The AACR was honored to showcase patient advocate posters at the 16th Annual Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved in Orlando, Florida.

A013 Advancing colorectal cancer outreach & screening strategies: Tailoring approaches for two-spirit and urban native LGBTQIA2S+ populations. Corinne E. Abrams. Roswell Park Comprehensive Cancer Center, Buffalo, New York.

Background: The focus of this one-year collaborative initiative between the Center for Indigenous Cancer Research at Roswell Park and Northwestern University’s Institute of Sexual and Gender Minority Health and Wellbeing is to refine and customize an existing colorectal cancer (CRC) screening program to suit the unique needs of Two-Spirit and Native American LGBTQ+ urban population. This undertaking, grounded in exploratory and explanatory qualitative methodologies, is not intended to test a predefined hypothesis, but rather aims to learn, understand, and adapt based on community input and participation. Methods: The project’s methodology incorporates two main objectives: (Objective 1) Conducting virtual roundtables with representatives from the Two-Spirit and Native LGBTQ+ community in NYC, with the goal of understanding indigenous perspectives on CRC outreach and screening, and to garner insights on how to tailor these interventions for native sexual and gender minority populations in urban settings; (Objective 2) Applying qualitative data gleaned from Objective 1 to modify NCI- endorsed materials, with the aim of more effectively conveying outreach and screening information to Two-Spirit and Native LGBTQ+ urban communities. Results: The initiative has engaged a Two-Spirit artist and educator to assist in the organization and co-facilitation of six virtual round table conversations, involving a total of 14 participants. Each 90-minute dialogue aimed to solicit input on current education materials, as well as suggestions for their adaptation. A team of five Northwestern University medical students collaborated on the project, contributing to the analysis of the collected qualitative data. Next Steps: Findings from this initiative will offer crucial insights into how the visuals, messaging, and information contained in the S2S colorectal cancer education materials can be revised to better engage Two-Spirit and Native LGBTQ+ individuals. By the project’s conclusion, partners will possess clear, community-informed directives on how to adapt CRC outreach and screening resources, paving the way for future testing and implementation.

A059 The role of conversational chatbots in enhancing shared decision making for African American men with early-stage prostate cancer. Angela D. Adams. Central Florida Pharmacy Council, Oviedo, Florida.

Introduction: Enhancing shared decision making (SDM) for African American (AA) men with early-stage prostate cancer using conversational chatbots (CCs) aims to improve communication, provide information, and empower them in their treatment decision making process. SDM is a collaborative approach that involves patients and healthcare providers working together based on medical evidence and patient preferences. However, AA men face significant disparities in prostate cancer (PCa) outcomes, including higher incidence and mortality rates compared to other racial/ethnic groups in the United States. Limited access to recommended PCa information and inadequate information during SDM conversations contribute to the challenges AA men face when making treatment decisions. The purpose of this study was to develop a conversational chatbot (CC) to provide PCa information in real time thus, enhancing SDM for AA men with PCa. Methods: The Ottawa Decision Support Framework and the International Patient Decision Aids Standards provided guidance and framework for the development of the CC. Our participatory research approach involved a diverse Community-Based Participatory Research Advisory Board (CBPRAB) consisting of twelve members. The CBPRAB included AA PCa survivors, AA men, caregivers, advocates, community leaders, and cancer care providers. Through training in research methods and focus group facilitation, CBPRAB members actively contributed their valuable insights, ensuring a collaborative and inclusive research process. Results: five stakeholder focus groups (n = 44) comprising AA men, PCa survivors, spouses, healthcare professionals, and advocates provided valuable input for the development of the CC. In total, 819 questions were generated through interviews conducted during the focus groups. These questions were either inferred from the discussions or explicitly provided by the participants. The answers to these questions were developed from evidence-based sources, such as the American Cancer Society and National Comprehensive Cancer Network Guidelines. An Android-based smartphone application that allows users to submit questions via speech was created. The application matches the user’s question within the data set of 819 questions and provides answers in both voice and text formats. Conclusion: The Android-based smartphone application was alpha tested on four stakeholder focus groups (n=35). The CC developed in the smartphone application demonstrated the capacity to provide real time responses to user questions sourced from an 819-question database derived from our stakeholder focus groups. By offering evidence-based information and directing users to additional resources if the question is not in the database, the CC can improve accessibility to medical information, thus enhancing the SDM process regarding early-stage prostate cancer.

B134 The art of science: Painting a new image of genomic research in the indigenous communities of the southwest. Shoshana Adler Jaffe, Kendal Jacobson, Joseph Rodman, Cindy Blair, Debra MacKenzie, Mallery Quetawki, Tamar Ginossar, V. Shane Pankratz, Andrew Sussman, Ursa Brown-Glabermen, Jeffrey Trent, Cheryl Willman, Shiraz I. Mishra. University of New Mexico, Albuquerque, New Mexico, Translational Genomics Research Institute, Phoenix, Arizona, Mayo Clinic Comprehensive Cancer Center, Rochester, Minnesota

Introduction: The Patient Engagement-Cancer Genome Sequencing Research Center (PE-CGS; NCI U2C CA252973) based at the University of New Mexico Comprehensive Cancer Center (UNMCCC) with partners at Mayo Clinic Comprehensive Cancer Center, the Translational Genomics Research Institute, and the Black Hills for American Indian Health Research Center are developing culturally appropriate strategies and methods to address the underrepresentation of American Indians (AIs) in genomic research. Our efforts are directed towards the implementation of tailored cancer prevention, diagnosis, and treatment strategies that reduce cancer health disparities in Tribal communities. Methods: the PE-CGS Center has three units, each tasked with specific research components to engage AI participants in participatory, clinically meaningful genomic research: 1) the Participant Engagement Unit; 2) the Genomics Characterization Unit; and 3) the Engagement Optimization Unit (EOU). The center also has a
Tribal Advisory Committee, composed of tribal governors, presidents, and tribal health advocates and experts, who provide direction on all research matters. The PE-CGS EOU uses iterative rapid-cycle research techniques to optimize engagement and shares these strategies with other units for timely implementation. To date, the EOU has developed and implemented three key efforts. First, to aid in recruiting participants for the study, the EOU tailored a series (6) of participant-facing informational materials that include artwork from a local AI artist who combined her traditional and scientific knowledge to prepare complementary imagery. Second, the EOU is currently implementing a series of semi-structured discussions to document participant perceptions on criteria including engagement, communication, and education. Lastly, the EOU implemented a survey among UNMCCC providers on their return of results processes. Results: EOU discussions are ongoing and have provided important perspectives on participant satisfaction and areas for improvement. Participants have commended study staff on their efforts to make enrollment straightforward. Participants report discussing the study with family prior to enrolling, highlighting the importance of continuing to engage with the entire community on the goals of the study. The provider return of results survey is complete (n=42/62, response rate=68%); one key finding was that providers who return somatic test results rarely provide participants with a hard copy of the results or utilize complementary materials that might enhance their explanation of the test findings. Conclusion: The EOU serves an innovative function through its rapid-cycle methods to optimize participant engagement. Although participants are generally pleased with their study participation, there are numerous opportunities for improvement. The informational materials represent a novel contribution to the field of genomic research. Efforts will continue to implement optimized processes for effective engagement of AI communities in genomic research and cancer care delivery.

A041 The iCCARE Consortium for prostate cancer in black men: Evaluability assessment of the implementation of a care plan for black prostate cancer survivors. Timethia Bonner, Kimlin Ashing, Folakemi Odedina. Mayo Clinic, Rochester, Minnesota, City of Hope, Duarte, California, Mayo Clinic, Jacksonville, Florida.

