Selected Current Grants and Contracts, 2008-2009

Grants and Contracts

This program’s members’ active portfolio of grants and contracts highlight several essential themes that characterize the future research interests and priorities of the Program, including:

a) reducing cancer-related disparities in the Rocky Mountain Region and beyond, with a particular focus on Hispanics and African Americans;

b) cancer survivorship and patient navigation programs as a high priority area of research, including the implementation of two new clinical programs for cancer survivors,

c) a particular focus on promoting cancer screening among high risk populations,

d) tobacco control research,

e) continuing our highly productive collaboration with the NCI’s CIS in health communications research, and

f) conducting intervention research that has significant potential for dissemination as usual service programs, both regionally and nationally.

What follows are brief descriptions of thirteen of these grant and contract awards.

The LIVESTRONG Survivorship Center of Excellence (Dr. Alison Jones, Principal Investigator):

Funded by the Lance Armstrong Foundation in 2006, this five year grant established a LIVESTRONG Survivorship Center of Excellence at UCCC.

This Center is serving as the focal point for coordinating and expanding all cancer patient and survivor support services at UCCC, as well as expanding cancer patient and survivor support services at three community-based centers in Colorado (i.e., Denver Health Medical Center, St Mary-Corwin Medical Center in Pueblo, Colorado, and St. Mary’s Medical Center in Grand Junction, Colorado).

Included among the support services that are being enhanced or expanded as part of this Center are on-site patient and survivor educational programs and workshops, dedicated Cancer Resource Centers at each collaborating institution (library of print materials with Intranet access to online resources), proactive telephone outreach and counseling to cancer patients and survivors, and continuing medical education seminars and programs in cancer survivorship offered to medical and other professional staff (especially at the three community-based centers).

In addition, a new transition clinic for adult survivors of childhood cancer was launched at UCCC in 2008 in collaboration with The Children’s Hospital (Denver), and a similar clinic for survivors of adult cancer was launched in 2009 for survivors of adult cancer. Both clinics are using a one-visit consultative model.

Cancer Information Service Research Consortium (Dr. Al Marcus, Principal Investigator):

Funded as a NCI program project grant in collaboration with NCI’s Cancer Information Service (CIS), three interrelated component projects are testing a state-of-the-science web-based multimedia program for:

• newly diagnosed prostate cancer patients (Project 1),
• newly diagnosed breast cancer patients (Project 2)
• and breast cancer patients completing their primary treatment for breast cancer (Project 3).

All program participants are being recruited from the CIS telephone service at the end of their usual service call to the CIS. A second intervention that is being tested for efficacy involves Information Specialists from the CIS making a scheduled outcall to program participants (Project 3 only).

Major outcomes for program evaluation include treatment decision-making, cancer-specific distress and depression, and cancer-related quality of life.

This program project, which was funded in 2006, represents the third such program project conducted in collaboration with the CIS. Collaborating institutions (with the UCCC) include the Fox Chase Cancer Center, the Jonsson Comprehensive Cancer Center at UCLA and Mount Sinai Medical Center.

Understanding and Improving Breast Cancer Survivorship in Latinas (Dr. Tim Byers, Principal Investigator):

In this longitudinal cohort study, approximately 1,000 participants in the Southwest Hormone, Insulin, Nutrition and Exercise (SHINE) Women’s Health Study have been re-interviewed.

The sample includes about 275 Hispanic and non-Hispanic White breast cancer survivors (cases), and a similar number of Hispanic and non-Hispanic White controls. Assessments that have been added to the original SHINE cohort study include diet, physical activity, quality of life, and health care system interactions.

When completed, this will be one of the largest studies of breast cancer survivorship among Hispanics in this country.

Patient Navigator Research Program (Dr. Peter Raich, Principal Investigator):

Funded in response to RFA CA-05-019, this randomized trial is testing an innovative patient navigation program at Denver Health Medical Center, targeting patients from the point of an abnormal screening test to treatment for breast, colorectal and prostate cancers. Innovative features of this patient navigation program include:

a) building upon an existing on-site and community-based patient navigation program involving lay health workers (i.e., Community Voices),

b) combining this program with a proactive telephone counseling service, and

c) integrating both of these program components within a large public-supported medical center, where a large percentage of eligible patients will be Hispanic and underserved.

Major outcomes for program evaluation will include accelerating the time between an abnormal screening test and diagnostic follow-up, on-set of therapy (for cancer patients), adherence to treatment and completion of treatment, as well as improving patient-reported outcomes (e.g., self-efficacy, satisfaction, psychosocial outcomes).

Metro Denver Black Church Initiative (Dr. Al Marcus, Principal Investigator):

Funded by the National Center for Minority Health and Health Disparities, this project involves implementing a program of community-based participatory research to promote diet, nutrition, physical activity and cancer screening among African Americans living in Northeast Denver.

The major community partner in this effort is the Center for African American Health, which has formed a consortium consisting of 35-40 primarily African American churches in Northeast Denver. A two-arm randomized pilot study is being implemented involving church members from six churches (three churches per arm), where the church is providing the venue for the intervention.

