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The Cancer Prevention and Control Program

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Disparities Research

A major piece of accomplishing our mission here at the Cancer Prevention and Control Program is investigating and ultimately eliminating the health disparities that are so prevalent across our state, country and globe. Most of our ongoing and completed studies, regardless of subject or research area, have a core underlying element that seeks to root out health disparities. In addition, many of our researchers investigate these disparities directly.

Ongoing and Completed Studies

Principal Investigator: Daniela Friedman

Funding Source: US Centers for Disease Control and Prevention (Healthy Brain Initiative Network Collaborating Center)

Study Period: 9/30/149/29/19

Alzheimer’s disease is the sixth leading cause of death among US adults, although a recent report suggests that Alzheimer’s-related deaths are vastly underreported and the death rate may be more comparable to that of cardiovascular disease and cancer. With the increasing age of our population, death rates from Alzheimer’s disease and related dementias (ADRD) will continue to rise. In response to this, national and international organizations have identified dementia, including ADRD, as a public health priority. USC was selected to serve in the role of Collaborating Center in the CDC Prevention Research Centers’ (PRC) Healthy Brain Research Network (HBRN). The SC-HBRN has three specific aims: (1) establish a research agenda concerning cognitive health and healthy aging, (2) advance research in the areas of cognitive health and healthy aging, and (3) support fellowship training of doctoral candidates. We share the funder’s goal of advancing the public health and aging agenda by making a major contribution to CDC’s Healthy Brain Research and working with other HBRN Centers and public health partners to increase their capacity to implement actions in The Public Health Road Map for State and National Partnerships, 2013–2018. The work of the SC-HBRN is aligned with the Healthy People 2020 topic area, “Dementias, including Alzheimer’s disease,” The National Plan to Address Alzheimer’s Disease, and The Public Health Road Map for State and National Partnerships, 2013–2018.

Principal Investigator: Daniela Friedman; Co-Principal Investigator: James Hébert; Co-Investigator: Swann A Adams; Co-Investigator: Heather Brandt; Co-Investigator: Thomas G Hurley; Project Director: James Lyndon McCracken

Funding Source: US Centers for Disease Control and Prevention (Cancer Prevention and Control Research Network Collaborating Center)

Study Period: 9/30/149/29/19

This study aims to disseminate, implement and evaluate the impact of efficacious, multilevel and multi-site public health interventions to address cancer-related health disparities; engage community partners and stakeholders locally, regionally and nationally in research, training and technical assistance to broaden the evidence base and increase the impact of the cancer prevention and control D&I research in SC and translate effective interventions into practice both here and nationally; and increase participation in cancer prevention and control behaviors, such as cancer screening, physical activity and access to and consumption of healthful foods among high-risk and disparate populations.

Co-Principal Investigators: Heather Brandt and James Hébert

Funding Source: National Heart, Lung and Blood Institute, National Institutes of Health

Study Period: 5/1/143/31/18

This dissemination and implementation research is based on our previous efficacious intervention trial that which focused on diet, physical activity and stress reduction in collaboration with the African-American (AA) faith community to reduce inflammation (the HEALS intervention). Extraordinary success in engaging the AA faith and greater AA community through community-based participatory research now allows us to disseminate and implement this intervention. We will ensure that this research contributes to achieving our overall goal of reducing health disparities among AAs through the following specific aims: (1) disseminate and implement the successful HEALS intervention in the AA faith community; (2) evaluate and monitor the dissemination process for adoption, recruitment, retention and fidelity to the HEALS intervention; (3) conduct a cost-effectiveness analysis of intervention dissemination and implementation to reduce health disparities in parameters associated with inflammation; and (4) enhance the capacity of the target community to sustain the delivery of the evidence-based intervention and engage in future research to address health disparities through cultivation of a network of active church and community educators and leadership development activities.