Despite notable progress in early detection, prevention, and treatment of prostate cancer within the United States, racial disparities are present very early in the patient journey of black men, starting with the shared decision-making process. The disproportionately higher number of black men diagnosed with prostate cancer also suggests that black men must also contend with the management of associated physiological and psychosocial symptoms. The survivorship care plan was designed to communicate critical information that cancer survivors and their health care advocates need as a guidebook for long term post treatment care, and improved survivorship. An associated systematic literature review conducted by our multidisciplinary investigative team revealed there was a severe underutilization of survivorship care plans within cancer survivorship care especially with black men. The considerable lack of utilization and/or tailoring of survivorship care plans may be a significant contributor to the worsening of health disparities in this population. Co-designing survivorship care plans with key stakeholders, specifically black survivors and their health care advocates, is imperative to ensure that the plan meets the needs and preferences that black men have for survivorship care. This presentation will discuss the steps the investigative team used to address the disparities in shared decision-making, and the subsequent underutilization of survivorship care plans. The investigative team utilized semi- structured interviews and focus group methodology to explore how they lived experiences of black male prostate cancer survivors are incorporated and addressed in the construction and contents of a culturally tailored survivorship care plan (CaP_SCP- Black Men). An evaluability assessment was conducted to determine whether implementation of the newly created survivorship care plan is feasible, appropriate, and addresses the specific needs of the population before full implementation. This presentation will discuss how this combination of approaches allowed the investigative team to understand how survivorship care plans affect the unique complexities of survivorship in black men and allows for the feasibility study of the implementation of a culturally relevant survivorship care plan (CaP_SCP- Black Men) in a population that bears the greatest burden nationally and globally.

A110 Results of a qualitative feasibility study to inform the design and development of a new longitudinal cancer cohort of black women. Jeuneviette E. Bontemps-Jones, Lauren E. McCullough, Lauren R. Teras, Elizabeth G. Kirkland, Alpa V. Patel. American Cancer Society, Atlanta, Georgia.

Black people have the highest death rate and shortest survival of any racial/ethnic group in the United States for most cancers. Despite having lower incidence rates of breast cancer, black women have a 41% higher mortality rate than white women. Diversity in research is necessary to lay the foundation for public health guidelines and clinical care practices that benefit all individuals, as well as specific groups. Black people have been underrepresented in research and while there have been efforts to increase diversity in research, these efforts have been largely unsuccessful. The purpose of this study was to gain insight into the motivating factors and potential barriers behind black women’s willingness to participate in research tailored to understanding their health as it relates to cancer. Findings from this feasibility study informed the development and design of a new cancer cohort of black women. We conducted a total of 6 focus groups, each having a convenience sample of 6–10 black women aged 25 to 65 years. These women were recruited through various community venues across geographic regions (n=38 total). Focus groups were conducted using an in-depth, semi-structured discussion guide which included topics such as participant perceptions and experiences with the healthcare system, perspectives on why structural racism and cancer disparities exist, and opportunities in research participation. Focus groups were recorded, transcribed, and key themes were coded separately by two team members. The major themes reported as factors that may facilitate research participation included: the belief that participation would help others and positively impact future generations, recruitment by a trusted messenger, having a research team with a history of research in this community, and the type of institution that sponsors the research. Some potential barriers included lack of knowledge about data and specimen access and use. Based on these findings, the initial design of a new cohort was developed. The cohort framework, including consent forms and data/specimen collection protocols, was then presented to a convenience sample of 10 women aged 25 to 55 years for quality assurance. This group provided assurance that the knowledge gained from the initial 6 focus groups had been appropriately and thoughtfully incorporated into our study design, recruitment strategies and materials, intended data collection tools, and follow-up strategies. This study provides supportive evidence and subsequent confirmation through a second separate group of women, that black women are willing and motivated to participate in research studies, particularly if the research helps others, is thoughtfully planned out to incorporate their personal and historical perspectives and engages trusted partners.

C014 Strengthening transdisciplinary teams through developmental evaluation: Learnings from a multi-year, multi-project initiative. Laura Pinsoneault, Tobi Cawthra, Alexis Krause, Kristen Gardner-Volle, Jenelle Elza, Kim Kinner, Melinda Stolley. Evaluation Plus, Waukesha, Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, American Cancer Society, Ashland, Wisconsin, American Cancer Society, Hobart, Wisconsin.

Cancer disparities are complex problems which require a deep understanding and strong collaboration from a broad set of perspectives across the academic and non-academic spectrum (community members, community-based organizations, policymakers) to identify sustainable solutions. The Community and Cancer Science Network (CCSN) initiative of the Medical College of Wisconsin Cancer Center is a transdisciplinary network focused on addressing statewide cancer disparities. CCSN grounds its approach in the principles of deep equity, systems-change, and the integration of biology to policy. CCSN currently includes multiple projects and more than 140 community and academic partners. Diverse transdisciplinary collaborations do not occur organically, often need facilitation and benefit from on-going assessment and support. To continually evaluate ways in which we can build and sustain strong teams and solutions, we utilize a developmental evaluation process leveraging the expertise of an external evaluation firm. Developmental evaluation supports social innovations by working with program leaders to focuses on learning and adaption. As CCSN has grown, developmental evaluation has allowed us to continually adapt how we build and guide our transdisciplinary teams. External developmental evaluators work with each project team as a cooperative partner and help guide the team leaders through understanding data needs, data collection, data analysis, and data interpretation. Our developmental evaluation began with journey mapping to understand the process and elements for successful leadership of a transdisciplinary team. This approach provided data allowing us to understand a pattern of certain pain points in collaborations and ways in which to prepare for and mitigate expected challenges. As the network has grown, we have utilized developmental evaluation to refine an annual partner survey and employ intermediate surveys (i.e., Right Now surveys) to assess team progress and openness to collaboration. Network mapping and stakeholder analysis have contributed to team formation helping team leaders consider new voices and perspectives. Further tools including before/after action reviews, situational analyses, and a readiness assessment were used to shape our understanding of successful transdisciplinary teams. We will show evidence of how these tools have positively impacted our ability to engage community and academic partners in authentic transdisciplinary collaborations over a four-year, and multi-project effort. Transdisciplinary collaboration involving community and academic partners offers great promise for innovative approaches to cancer disparities. These unique collaborations may need additional support and guidance. Developmental evaluation provides tools to allow leaders to adapt to the needs and changes within complex teams.

A086 Increasing the arm of research by finding and training key community stakeholders: The Mayo Clinic “Community Engagement in Research and Clinical Trial (CERCT)” curriculum phase 2. Jennifer M. Crook, Opeyemi Bolajoko, Barbara Greguson, Gwen Boe, Karen Young, Katrina Croghan, Folakemi Odedina1. Mayo Clinic, Jacksonville, Florida, Mayo Clinic, Rochester, Minnesota, Mayo Clinic, Rochester, Minnesota.

Background: Equitable representation in research remains a critical issue. Barriers to diversity in research have been identified across personal, provider, and health systems levels. To achieve true health equity, investigators must creatively collaborate with community stakeholders for increased education and partnership. The Mayo Clinic Community Engagement in Research and Clinical Trial (CERCT) curriculum was developed in 2022 to improve the inclusivity and diversity of frontline community-based health workers in research, including community health workers (CHWs), pharmacy technicians, health advocates, and citizen scientists. Aim: The CERCT curriculum was designed to empower and improve the skills necessary for engaging members of the communities about research and clinical trial (CT) participation. Aims for this project include beta pilot training of key community stakeholders in underserved minoritized communities, evaluating the efficacy of CERCT modules through increased recruitment into the Mayo Clinic Florida Community Research Registry; and increased diverse representation in research studies. Methods: This project will train community health advocate cohorts in educating the community on the importance and benefits of participating in research and CT and how to effectively communicate that information within their circles of influence both at work and where they live. Five community health advocate cohorts in Florida counties will be trained through 2-hour online modules, taken at their leisure. Results: Eight online module units will be utilized for beta training of CHWs, pharmacy technicians, health advocates and citizen scientists. Modules include explaining importance of biomedical research and CT; recognizing the different types of research and human participation studies; describing the importance/need of increased representation and inclusion; identifying how the safety, welfare, and well-being of participants are protected at every step in the research process; understanding the role of healthcare providers in research participation; learning communication strategies and tools to raise awareness of CT; examining at an in-depth level the informed consent process and conversation with potential participants; and learning to build trust and address common patient concerns and questions. Efficacy will be assessed via community enrollment in the Mayo Clinic Community Research Registry. Conclusion: Currently, community health workers and pharmacy technicians are an underexplored avenue for disseminating CT education and research inclusivity. The development and beta testing of a curricula specifically created for key community stakeholders who may or may not work in the healthcare or research fields seeks to empower those members with the education to inform their communities and increase representation in science. Designed for increasing education, dispelling common misperceptions, and an easy format, these modules are expected to increase the reach of research into historically underrepresented communities.