Outcome measures include changes in BMI, blood pressure, physical fitness (step test) and self-reported cancer screening. It is anticipated that this pilot study will evolve into a larger efficacy trial.

The Colorado Colorectal Screening Program (Dr. Tim Byers, Principal Investigator):

In September, 2006, the Colorado Colorectal Screening Program received a $3 million grant to provide colon cancer screening for uninsured residents of Colorado. The funding for this initiative comes from the tax increase on tobacco products in Colorado.

This grant was subsequently renewed in July, 2008 for another $4.5 million. This landmark initiative, which could provide a model program for the nation, is supporting colorectal cancer screening across all community clinics in Colorado, targeting patients who are uninsured and 250% below the Federal poverty level.

Eligible patients are being screened by sigmoidoscopy or colonoscopy, with the long-range goal of screening 12,500 Coloradans by 2010. Accompanying this screening outreach program is an awareness and promotion campaign to encourage all age-appropriate residents to seek colorectal cancer screening.

Psychoeducational Intervention for BMT Caregivers (Dr. Mark Laudenslager, Principle Investigator):

Funded by the NCI in 2008 in response to PA-07-046 (“Research on Mind-Body Interactions and Health”), a two-arm randomized trial will be conducted comparing usual care vs. a stress management and psychoeducational intervention that will target the caregivers of patients receiving allogeneic blood and marrow transplants.

Outcome measures will include caregiver health, immune and endocrine markers, physical activity and sleep characteristics, as well as stress and mood disturbance.

Smoking Cessation Navigation Pilot Study (Dr. Arnold Levinson, Principal Investigator):

Funded by the NCI this year as a R21, this pilot study will test for feasibility the use of a smoking cessation navigator to increase initiation and completion of proven smoking cessation strategies (e.g., nicotine replacement therapy, quit line coaching), and biochemically validated abstinence rates.

The main target group will be low income smokers. Navigation cost data will also be collected and analyzed pursuant to a future randomized trial.

Promoting Breast Cancer Screening in Women Who Survived Childhood Cancer (Dr. Kevin Oeffinger, Principal Investigator):

Also funded this year as a R01, this five year randomized trial will test for efficacy a telephone counseling intervention to promote screening mammography. The target group will be young women (ages 25-39) who are survivors of childhood cancer and were treated with chest radiation.

The sample will be recruited from the Childhood Cancer Survivor Study cohort.

Dr. Oeffinger is affiliated with Memorial Sloan-Kettering Cancer Center (MSKCC). Dr. Al Marcus and colleagues from UCCC will develop and implement the telephone counseling intervention via a subcontract from MSKCC.

Colorado Front Range Community Network Project (CO-CNP) (Dr. Paula Espinoza, Principal Investigator):

Funded by the NCI in 2005, the goal of the CO-CNP is to reduce cancer health disparities among Colorado Front Range Latinos. CO-CNP includes a pilot project program, a junior investigator training program, a cancer education program and an undergraduate education research opportunity program.

CO-CNP recently funded three pilot projects as follows:

• “Developing a Navigation System for Latinos with Lung Cancer and Head and Neck Cancers” (Dr. Evelinn Borrayo, PI);
• “Formative Research on Latinos and Leaders on HPV Vaccine Acceptance and Promotion” (Ms. Patricia Valverde, PI), and
• “Targeting Tobacco Cessation Intervention for Latino/as with Depression” (Dr. Jeanette Waxmonsky, PI).

The CO-CNP comes up for competitive renewal in 2010.

Promoting Colonoscopic Screening Among High Risk Families (Dr. Dennis Ahnen, Principal Investigator):

Funded by the NCI in 2005, this large-scale randomized trial is testing a telephone counseling intervention to promote colonoscopies among families at high risk for colorectal cancer.

This multisite randomized trial recruited high risk family members from the NCI-funded Cancer Genetics Network and the Collaborative Family Registry for Colorectal Cancer Studies. Follow-up occurred at 6, 12 and 24 months post-enrollment.

This study is now in the analytic phase.

The Colorado Prevention and Control Research Network (CPRCN) (Dr. Betsy Risendal, Principal Investigator):

Recently funded (2009) by the CDC, the goal of the CPRCN is to effectively translate evidence-based health promotion interventions to providers and the community to improve cancer survivorship and reduce health disparities in cancer outcomes.

Among the high priority areas for dissemination, evaluation and education are evidence-based programs in diet, nutrition, weight management and physical activity for cancer survivors.

Quality of Life and Health Behavior in Long-Term Colon Cancer Survivors (D. Betsy Risendal, Principal Investigator):

Funded by the ACS in 2009, this longitudinal cohort study will re-interview by telephone 500 probands and 500 non-cancer controls from the NCI-funded Colon Cancer Family Registry who were initially enrolled in 1998-2003.

Among the endpoints that will be compared in this study (cases vs. controls) will be quality of life, mood disturbance, cancer-specific distress, fatigue, as well as diet, nutrition and physical activity practices.