabulary itself has limited signs for medical terms. This becomes particularly pronounced in complex tertiary care settings like oncology. Description: NCI funded this partnership to create and test a comprehensive, online oncology training program for ASL interpreters and CDIs that could be completed in fulfillment of their continuing education requirements. As part of this program, a glossary of oncology terms described in ASL was also created by community focus groups held throughout the nation. Evaluation: Data, collected from a nationwide sample of 242 participants, showed that the program contributed to significant gains in interpreters’ oncology knowledge from baseline to the completion of the training program. Significant knowledge gains were achieved among interpreters at all levels of interpreting experience and training. Equally important, the program was delivered entirely in ASL to advance interpreters’ signing familiarity and competency in the oncology setting. Usefulness: The program is available online at http://healthcareinterpreting.org/oncologyinterpreter-training-program/. Since this problem is not unique to the deaf community, this program can also serve as a model for training other language interpreters. Learning Objectives: Learn about the deaf community’s multiple serious barriers to accessing health information and care and subsequent health disparities risks. Learn about a strategy to increase American Sign Language interpreters’ and Certified Deaf Interpreters’ signing proficiency in the oncology setting. Learn how this program could readily be applied to other language interpreters. References: Zazove, P., Meador, H. E., Reed, B. D., Sen, A., & Gorenflo, D. W. (2012). Effectiveness of videos improving cancer prevention knowledge in people with profound hearing loss. Journal of Cancer Education, 27, 327–337. doi:10.1007/s13187-011-0292-1. Kuenburg, A., Fellinger, P., & Fellinger, J. (2016). Health care access among deaf people. Journal of Deaf Studies and Deaf Education, 21, 1–10. doi:10.1093/deafed/env042

3C-4: The University of Maryland Baltimore CURE Program Integrates Academics, Mentorship, Family, and Community into STEM Education in Underserved West Baltimore Middle Schools

Bret Hassel¹, Robin Saunders², Elsie Stines³, Brian Sturdivant⁴, Gregory Carey⁵, Dane Weinert², Tierra Johnson¹, Lise Mafodong⁶, Timothy Shu⁶, Heather Ezelle¹, Patricia Young⁵, Christine Callahan⁶, Jay Perman⁷, Kevin Cullen^1
1University of Maryland Greenebaum Cancer Center, Baltimore, MD, USA; ²University of Maryland Baltimore CURE Scholars Program, Baltimore, MD, USA; ³University of Maryland Baltimore Office of the President, Baltimore, MD, USA; ⁴University of Maryland Baltimore Office for Community Engagement, Baltimore, MD, USA; ⁵University of Maryland Baltimore Center for Vascular and Inflammatory Diseases, Baltimore, MD, USA; ⁶University of Maryland School of Social Work, Baltimore, MD, USA; ⁷University of Maryland Baltimore, Baltimore, MD, USA