A054 Leveraging the power of hope leaders for enhancing diversity in clinical trials via a bi-directional cancer health information model. Joseph Dufraine, Yamile Molina, Jeanette Gonzalez, Maria Olivero, Theresa Mobley, Saria Lofton, Dedra Reis. University of Illinois Cancer Center, Chicago, Illinois.

Introduction: Despite increasing recognition of the need for diversity in clinical trials, participation from racial and ethnic minorities, particularly from low socioeconomic communities, remains dismally low. This underrepresentation hinders the generalizability of trial results and perpetuates health disparities. Low socioeconomic environments, characterized by economic instability, restricted healthcare access, food scarcity, and deficient educational resources, exacerbate these challenges. Residents of such communities often lean on “Hope Leaders” – trusted community figures – as a strategy to navigate through these adversities. Recognizing the pivotal role of these hope leaders, we advocate for a community-centered bi-directional cancer health information flow model, which positions these leaders at the core of community engagement endeavors. This model fosters a bi-directional health information exchange that synergizes Hope Leaders with the scientific community, thereby promoting improved health equity within clinical intervention research. The implementation of this model commences with a pre-engagement phase, a respectful approach where we familiarize ourselves with the community and its dynamics, without imposing any specific demands or expectations. Approach: The University of Illinois Cancer Center has had six community engagement specialists that have engaged with community members through numerous pre-engagement events that encompass activities ranging from mental health, cancer prevention, survivorship events, education, health fairs and community meetings. Based on these insights, we established a dedicated working group to identify hope leaders and to create targeted engagement strategies for specific areas of our catchment region through the bi-directional cancer health information flow model. These strategies are tailored to address the unique challenges and barriers these communities face regarding enrollment in cancer clinical trials. Additionally, the community-driven health communication model was implemented to identify hope leaders and engage them with cancer researchers as a part of our phase I activities for this model. Conclusion: This innovative approach aims to leverage the unique position of hope leaders in underserved communities to amplify community voices, improve engagement, and ultimately, increase minority representation in cancer clinical trials. The model provides a promising strategy to address the persistent disparity in clinical trial participation, facilitating more equitable and inclusive research outcome.

A057 Contact registry for health-related cancer research: Promoting inclusion in research. Ileana Guzman, Brooke Hensel, Carolina Aristizabal, Eduardo Ibarra, Rosa Barahona, Brandon Hazelton-Glenn, Diana Wilkie, Janice Krieger, Mariana C. Stern, Sandra Suther, Lourdes Baezconde-Garbanati, Fern Webb. University of Florida, Orlando, Florida, University of Southern California, Los Angeles, California, Florida A&M University, Tallahassee, Florida, University of Florida, Gainesville, Florida, University of Florida, Jacksonville, Florida.

Contact registries are an essential resource in recruiting and retaining research participants. They are often used to gather contact and demographic information such as a person’s mailing address, age, phone number, race and/or ethnicity, and health interests which help to determine their eligibility for future studies. Contact registries can play a key role in promoting research participation among underrepresented groups, and therefore aid in the elimination of cancer health disparities. The purpose of the Florida-California Cancer Research, Education, and Engagement (CaRE2) Health Equity Center Contact Registry was to create a database of black/African American and/or Hispanic/Latino/a participants who are interested in learning about future research projects conducted at one of the following CaRE2 institutions: the Florida Agricultural and Mechanical University (FAMU), the University of Florida (UF), and the
University of Southern California (USC). Our primary objective is to increase the number of persons aware of the conduct of cancer research, to ultimately increase the number of persons participating in cancer health-related research from African American and Hispanic/Latino communities in both Florida and California. The CaRE2 Contact Registry was implemented in August 2022 by the CaRE2 Community Outreach Core, one of the six (6) key cores within the CaRE2 Center. Recruitment consists of both in-person and online methods available in both Spanish and English and data storage through REDCap. For in-person enrollment a consent/authorization form and OPT IN survey are completed; meanwhile, our online recruitment requires an additional screening questionnaire. Eligibility for our registry requires that the participant resides in either California or Florida, must be 18+ years old, black/African American, and/or Hispanic/Latino/a. In addition to collecting contact and demographic information, participants are ab e to choose their research study preferences. For example, they can choose to participate in surveys, community forums, focus groups, a cancer advocacy training program, and/or to provide a hair, saliva, or blood sample. Upon survey completion, a compensation of a $10.00 Walmart gift card, either in a physical or electronic version, is provided to each participant. Our study team promotes the registry at local community events and through our center’s social media accounts and website (https://care2healthequitycenter.org/the-care2-contact-registry/). With a targeted goal of 2,000 participants, we currently have 509 at UF; of which, 440 are Black/African American and 69 Hispanic/Latino and have agreed to learn more about cancer research in their communities. In conclusion, we present information on our innovative recruitment efforts that can be beneficial in other community-based participatory research studies. We also share the challenges and barriers experienced when implementing this registry. It is of high importance to engage minorities in these types of registries for representation in these areas of cancer research.

A007 Expanding clinical trial awareness among Black communities through digital engagement. Eliza B. Cohn, Ryan Huu-Tuan Nguyen, Leslie Carnahan, Kauthar Salum, Neha Hippalgaonkar, Tigist Mersha, Ana Williams, Robbin Block, Kent Hoskins, Vida Henderson. Fred Hutchinson Cancer Center, Seattle, Washington, Department of Hematology Oncology University of Illinois of Chicago College of Medicine, Chicago, Illinois, University of Illinois Chicago, Chicago, Illinois, BlockBeta, Seattle, Washington.

Background: Black patients are less likely to be enrolled in clinical trials compared with white patients, resulting in reduced access to breakthrough treatments and limited understanding of treatment effect. Ineffective dissemination of cancer research, education, and interventions among the public contributes to cancer inequities. Dissemination rarely involves non-research audiences and end-users. We conducted community-engaged research through focus groups with black community members and family members of cancer survivors. Through these efforts, we are creating a culturally responsive public service announcement (PSA) video to increase clinical trial awareness among black audiences. Methods: We conducted five focus groups over two phases with 1) social support networks of black cancer survivors (n=20) and 2) black community members (n=30) to inform the PSA to be disseminated through media and public health outlets. A final focus group will be conducted to elicit video feedback after production. Phase 1 focus groups informed PSA content. Data was triangulated with qualitative data from black women with breast cancer, oncologists, clinical trial staff, and advocates from a concurrent study about clinical trial participation. Phase 2 focus groups sought feedback on video content prior to production. Content and thematic analyses identified themes and recommendations. Results: For Phases 1 and 2, we used maximum variation sampling to recruit black participants (n = 50) varied in age, geographic region, education, and gender. Phase 1 themes included: 1) clinical trial mistrust due to experiences of racism persists, but diminishes with younger respondents or those who participated in clinical trials; 2) clinical trial trust-building was associated with transparency from medical experts and information relayed by someone in the black community and from clinical trial participants; 3) invasive procedures impact views on risks and benefits of participation; 4) messages that are not coercive, but support decision- making are more credible; and 5) sharing the PSA on social media with links to primary resources was recommended. Phase 2 participants reported that the: 1) storyline and script were informative, culturally representative, realistic, and understandable; 2) participants saw themselves in the characters and family dynamics; 3) opening scene should be altered to avoid racial stereotypes; and 4) storyline elicited desire to pursue additional information before making a decision about participation. The script triggered discussion about factors impacting low clinical trial participation and ineffective information dissemination to black communities. The revised script integrated participant feedback: the video is under production. The PSA is planned to be aired on a national cable network. Conclusions: By eliciting and integrating feedback from black community members, we developed a culturally representative and responsive PSA that facilitates agency for decision making and information seeking about clinical trials that can be widely disseminated.