Principal Investigator: Swann Adams

Funding Source: National Cancer Institute, National Institutes of Health

Study Period: 9/19/149/18/16

We propose to apply geospatial methodologies in innovative ways to the problem of breast cancer disparities among African American women. This represents an area that has never to our knowledge been explored and has the potential to introduce a new paradigm in the conceptualization of minority cancer disparities. Considering this, we plan to examine breast cancer treatment and mortality patterns among a racially and geographically (urban vs. rural) cohort of women residing in South Carolina.

Principal Investigator: Susan Steck

Funding Source: USA Medical Research Acquisition Activity, US Department of Defense

Study Period: 3/30/119/29/15

The overall goal of the study is to examine whether altered vitamin D status (as measured by serum metabolites and by functional polymorphisms with genes related to vitamin D transport, metabolism and activity) is associated with increased risk of aggressive prostate cancer and may explain some of the racial disparity seen in aggressive prostate cancer. With large representation of African Americans in this investigation, the proposed research has tremendous potential to provide insights into a chronically underserved population carrying an unequal burden of disease.

Principal Investigator: Jan Marie Eberth

Funding Source: University of South Carolina Office of the Vice President for Research

Study Period: 5/16/149/15/15

The purpose of this study is to explore racial/ethnic differences in knowledge and myths regarding radiation therapy for breast cancer among a sample of women diagnosed with breast cancer in South Carolina. This collaborative effort with 21st Century Oncology in Myrtle Beach, SC will inform the development of a radiation therapy education series to be delivered to women newly diagnosed with breast cancer.

Principal Investigator: Daniela Friedman

Funding Source: Central Carolina Community Foundation, Knight Foundation

Study Period: 9/1/148/31/15

Co-Principal Investigators: Heather Brandt and James Hébert

Funding Source: National Cancer Institute, National Institutes of Health

Study Period: 9/1/148/31/15

The goal of the administrative supplement program is to expand the community outreach capacity of the NCI through collaborating institutions, such that cancer information is relevantly disseminated to diverse communities. This supplement will help our researchers in interacting with diverse communities (e.g., engaging study participants to foster recruitment and retention) to use optimal, culturally-sensitive approaches, as well as gain insights to adapt research strategies to enhance inclusion of underrepresented groups.

Principal Investigator: James Hébert

Funding Source: National Cancer Institute, National Institutes of Health

Study Period: 9/1/148/31/15

The Geographical Management of Cancer Health Disparities Program (GMaP), developed with American Recovery and Reinvestment Act (ARRA) administrative supplements, is a systematic and comprehensive approach to facilitating collaboration, cooperation, information- and resource-sharing, and capacity-building among cancer health disparities researchers, trainees, outreach workers and organizations, with the key goal of advancing cancer health disparities (CHD) research and training. To build these bridges, five regional networks or "hubs" were developed that link CRCHD's three flagship programs — the Community Networks Program Centers (CNPC), the Partnerships to Advance Cancer Health Equity (PACHE), and the Continuing Umbrella of Research Experiences (CURE).

               The goal for GMaP Regions 1 & 2 is to enhance the capacity of regional players to foster novel research aimed at discovery, development, delivery and dissemination of cancer health disparities information. This ongoing supplement funded by CRCHD supports new collaborative research applications and community outreach endeavors related to cancer disparities, including in the designing studies and encouraging appropriate biospecimen donation, and facilitating the career development of minority researchers. Research projects within the region are designed to identify health disparities in areas with the largest cancer-related health disparities in the nation.

Principal Investigator: Jan Marie Eberth

Funding Source: Health Resource and services Administration

Study Period: 9/1/148/15/15

Studies have shown that increased distance to the closest endoscopy provider is associated with lower screening utilization among Medicare enrollees. The purpose of this study is to examine urban vs. rural trends in the use of colonoscopy, and the availability of colonoscopy providers over time, in North and South Carolina using ambulatory surgery data. This study will inform workforce capacity building efforts and provide key insights into potential interventions to increase utilization of colonoscopy in rural areas.