Abstract: Background and Purpose. Underrepresented minorities are the fastest growing populations in the USA but make up only a small percentage of the biomedical workforce. Increasing diversity in these fields is expected to have positive impacts in addressing healthcare disparities and on the quality of biomedical research. To address this need, the NCI Continuing Umbrella of Research Experiences (CURE) program was developed to attract promising students from diverse racial/ethnic and socioeconomic backgrounds to careers in health, biomedicine, and broader STEM fields. Current efforts span high school through post-graduate studies. Despite the successes of this program, minority representation in science and healthcare fields remains low. Description: The University of Maryland Baltimore (UMB) CURE is a pilot expansion of the CURE program that targets a younger population of underserved scholars with the goal of inspiring them to enter a STEM or healthcare career. The program takes a holistic approach by (i) introducing hands-on activities to enhance STEM curriculum and engage scholar interest, (ii) improving the home learning environment by assisting families with social services and job training and placement, (iii) providing role models and educational and emotional support through mentoring, and (iv) leveraging UMB and its partners citywide to broaden scholar opportunities through diverse resources and support. UMB CURE engages scholars multiple days each week, year-round. A target ratio of 5 mentors:1 scholar ensures consistent support and promotes mentor retention in the program. Evaluation: Each component of UMB CURE is critically evaluated through scholar, mentor, family, and Advisory Board assessments. The CURE infrastructure will be utilized to track and support scholars through college and beyond and evaluate program outcomes as an important metric of program success. Usefulness: Exciting, educating, and supporting underserved middle school students will enhance minority science education and increase diversity in the healthcare and biomedical research workforce, reducing health disparities and inequity. Learning Objectives: The participant shall be able to identify the four components of the holistic strategy used by UMB CURE to promote scholar interest in STEM and healthcare careers and identify two aspects of the rationale for training underserved minorities to become healthcare professionals as a strategy to alleviate healthcare disparities and inequity. References: “Matching by Race and Gender in Mentoring Relationships: Keeping our Eyes on the Prize.” (2011) Journal of Social Issues, 67(3):622-643. “PROMISE: Maryland’s Alliance for Graduate Education and the Professoriate Enhances Recruitment and Retention of Underrepresented Minority Graduate Students.” (2012) Academic Medicine, 87(11):1562-1569. “Bringing Up Girls in Science (BUGS): The Effectiveness of an Afterschool Environmental Science Program for Increasing Female Students’ Interest in Science Careers.” (2012) J Sci Educ Technol, 21:46-55

3C-5: St. Jude Cancer Education for Children Program: Partnering with Local Schools to Promote Cancer Education

Katherine Ayers
St. Jude Children’s Research Hospital, Memphis, TN, USA

Abstract: Background: School health educators are ideal partners for institutions seeking to promote cancer education and improve health literacy equitably among diverse populations as the many children attend such institutions. In addition, many states require school health curricula to include education in nutrition and dietary behavior, physical activity and fitness, and tobacco use prevention, important issues in primary cancer prevention. We conducted a pilot evaluation of a cancer prevention curriculum for fourth-grade students to determine the feasibility of a teacher-led version of the program. Methods: This study utilized a single-group, pre-test/post-test design to determine the effect of the curriculum on matched knowledge scores among fourth-grade students. Teachers also completed a survey and follow-up interview to determine their perceptions of the program and its usefulness in the classroom. Results: The mean scores of the student knowledge-based tests increased from 6.45 to 8.12, 5.99 to 7.65, and 5.92 to 7.96 on cell, cancer, and health behaviors units, respectively (all p values < .001). Analysis of the teachers’ survey showed that teachers accept the program and find it to have educational value for their students. Discussion: This study demonstrates that teachers can effectively deliver cancer educational materials to young children in the classroom setting in a way that is comparable to a St. Jude staff-led curriculum. In addition, the demographics of the study participants are representative of the larger demographics of the region, indicating the program was effective across a broad demographic spectrum. This study was limited by the single-group versus cohort design and the lack of a control group. Further research is needed to measure any changes in students’ beliefs, attitudes, perceptions of susceptibility to cancer, intentions, and self-reported health behaviors that may result from student participation in the program. Learning Objectives: The participant shall be able to recognize the potential for teachers to effectively deliver cancer educational materials to young children and identify at least one benefit in partnering with local schools and school system in disseminating cancer education to young children. References: Rechis, R., C. Neal, and D. McGoldrick. 2010. LIVESTRONG at school: Changing classroom talk about cancer. Journal of Cancer Education. 25(1): 127128. Stöver, L.A., B. Hinrichs, U. Petzold, H. Kuhlmei, J. Baumgart, C. Parpart, O. Rademacher, E. Stockfleth. 2012. Getting in early: primary skin cancer prevention at 55 German kindergartens. Br J Dermatol. 167(Suppl 2): 63-9. Shihab, R.A., N.A. Obeidat, R.K. Bader, A. Shtaiwi, A. Ayub, F.I. Hawari. 2012. Cancer-related knowledge, attitudes, and risk perception among 6 grade students in Jordan. Stud Health Technol Inform. 172: 155-60.