A056 Community scientist research advocacy program: Bridging cancer research and community advocacy. Brooke Hensel, Eduardo Ibarra, Carolina Aristizaba, Ileana Guzman1, Rosa Barahona, Brandon Hazelton-Glenn, Ji-Hyun Lee, Zhongyue Zhang,, Mariana C. Stern, Lourdes Baezconde-Garbanati, Sandra Suther, Fern Webb. University of Florida, Orlando, Florida, University of Southern California, Los Angeles, California, Florida A&M University, Tallahassee, Florida, University of Florida, Gainesville, FL, University of Florida, Jacksonville, Florida.

Community Scientist Research Advocacy (CSRA) programs are designed to connect researchers with community members, to effectively inform and involve the general population on clinical research. More programs like such are needing to be implemented into the community for better outcomes among cancer health disparities. The purpose of our study was to develop and evaluate a novel bi-coastal and bilingual program to inform, educate and empower community members to become cancer research advocates in Florida (FL) and California (CA). Our program was tailored for African American (AA) and Hispanic/Latino/a (H/L) adults. Primary objectives are to increase person power for cancer research advocacy and increase multi-directional communication between cancer advocates with cancer survivors, community members, academic scientists and policy makers. The CSRA program is a 13-week program implemented 100% virtual by the FL-CA Cancer Research, Education and Engagement (CaRE2) Health Equity Center, a bi-coastal partnership between the Florida A&M University, University of Florida, and University of Southern California where participants learned about cancers that disproportionately impact AA and H/L adults. Participants completed surveys at program start, midway, and end to assess knowledge gained and program evaluation, and a mentored advocacy project for community implementation. Five months after program end, we surveyed participants on impact and to provide support for their research advocacy. To date, a total of 26 adults have graduated from our program. We present data from the 2022 CSRA cohort (N = 20) that included participants from FL and CA, which are among the top five states in the U.S with the largest AA and H/L populations. Participants self-identified race, ethnicity, and gender were: 13 (68.4%) AA, 7 (26.3%) H/L, 90% female. This cohort had 90% program completion (N = 18) and 5 advocacy projects on breast cancer, lung cancer, pancreas cancer, and prostate cancer. Participant knowledge had a mean (SD) of 67.9 (7.9) at pre-survey and 71.4 (9.0) at post-survey, with a p-value of 0.2. Participants had a mean (SD) of 60.0 (14.6) at mid-survey and 68.2 (11.0) at post-survey, with a p-value of 0.13. We used a Likert scale to evaluate program expectations, which resulted in a mean (SD) of 94.0 (8.8) participants who ‘agreed’ that they were satisfied with the program at the start compared to a mean (SD) of 91.0 (12.9) of participants who ‘agreed’ that they were satisfied with the program at the end, with an overall p-value of 0.5. In conclusion, we present findings from a novel virtual CCS bi-coastal and bilingual training program tailored for AA and H/L adults that can foster multi-directional communication between cancer research advocates with multiple stakeholders to reduce cancer health disparities. We will further evaluate our program for 2023 cohort implementation.

C115 Framework for a community-based multiple myeloma screening program. Heather McKee Hurwitz, Kimberly Bell, Diana Basali, Raymond D. Jackson II, Jason Valent. Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio.

Purpose: We develop a framework for a community-based screening program for multiple myeloma (MM). MM is known to be twice as common in black/African American (B/AA) persons compared to white persons and B/AA patients have a higher risk of delay in initial treatment compared to white patients. Therefore, we developed a community-wide screening program for B/AA persons 50 years and older. As the first of these programs, we reveal an organizational framework that prioritizes engagement with key community partners who address barriers to cancer screening. Experimental Procedures: We expand organizational development knowledge about how to implement community-based MM screening and address barriers. The study uses an iterative and qualitative continuous improvement process. The study draws on literature review and multi-disciplinary team collaboration among clinicians, researchers, administrators, and the Cleveland Clinic Community Outreach Program (Cleveland Outreach). Data summary: Our framework includes three interrelated partners and each address barriers to MM screening: 1) Cleveland Clinic Cancer Center. The multi-disciplinary team designs an educational brochure, secures pilot grant funding, plans for insurance/financial assistance as needed, develops care algorithms, and evaluates the impact of the program. Cleveland Outreach, a department within the cancer center, uses the Harold Freeman model as its foundational approach, which includes patient navigators and community outreach managers who are culturally/linguistically matched to medically underserved communities. The cancer center addresses barriers including program implementation despite a lack of national screening guidelines, insurance/financial barriers, and patient navigation to address fears and health literacy. 2) Faith-based organizations. Church leaders committed to cancer prevention participate in Cleveland Outreach’s faith-based outreach model. Faith-based partners address barriers of trust and fear. Also, by providing space at churches for on-site screening blood draws, they address transportation barriers. 3) clinicians at federally qualified health centers (FQHC’s). Providers and nurses at FQHC’s receive a continuing medical education program about MM screening designed/funded by the cancer center. From within the community, providers notify medically underserved patients about the screening. With their primary care patient population, FQHC partners address barriers such as trust, health literacy, and fear of blood draws. They facilitate on site screening at FQHC’s and health fairs, which addresses transportation barriers. Conclusions: Given that there are no universal guidelines for MM screening, we develop a novel approach to early disease detection in B/AA patients. Our framework is a partnership between the cancer center, faith-based organizations, and FQHC’s. Collaboratively, we address barriers to screening including fear, trust, insurance/financial, health literacy, transportation, and patient navigation if abnormal results suggest the need for further testing.

A047 Increasing cancer-related community-engagement strategies among historically black colleges and universities and minority serving institutions. Rohan D. Jeremiah, Marcus Murray, Maisha Standifer, LeChaun Kendall, Carrie Wright, Candace Savonen, Jeff Leeks. University of Illinois Cancer Center, Chicago, Illinois, Project Brotherhood, Chicago, Illinois, Morehous School of Medicine, Satcher Health Leadership Institute, Atlanta, Georgia, 4Fred Hutchinson Cancer Center, Seattle, Washington.

Addressing cultural beliefs and barriers is imperative to successfully designing and implementing behavior change interventions to increase cancer screening and treatment among underserved communities. Community-based participatory research (CBPR) fosters proven strategies that reduce barriers to cancer screening in several diverse population groups. Citizen scientists are laypersons who do not have formal science training but receive training to engage in research efforts responsive to community needs. Project Brotherhood, a community-based health organization on Chicago’s southside, has developed a community engagement model known as the Murray Model. It specifically engages black men in improving their health status. One aspect is engaging black men as citizen scientists to address cancer disparities within their communities. Evidence shows that citizen scientists were better equipped to understand lung cancer risks and increased their advocacy for better health within their communities. In partnership with Project Brotherhood and the University of Illinois Cancer Center, the National Cancer Institute, Informatics Technology for Cancer Research (ITCR) Training Network (ITN) Program is scaling up the citizen scientist Train-the-Trainer program at historically black colleges and universities and minority-serving universities. The Train-the-Trainer ITCR citizen scientist program is partnering with the Morehouse School of Medicine to increase its community and academic capacities in the Atlanta metro area to address cancer disparities.