Principal Investigator: James Hébert; Co-Investigator and Community Outreach Core Leader: Heather Brandt; Co-Investigator and Research Core Leader: Swann Adams; Co-Investigator and Training Core Co-Leader: Cheryl A Armstead; Co-Investigator and Pilot Project Leader: Daniela B Friedman

Funding Source: National Cancer Institute, Center to Reduce Cancer Health Disparities

Study Period: 7/106/15

The overall goal is to continue to address cancer disparities through research, education, and training. The focus of the SCCDCN-II is on addressing cancer disparities among African Americans in South Carolina through partnerships with community-based organizations, specifically the State Baptist Young Woman’s Auxiliary of the Woman’s Baptist Education and Missionary Convention.

Principal Investigator: Jim Burch

Funding Source: Magellan Scholar Program, University of South Carolina

Study Period: 5/1/144/30/15

In collaboration with community members, we will complete construction and an evaluation of a gravity fed water pipeline and irrigation system to address the needs of organic coffee farmers in La Victoria, Ecuador. We also will use Photovoice methodology to identify and characterize the Public Health needs in La Victoria, including issues related to water access and sanitation.

Co-Principal Investigator: James Hébert; Co-Investigator: Cheryl A Armstead

Funding Source: National Center on Minority Health and Health Disparities, National Institutes of Health

Study Period: 8/1/083/31/15

The overall goal of this project is to reduce colon cancer-related health disparities, by conducting (specific aims): 1) a faith-based community-designed, screening to identify individuals having colon polyps; 2) a case-control study designed collaboratively by the faith-based community and USC scientists to identify factors associated with the presence of polyps; and 3) a study to test the effectiveness of a community-designed, family-based dietary and physical activity intervention aimed at modifying levels of inflammatory markers associated with colon cancer risk.

Principal Investigator: Cheryl A Armstead

Funding Source: Institute for African-American Research (IAAR)

Study Period: 2013–2014

The experience of racism is a complex, multidimensional phenomenon exhibiting both historical and contemporaneous influences on health. At present, the perceived racism scale (PRS) is one of few established instruments that capture the complexity of the experience of racism. The PRS will be psychometrically evaluated with the goal of enhancing the revised instrument’s (PRS-R) ability to identify important pathways by which racism “gets under the skin” to produce health disparities. The new scale will not only provide an updated measure of the frequency of exposure to racism but will also take a step forward in improving its predecessor’s assessment of racism in health care and coping responses to racism among middle-aged African Americans (AAs). Enhanced sample size and measurement of racism-related pathways to ethnic disparities will improve the PRS-R’s sensitivity and scope. Middle-aged AAs are more likely than any other group to have coexisting chronic disease risk factors and comorbid health conditions (e.g., cancer, high blood pressure). This age cohort is particularly important to our understanding of psychosocial determinants involved in the onset of cancer, hypertension and other chronic diseases. Making necessary psychometric adjustments and norming our questionnaire on middle-age AAs is a pivotal step toward closing the gap in ethnic health disparities.

Principal Investigator: Daniela Friedman

Funding Source: Central Carolina Community Foundation, Knight Foundation

Study Period: 9/1/138/31/14

Principal Investigator: Jan Marie Eberth

Funding Source: National Institute of General Medicine Sciences, National Institutes of Health

Study Period: 9/10/137/31/14

The purpose of this pilot project funded by the Center for Colon Cancer Research was to establish a research data registry of patients who participated in the SC Colon Cancer Prevention Network’s Screening Program for uninsured residents.