A034 How we learn from black TNBC patients to act for equitable and unbiased care. Virginia Leach, Jeanne Regante, Maimah Karmo, Lizzie Wittig. Tigerlily Foundation & University of Illinois at Urbana-Champaign, Urbana, Illinois, Tigerlily Foundation & Patient 3i LLC, Branford, Connecticut, Tigerlily Foundation, Stone Ridge, Virginia.

Background: Black women are at higher risk for early onset and increased breast cancer mortality, especially from the sub-type Triple-Negative Breast Cancer (TNBC), than their white peers. A patient experience survey has not been implemented or published for Black women diagnosed with TNBC. Tigerlily Foundation (TLF) conducted a TNBC survey of bIack women to understand the patient experience throughout the cancer continuum of care. Methods: The survey instrument received an IRB exception and included 40 questions organized by the following themes: demographics, self-detection/early assessment, screening to diagnosis, diagnosis to treatment, post treatment and palliative care/survivorship, emotional trauma and mental health, and trust/bias. Data collection occurred between December 2022 and January 2023. Two methodological approaches influenced this innovative study design: 1) a health literate and culturally sensitive approach and 2) a trusted outreach approach. The survey was sent to leaders of patient-based organizations who shared the TLF survey with their constituents. Results: All participants (N = 106) racially identified as black women diagnosed with TNBC. The age of participants ranged from 25 – 71. Participants were not always given information to manage their expectations before or after the screening process, as 38% reported they did not receive such information, while 45% reported they did. The number of times participants required diagnostic imaging ranged from only once (24%), two-three times (41%), four-five times (17%), or greater than six times (11%). Biopsies also varied among participants from one (25%), two-three times (40%), four-five times (15%), or greater than six times (8%). Biomarker testing was not equitably offered to all participants, as 30% reported they were not given the opportunity, while 48% were given the choice. While most participants reported a good understanding of their prognosis and treatment options (59%), other participants shared that the information they received could have been better (26%). Others stated they were given zero information to work with (15%). Many participants experienced a diagnosis change, and 57% were initially diagnosed with a different breast cancer subtype, while 24% were initially diagnosed with TNBC. Conclusions: Prospective implementation science is needed to ensure equitable care standards are sustainably provided to Black women. It is imperative to understand the cancer care continuum from the perspective of the patients, what they think of the care received and what education, resources and care they would have liked to receive before or upon diagnosis. Health equity is not achieved based on EHR, county-level beneficiary data, or SEER data alone. Gathering patient experience information is a factor in achieving health equity. TLF successfully reached Black TNBC patients to share their authentic experiences and provided a framework for other research institutions and patient advocacy groups to do the same.

A033 Use of a novel healthtech platform to record patient-reported needs in real time. Katherine Cornish, Mary Stober Murray, Maimah Karmo, Jeanne Regnante, Virginia Leach. Tigerlily Foundation, Minneapolis, Minnesota, Tigerlily Foundation, Princeton, New Jersey, Tigerlily Foundation, Stone Ridge, Virginia, Tigerlily Foundation & Patient 3i LLC, Branford, Connecticut, Tigerlily Foundation & University of Illinois at Urbana-Champaign, Urbana, Illinois.

Background: Financial toxicity refers to the challenges that a patient faces due to the high costs of medical care. BIPOC (black, indigenous, and people of color), rural, and other vulnerable populations often bear a disproportionate burden when diagnosed with a chronic disease. As a result, these populations often experience financial toxicity at higher rates. The estimated annual costs of health disparities in the U.S. are $1.24 trillion. Financial toxicity and logistical barriers that affect daily life, such as transportation, family care, rent, and home maintenance, can negatively affect a patient’s life. Many clinical trial sponsors and patient advocacy groups focus on providing support to patients around these barriers, but services are often generalized and provided in a ‘one-size-fits-all’ format, which may not be beneficial on an individual level for each patient. In 2023, together with health IT provider The WiTT Group, Tigerlily launched the innovative web-based Resources and Assistance for Support and Empowerment (RAISE) platform, which brings together the best of wedding registry, crowdsourcing, and digital payment concepts and tools to match patients with the non-clinical services they need in real time as they go through treatment. With RAISE, Tigerlily empowers Black women with breast cancer to specify needs in their registry in real time, delineated by the time and urgency of each need. Our research question is, “What is the relationship between patient informed financial and non-financial stressors and patient’s geographical location, age, cancer sub type and staging?” Methods: Tigerlily captured the “voice of the patient” using user-generated profiles and patient-identified needs on the RAISE platform. Patient-submitted data during the months of May through July 2023 was analyzed. Results: Patients (n=60) documented current financial and non-financial stressors and challenges, as well as other impacted areas of their daily life. Preliminary results indicate that financial costs associated with groceries, insurance copays, and out-of-pocket medication costs were the most requested needs. Additionally, patients reported rent/mortgage, groceries, and childcare as the most financially necessary needs. Conclusions: RAISE allows breast cancer patients from BIPOC, rural, and other vulnerable populations to specify their needs on an individual basis. The most urgent and frequent patient-reported needs were. This approach will be used to inform community-based organizations, advocacy partners, and healthcare providers about patient-reported needs in their communities in order to guide the development of support programs and services. Future research will compare the impact of meeting patient-reported needs on outcomes such as quality of life and the impact of patient-identified stressors.

A112 Approaches to addressing cancer mortality disparities in U.S. health organizations: Identifying key themes in collaborative grant projects. Emily C. Marlow, Kristen A. Wehling, Karla L. Wysocki, Dewayne Brumlow. American Cancer Society, Atlanta, Georgia, Pfizer Global Medical Grants, Manhattan, New York.

Background: Black men and women facing cancer diagnoses are more likely than white men and women to die from their disease despite similar or lower cancer incidence rates (American Cancer Society Cancer Facts & Figures for African American/Black People 2022-2024). The American Cancer Society (ACS), in partnership with Pfizer Global Medical Grants (Pfizer), provided grant funding and engagement support to 16 projects based in 12 U.S. states and the District of Columbia examining prostate or multi-site cancer disparities along the cancer care continuum. Post hoc interviews by ACS team members were conducted with researchers to identify main themes discovered during their project period. These findings were key takeaways to be utilized in future work related to cancer mortality disparity efforts. Methods: From April through June 2023, 16 grant-funded project leads were invited to participate in 30–45-minute qualitative virtual interviews. These semi-structured interviews included questions related to how projects addressed racial disparities in their communities, partnerships with stakeholder groups, and resources and educational materials created. The open-ended questions were adopted to allow for project leads to share their unique perspective and project details they deemed important to address in the cancer disparities research area. Interviews were audio recorded and transcribed for accuracy. Three independent coders read and extracted important quotes to identify common themes. Results: A total of 15 out of the 16 grant-funded project teams were interviewed, with one interview postponed to outside the study period. Various themes were identified among the project interviews, with most centered around interventions addressing health system on the patient- and provider- levels. The most common interventions and themes identified as ways to bridge the cancer mortality gap in black and white people include: creating relatable and culturally adaptive educational materials, assistance with transportation and communication barriers, prioritizing patient social needs, utilizing patient navigators to supplement patient support, addressing providers’ unconscious bias and patient mistrust, incorporating artificial intelligence to streamline patient care, and organizing community partnerships to expand the reach of potential patients and encourage visitation for cancer screenings. Conclusion: These post hoc interviews among grant funded projects highlighted important areas along the cancer care continuum that can be addressed and further studied as ways to decrease the cancer mortality gap between black and white people. The public-private grants partnership between ACS and Pfizer provided a unique opportunity to explore novel interventions in the field of cancer disparities. This meaningful work can be similarly extended to other health organizations to continue the work in communities across the U.S. in an effort to eliminate racial disparities in cancer outcomes.

B099 Association between obesity and mortality by race, ethnicity, and sex in the United States, 1999-2018. Emily C. Marlow, Blake Thomson, Ahmedin Jemal, Farhad Islami. American Cancer Society, Atlanta, Georgia, American Cancer Society, Palo Alto, California.

Background: The association between obesity and mortality risk is well established. This prospective cohort study will examine whether there are disparities in this across sex and race/ethnicity in the US and provide updated risk estimates for all-cause, cancer, and five other leading causes of death. Methods: We created a cohort of 282,602 never-smoking participants using the National Health Interview Survey (NHIS) linked to the National Death Index that follows mortality up to December 31, 2019. We considered participants aged 25-84 years at enrollment, with at least 2 years follow up, and the following race/ethnicity groups: non- Hispanic white [White], non-Hispanic black [Black], Hispanic, and other. Self-reported BMI values from NHIS were adjusted using the National Health and Nutrition Examination Survey objectively measured BMI averages by sex, race/ethnicity, and education. The adjusted BMI categories included 12 <18.5(underweight), 18.5-<25(healthy weight), 25-<30(overweight), 30- <40(obese), and 40-≤70(severely obese). Adjusted mortality rate ratios (RR) obtained by the Cox proportional hazard model using NHIS complex survey design compared individuals with healthy weight to those with lower or higher BMI by sex and race/ethnicity. Results: A total of 22,591 deaths occurred in this study period, of which 4,539 were cancer. In men and women, obesity and severe obesity were associated with higher risk of cancer mortality. Compared to men with healthy weight, the risk of cancer mortality was higher among individuals who were underweight (RR=1.95,95%CI=1.06-3.58), overweight (RR=1.03,95%CI=0.88-1.19), obese (RR=1.30,95%CI=1.11-1.53), and severely obese (RR=1.68,95%CI=1.21-2.32). Among women, the risk for cancer mortality was higher among individuals who were underweight (RR=1.18,95%CI=0.78-1.80), overweight (RR=1.06,95%CI=0.95-1.18), obese (RR=1.17,95%CI=1.04-1.32), and severely obese (RR=1.62,95%CI=1.35-1.93) compared to the risk for those with healthy weight. In general, similar patterns were observed in all-cause and leading causes of death evaluated in this study. Similarly, being underweight, obese, and severely obese, as compared to being healthy weight, was generally associated with all-cause and cause-specific mortality among white and Hispanic populations. However, obesity and severe obesity were not significantly associated with cancer mortality among black people likely due to sparse data. The magnitude of some mortality associations also differed by sex and race/ethnicity. For example, the association between obesity and all-cause mortality was stronger among Hispanic men (RR=1.64,95%CI=1.33-2.02) compared to Hispanic women (RR=1.10,95%CI=0.94-1.28). The all-cause RR for severe obesity among White females (RR=1.96,95%CI=1.78-2.17) was larger than among black females (RR=1.52,95%CI=1.31-1.76). Conclusions: Higher BMI was associated with higher risk of all-cause and leading causes of mortality by sex and race/ethnicity, emphasizing the importance of interventions to help reduce excess body weight and maintaining healthy body weight.

B140 Towards cancer health justice: Considerations in designing a US cohort of 100,000 black women. Lauren E. McCullough, Lauren R. Teras, Anusila Deka, Elizabeth G. Kirkland, Jeshondria McCray, Holly Vins, Jeuneviette E. Bontemps Jones, Alpa V. Patel. American Cancer Society, Atlanta, Georgia.

Background: Racism is a fundamental driver of health inequities, perpetuating systemic disadvantages that disproportionately impact marginalized communities. Structural racism affects multiple domains of an individual’s life, including housing, education, health, and employment. Recent studies have leveraged census data to examine the impact of racism — typically captured using area-level factors such as residential racial segregation and neighborhood socioeconomics — on health outcomes, including cancer. However, these studies often fail to capture the complex multidimensional mechanisms by which structural racism uniquely impacts minoritized groups and seldom consider facilitators of resilience, which may better inform interventions. Purpose: Large-scale contemporary cohort studies are needed to understand the drivers of social determinants of health and their potential impact on cancer. The American Cancer Society (ACS) has committed to establishing a US cohort of at least 100,000 black women to understand multi-level drivers of cancer development and outcomes. Approach: ACS investigators have implemented a culturally sensitive approach that recognizes and validates the experiences of Black women, actively centering them in the design process. Relying on the principles of accountability, rigor, transparency, and impact to guide decision making, the research team has addressed novel challenges around eligibility, recruitment, and retention. ACS investigators considered the mechanisms and frequency of engagement to ensure meaningful participation. They designed survey tools to assess known drivers of cancer and non- cancer outcomes but reflect an understanding of the interconnected systems of oppression that uniquely impact marginalized communities. The research team has also taken steps to address expectations around the collection of biospecimens, recognizing the importance of establishing trust and respecting individual choice. Outcomes: The study population will be comprised of black women between the ages of 25 and 55 years who reside in the District of Columbia or one of 20 US states. The ACS will partner with organizations primarily representing or serving the target population to identify interested participants. Study activities will be conducted through an online portal optimized for mobile use. Through the portal, interested individuals will complete an electronic eligibility survey, review the informed consent, and complete the 60-minute baseline survey. Follow-up questionnaires will be sent to participants twice per year for at least 30 years to track exposure and health outcomes and their lived experiences. Enrollment will take place in two pilot markets in Fall 2023 to test the feasibility of the recruitment, e-consent, and e- surveys with anticipated full-scale launch and biospecimen substudy in 2024. Conclusions: In designing a cohort of 100,000 black women, ACS investigators aim to amplify the VOICES of black women — honoring their lived experience and strengthening partnerships in the community for long-term health improvements.

C095 County-level disparities in lung cancer mortality rates by sex for non-Hispanic blacks and non-Hispanic whites residing in the United States. Shanada Monestime. GO2 for Lung Cancer, Washington, D.C.

Background: Lung cancer is the deadliest cancer in the United States and mortality rates are highest for non-Hispanic black (NHB) and non-Hispanic white (NHW) individuals compared to other racial groups. Additionally, lung cancer mortality rates are higher in men compared to women. However, county-level data for lung cancer mortality rates have not been studied in NHB and NHW populations stratified by sex. Further insight into county-level data disparity rates will provide stakeholders with tailoring and prioritizing community-based interventions to reduce lung cancer mortality disparities. Methods: Data from the 2015-2019 Centers for Disease Control and Prevention, United States Cancer Statistics were used to identify counties with age-adjusted lung cancer mortality rates for NHB and NHW males and females. Comparator groups were the general population for NHB and NHW, NHB vs. NHW females, and NHB vs. NHW males. Relative risk (RR) was used to determine the disparities in mortality rates between comparator groups in each county. A chi-square test was performed to identify the p-value between comparator groups. Results: Data were available for 336 counties across 40 states in the U.S. Overall, the majority of counties (N=172) demonstrated that NHBs had higher lung cancer mortality rates compared to NHWs with a mean RR of 1.24 (1.01-2.31). However, when stratified by sex, NHW females exhibited higher lung cancer mortality rates across the majority of counties (N=225) with a mean RR of 1.38 (1.01-2.7) compared to NHB females. North Carolina (N=25) and Texas (N=10) had the most counties experiencing disparities in lung cancer mortality rates between NHW and NHB females respectively. However, Dane County, Wisconsin had the highest disparity in mortality rates for NHB females compared to NHW females, RR:2.14 (p=0.001), and Middlesex County, Massachusetts had the highest disparity in mortality rates for NHW females compared to NHB females, RR:2.7 (p=0.002). NHB males exhibited higher lung cancer mortality rates across the majority of counties (N=230) with a mean RR of 1.34 (1.01-2.73) compared to NHW males. North Carolina had the most counties experiencing disparities in lung cancer mortality rates in NHW (N=13) and NHB (N=21) males. However, the District of Columbia had the highest disparity in mortality rates for NHB males compared to NHW males, RR: 2.73 (p=0.0001), and Petersburg County, Virginia had the highest disparity in mortality rates for NHW males compared to NHB males, RR:3.18 (p=<0.0001). Conclusion: Lung cancer mortality disparities are occurring throughout the United States for NHW and NHB females and males with the highest disparity in Middlesex County, Dane County, Petersburg County, and the District of Columbia respectively. However, consistent data highlighted a high prevalence of counties in North Carolina demonstrating lung cancer mortality disparities for all groups, except for NHB females. Future research and interventions are needed to understand the social and structural factors associated with mortality differences within these areas.