Principal Investigator: Daniela Friedman

Funding Source: South Carolina Cancer Alliance

Study Period: 12/1/136/30/14

Principal Investigator: Daniela Friedman

Funding Source: Health Sciences South Carolina

Study Period: 1/15/1112/15/13

This research addresses the important question of how to promote awareness of and participation in clinical trials among rural residents in South Carolina (SC). The state of SC remains largely rural, with 39.5% of the population living in rural areas, compared to 21% nationally (US Census Bureau, 2000). It has long been demonstrated that rural citizens experience significant health disparities, with factors such as limited access to health care services, lower rates of health insurance, lower socioeconomic and educational status, and cultural and social differences contributing to these disparities. The specific aims of this study are 1) to examine the current state of clinical trials in SC and to determine to what degree rural residents are represented in state clinical trials; 2) to assess rural SC adults’ current knowledge and beliefs about clinical trials; 3) analyze current communication messages and channels being used to recruit and educate SC residents about clinical trials; and 4) to provide recommendations for innovative strategies for communicating about clinical trials with SC rural populations.

Co-Principal Investigator: Susan Steck

Funding Source: Wake Forest University Health Sciences, National Institutes of Health

Study Period: 5/1/128/31/13

Principal Investigator: James Hébert

Funding Source: George Washington University, National Institutes of Health

Study Period: 1/1/138/31/13

Investigator: Cheryl A Armstead

Funding Source: University of South Carolina - Intramural: Associate Professor's Development Grant

Study Period: 7/1/08–6/30/13

This study developed, piloted and implemented an online survey measuring the association between home ownership and health, a portion of which inquired about home foreclosures and stressors.

Principal Investigator: Heather Brandt

Funding Source: South Carolina Clinical and Translational Research Institute

Study Period: 10/15/1010/14/12

Participation in cervical cancer screening is relatively high, whereas HIV testing uptake remains low, which points to a potential opportunity for earlier intervention. Further, HIV+ women are purportedly less likely to have Pap tests as frequently as recommended despite increased risk of cervical cancer. This research is a secondary data analysis of the South Carolina (SC) Medicaid database with linkage to the SC HIV/AIDS Reporting System (HARS) database for HIV+ women to learn more about the scope of this problem in SC. The specific aims are to: 1) describe cervical cancer screening and HIV testing behaviors; 2) identify sociodemographic factors associated with these preventive health behaviors among females with unknown HIV status; 3) identify sociodemographic and HIV-related clinical factors associated with preventive health behaviors among females who are HIV-positive; 4) identify sociodemographic and clinical factors associated with these preventive health behaviors among females aged 40-64 years who have been diagnosed with breast and/or cervical cancer; and 5) create county-level maps using spatial epidemiology techniques to show utilization of cervical cancer screening and HIV testing health services. The research will result in evidence to support cervical cancer screening among HIV-positive women to reduce AIDS-related deaths from cervical cancer, and Pap testing as a potential missed opportunity to promote the uptake of HIV testing among post-reproductive age women for an earlier diagnosis of HIV infection among an interdisciplinary team of researchers.


Principal Investigator: James Hébert

Funding Source: SAID-Frederick, Inc., National Cancer Institute, National Institutes of Health

Study Period: 8/18/106/30/12

The purpose of this study was to serve as a regional Community Network Program Institute partner to the NCI Community Cancer Centers Program (NCCP), which is a network of 21 community hospital-based cancer centers in 16 states working to support cancer research and enhance the quality of cancer care at the nation's community hospitals, as well as explore ways in which community hospitals can best support a wide range of basic, clinical and population-based cancer research, with the goals of enhancing the quality of patient care and advancing cancer research. This particular partnership’s goal was to increase cancer screening among minorities and underserved populations in South Carolina specifically.

Principal Investigator: Susan Steck

Funding Source: National Center for Research Resources

Study Period: 6/1/105/31/12

Principal Investigator: Tisha Moniek Felder

Funding Source: Pharmaceutical Research and Manufacturers of America (PhRMA) Foundation

Study Period: 5/1/11–4/30/12

This nationally-competitive fellowship provides support for postdoctoral research that will examine racial differences in the use of oral anti-cancer agents among SC Medicaid enrollees diagnosed with breast cancer.



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