A026 Expanding access to oncology navigation in rural Appalachia with a volunteer support model. Bonny B. Morris, Charlotte Waugh, Adam Hege, Maggie Anderson, Woods Curry, Allison Benton, Ronny Bell, Chandylen Nightingale. 1American Cancer Society, Winston-Salem, North Carolina, Appalachian State University, Boone, North Carolina, Wake Forest University, Winston-Salem, North Carolina, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Wake Forest University School of Medicine, Winston-Salem, North Carolina.

Background: Despite the benefits of patient navigation as an evidence-based practice for reducing health disparities in underserved communities, widespread implementation has proved challenging. Cost often limits the number of navigators a cancer center can hire and thus their depth of coverage, resulting in high caseloads or limited availability, particularly in rural-serving clinics. Successful utilization of college student volunteers to expand capacity in health clinics has been previously reported yet has not been extended to support oncology navigation. We employed implementation science methodology to determine barriers, facilitators, and implementation strategies for patent navigation to be supported by student volunteers in a community cancer center serving rural Appalachia. Methods: Leveraging Context-Driven Co- Design (CD2), we conducted clinic observations and key informant co-design sessions with a user-centered design context assessment form previously developed by our team. Co-design sessions were audio-recorded and transcribed. CFIR guided data collection and thematic analysis with inductive coding to identify contextual barriers and facilitators to include in the translation table and implementation model. Co-design sessions prioritized contextual factors in the implementation model, intervention adaptations to optimize fit, and implementation strategies to address the remaining friction, while iteratively refining the model. Results: We observed the radiation oncology and hematology oncology clinics in an Appalachian community cancer center. We conducted seven key informant interviews with an oncologist, a cancer center director, a radiation oncology nurse, a hematology oncology nurse, a social worker, a financial navigator, and a patient. Facilitators included need (high caseload, patient population, transportation and information barriers), mission alignment (maximize patient support), and culture (high team cohesion). Barriers included available resources (physical space, time), work infrastructure (qualifications, maintaining clinic efficiency, role delineation), and access to knowledge and information (guidance and training). Implementation strategies selected were a rigorous volunteer screening process, training sessions designed and executed by volunteer organization leadership, a comprehensive training curriculum, and consideration of staff limitations (physical space, time, caseload, work infrastructure). Conclusion: The final proposed implementation model utilizes student volunteers to support oncology navigation adapted to contextual factors at a community cancer center serving rural Appalachia. This model extends navigation services in underserved, rural communities and can be leveraged in other similar oncology settings to support health equity. The American Cancer Society Community Access to Resources, Education, and Support (ACS CARES program) will be launching student volunteers to support navigation in a four-site pilot study in September 2023 utilizing the findings from this study to enhance implementation.

A049 Community partnership to empower Black men to drive research to identify barriers to prostate cancer early detection and equitable care. Jenney R. Lee, Dante’ Morehead, Ben Young, Victor Tolbert, John Masambe, Garrett Britt, Lars Neuenschwander, Kyle Schuppe, Richard Pelman, Debi Johnson, Sung Min Kim, Erika M. Wolff, John L. Gore, Yaw A. Nyame. University of Washington, Seattle, Washington, Black and African-descent Collaborative for Prostate Cancer Action, Seattle, Washington, Washington State University, Spokane, Washington, Washington State University, Spokane, Washington, Washington State Urology Society, Mill Creek, Washington.

Introduction: Black men have a two-fold higher rate of prostate cancer death in the US compared with other men, the largest racial inequity in US cancer-related deaths. Annual PSA testing among black men starting at age 45 years would reduce mortality compared with current screening practices. However, the US Preventive Service Task Force (USPSTF) guidelines do not make screening recommendations specifically for black men. Black men comprised only 0-3% of practice-informing PSA screening trial cohorts. Given the burden of prostate cancer among Black men, capacity must be built to empower black men and their communities to develop and execute clinical trials that may provide guidance on early detection strategies. Methods: We conducted semi-structured interviews to examine prostate cancer screening access among black men in the Pacific Northwest, and we surveyed primary care physicians (PCPs) and urologists in the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region to assess knowledge, attitudes, and practices about prostate cancer screening. Interviews were recorded and transcribed; consensus coding and thematic analysis were used to identify structural barriers associated with screening access. Anonymous online surveys were distributed to physicians via email using REDCap. Results: 29 men participated in semi-structured interviews. We identified three equity-related barriers related to prostate cancer screening access: (1) lack of information on the benefits and harms of prostate cancer screening, (2) lack of PCP knowledge about prostate cancer disparities confronted by black men, and (3) lack of trusted relationships with PCPs to support shared decision-making about prostate cancer screening. 32 urologists and 31 PCPs completed the survey. Nearly all urologists and PCPs were aware of the 2018 USPSTF guidelines regarding PSA testing (93.8% and 96.7%, respectively). 75% of urologists and 6.5% of PCPs agreed that PSA testing can significantly reduce prostate cancer mortality. Conclusion: Findings from the survey support the perception reported by interviewees that there is variation in knowledge and support for prostate cancer screening for early detection of prostate cancer among black men. Our combined findings further demonstrate that (1) black men have unique needs around early detection of prostate cancer and (2) patient partnerships can identify these areas of need and best inform patient-centered design of practice-changing research studies. Future directions: With funding from the Patient Centered Outcomes Research Institute we will apply these findings by (1) building engagement and research capacity among a cohort of black men with a history of prostate cancer and their advocates, (2) identifying community derived research priorities around the early detection of prostate cancer in black men, and (3) developing a research agenda to inform future large, patient-centered, comparative effectiveness clinical trials in early detection of prostate cancer in black men.

A014 Connecting with Black patients through targeted, breast cancer messaging in the clinic setting. Nikki Hopewell, Brady Kazar, Michelle Strong, Krissa Smith. Susan G. Komen, Dallas, Texas, 2iCAD, Nashua, New Hampshire.

Background: While overall breast cancer incidence among black women is lower than among white women, black women are, on average, about 40 percent more likely to die of the disease as compared to white women. And the incidence rates are higher among black women under age 40 (where incidence is the number of new cases that develop in a specific time period). Black women experience higher rates of death from breast cancer due to a combination of factors, including barriers to early diagnosis, the aggressive nature of certain breast cancers that are more prevalent in black women (Triple Negative Breast Cancer and Inflammatory Breast Cancer, for example), and a lack of quality care. One of the key findings from Komen’s report ‘Closing the Gap: A Roadmap to Save the Lives of Black Women in America’ (2021) indicated a need for better education and resources for patients to support health decisions. Specifically, qualitative data from focus groups across 10 cities with significant disparities in breast cancer outcomes showed information was needed about breast cancer screening guidelines and family health history in the community to identify high-risk families. Hypothesis: To determine if targeted, patient-faced educational messages in point-of-care settings would connect with Black patients and educate them on breast cancer resources provided by Susan G. Komen. Our efforts focused particularly in cities with the greatest breast cancer disparities (Atlanta, GA; Chicago, IL; Dallas, TX; Houston, TX; Los Angeles, CA; Memphis, TN; Philadelphia, PA; St. Louis, MO; Tidewater, VA; Washington, DC). Methods: In 11 focus cities, select educational messaging over a six-month period appeared through static digital content in patient exam rooms featuring black imagery and patient-empowering breast cancer resources content. The 20-second reels appeared every 15-20 minutes in 471 primary care and OB/GYN offices/2,336 exam rooms. Patients in these offices responded (n=315) through an online survey to share demographic information including gender and ethnicity and to identify how aware they were of black women’s risk of breast cancer mortality, that resource programs exist to support breast health including those offered by Susan G. Komen and that Komen has a program aimed at addressing this disparity within the black community. Results: By sharing educational messaging directly to patients in the clinic, significant awareness was achieved. Those who responded to the survey included 38% black women. The targeted messaging campaign reached the intended audience and connected black patients with additional resources to take action on their breast health. In particular, increased awareness of specific interventions was achieved. In future efforts to empower black women and improve outcomes, direct, culturally tailored education presented in the clinic setting may be a useful tool and lead to better utilization of key resource programs and overall improved health education.

A029 LGBTQ+ health navigation panel: Discussing barriers and facilitators in navigation to services for immigrant and non-immigrant LGBTQ+ community members in New York City area. Alexandr Trifonov, Kevin Moore, Megan C. Haseltine1, Jason Domogauer. NYU Langone Health – Perlmutter Cancer Center, New York, New York, NYU Langone Health, New York, New York.

Background: Patient navigation plays a crucial role both in patient care management and overcoming barriers to care. Navigating the complexities of US healthcare is difficult for everyone, including individuals who are native to the US as well as newly arrived immigrants and refugees from across the world. The LGBTQ+ community is greatly affected by a multitude of health disparities. Discrimination, stigma, bias, and prejudice towards the LGBTQ+ community contribute to those health disparities, which makes the role of LGBTQ+ health navigation even more essential. Patient advocacy and support in finding proficient clinical and social services is the core of LGBTQ+ patient navigation. The authors of this abstract will create a discussion-based panel to share experiences and tailored approaches that have successfully helped in navigating LGBTQ+ patients, addressing social determinants of health, creating inclusive environments, and contributing to LGBTQ+ proficient care. Methods: LGBTQ+ Health Navigation Panel will consist of several LGBTQ+ health advocates, navigators, and/or policymakers from healthcare and community-based institutions from across New York City area. They will participate in a discussion-based session model, which will be moderated by one of the authors of this abstract. Discussion: This LGBTQ+ patient navigation panel will focus on discussing healthcare services and navigation support for immigrant and non-immigrant LGBTQ+ community members in the New York City area. Services that we would focus on will be physical, mental, and social health, as well as patient advocacy and community education. In addition, a significant portion of our discussion will include topics of cancer prevention, screening, diagnosis, treatment, and survivorship in the LGBTQ+ community.

A030 Identifying LGBTQ+-related barriers and gaps in patient and workplace environments: An LGBTQ+ environmental needs assessment at Perlmutter Cancer Center. Alexandr Trifonov, Rachel Monahan, Megan C. Haseltine, Kevin Moore, Gwendolyn P. Quinn, Rachel Nelson, Abraham Chachoua, Jason Domogauer. NYU Langone Health – Perlmutter Cancer Center, New York, New York, NYU Langone Health, New York, New York.

Background: The LGBTQ+ community faces disproportionately higher cancer-related health disparities compared to the general population. Lack of access, knowledge, and cultural attitudes are known factors attributing to lower rates of receiving cancer-preventative services, as well as higher rates of later-stage cancer diagnoses. Many factors contribute to these disparities, including finding a trusted provider, poor visual representation at clinics, missing sexual orientation and gender identity (SOGI) data, and negative patient experiences. To address these issues and to promote equitable care it is important to identify gaps and barriers that present in patient and healthcare staff environments. The LGBTQ+ Staff Task Force (STF) at NYU Langone Health Perlmutter Cancer Center (PCC) will utilize the Exploration, Planning, Implementation, Sustainment (EPIS) framework to address these inequities. Methods: As part of the “Exploratory” phase, the STF will deploy an environmental needs assessment survey, to evaluate patient and employee areas. The assessment includes the following LGBTQ+ domains to evaluate the environments: policy; visualization and safety; knowledge and awareness education; complaint and feedback reporting; workplace inclusions and non-discrimination; resources. The survey will be administered to all clinical and non-clinical departments of PCC and will be completed by STF members from their respective departments and by managers or supervisors from each department location. Surveys will be submitted electronically via REDCap Data will be analyzed by the research team and discussed in small focus groups. Discussion: The LGBTQ+ Needs Assessment will be carried out across all PCC departments and locations within an 8-week period between May and July 2023. The findings from utilizing the EPIS framework will enable the identification of gaps and barriers to inclusive patient care and evaluate the efficacy of current processes and resources in place for LGBTQ+ patients and employees. Findings will inform strategies and planning to decrease identified factors impacting access to equitable healthcare.

A032 Collaborative work groups – authentic community collaboration to reduce Wisconsin’s breast and lung cancer disparities. Staci Young, David Frazer, Tim Meister, Tobi Cawthra, Laura Pinsoneault, Jada Proctor, Kailey Taebel, Felicia Fairfield, Claire Piehowski, Melinda Stolley. Medical College of Wisconsin, Milwaukee, Wisconsin, Center for Urban Population Health, Milwaukee, Wisconsin, Evaluation Plus, Waukesha, Wisconsin, YWCA Southeast Wisconsin, Milwaukee, Wisconsin, Wisconsin Women’s Health Foundation, Milwaukee, Wisconsin.

Authentic community collaboration creates space for a deeper understanding between researchers and community partners and is critical to solving cancer disparities. Collaborative Work Groups (CWG), a program of the Community Cancer Science Network (CCSN) at the Medical College of Wisconsin Cancer Center, brings researchers and community partners in collaboration to address breast and lung cancer disparities statewide using a transdisciplinary approach to understand cancer disparities and create solutions that are grounded in three principles: deep equity, systems thinking, and an integration of biology-to-policy perspectives. CWGs have been actively engaged since the Spring of 2022 in several Wisconsin communities working to uncover the complex factors that drive breast and lung cancer disparities at the local level. Guided by a human-centered design process, the groups are defining the local scope of the problem, integrating diverse perspectives into root cause analyses, and designing solutions that will target the disparities. As part of data gathering to inform community-level priorities, three CWGs collaborated to host a World Café event, a methodology for facilitating a large group dialogue, focused on breast cancer disparities. The CWGs invited community members, breast cancer survivors and co-survivors, health care providers, allied health professionals, and breast cancer advocacy organizations from three different counties to attend. Approximately 80 attendees gathered at small tables centered around various topics associated with breast cancer disparities including mammography access and process, social factors, co-morbidities, screening, insurance, and treatment. At each table, attendees discussed the topic and recorded their thoughts on a large notepad, and after 20 minutes switched to a different topic table and added on to previous contributions. Following the three rounds, a representative of each table reported the findings to the entire group. A graphic recorder captured the discussion, table notes were preserved, and attendees provided feedback on the meeting. Open coding validated the graphic recorder. Results of the World Café provided CWGs with data on community priorities. The meeting demonstrated two key values of the CWG: reliance on transdisciplinary relationships to nurture collaboration and the prioritization of building capacity with the community to lead local efforts to improve health outcomes. This dynamic was exemplified as staff of local community organizations were involved at every level of the event, including conceptualization, planning, facilitation, and evaluation. A World Café event is an effective methodology for collecting robust data on solutions for multi-county efforts. CWGs can contribute to eliminating cancer disparities in communities through a human centered design process that integrates diverse sectors with knowledge of biology, behavior, and the socio-cultural and physical environments, and creates an equitable voice for all participants to contribute to designing viable solutions.