Cancer Prevention and Control Research Network (CPCRN)
From 2015-2019, Case Western Reserve University was one of eight funded research institutions in the Cancer Prevention and Control Research Network (CPCRN). The CPCRN is a national network of academic, public health, and community partners who work together to reduce the burden of cancer, especially among those disproportionately affected. Its members conduct community-based participatory cancer research across its eight networks, crossing academic affiliations and geographic boundaries. The CPCRN is a thematic research network of the Prevention Research Centers (PRCs), which is the Centers for Disease Control’s flagship program for prevention and controlling chronic diseases.
Grant Objectives & Aims:
The overall objectives of the grant were as follows:
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- Engage in cross-center collaborative projects; conducting research and disseminating findings.
- Implement and evaluate an Ask-Advise-Connect intervention to facilitate a closed loop e-referral to the state Quitline.
- Establish an evidence activation team and implement analysis of existing data and PDSA cycles to inform policy and practice.
In contributing to the national CPCRN, the aims of the grant were as follows:
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- Provide cancer prevention content and methods expertise and collaborative leadership to the CPCRN, thereby advancing the mission to accelerate the adoption and implementation of evidence-based cancer prevention approaches in communities.
- Engage public health and academic partners to use local data to identify and address gaps in dissemination and implementation of evidence-based cancer prevention and control strategies especially for tobacco, and colon and breast cancer to promote health equity.
- Conduct a core project designed to increase community health clinic use of evidence-based tobacco cessation strategies (Ask-Advise-Connect and e-Referral to the state Quitline) by establishing, implementing and evaluating systems approaches and by disseminating findings and tools through regional and state collaboratives.
Partnership & Collaborations
Grant Year 1-4 Partnerships:
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Ohio Department of Health, the County Board of Health, MetroHealth System and providers of the Ohio 2-1-1 Quitline.
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Community coalitions: Cuyahoga County Tobacco Coalition, Minority Health Alliance, African American Outreach Committee for the Hospice of the Western Reserve, and Colon Cancer Coalition for the American Cancer Society.
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These partnerships provided feedback on the revision of the Ask-Advise-Connect model that was implemented in primary care settings. The partnerships also assisted in networking opportunities to implement the project within the various health systems.
Grant Year 5 Partnerships:
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Counter Tools: A partnership was developed with Counter Tools to implement a store audit tool in order to examine the tobacco retail environment in Cleveland, Ohio.
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The Breathe Free Committee consisting of partners from the Cleveland Department of Public Health, American Lung Association, American Heart Association, University Hospitals, MetroHealth, Cleveland Clinic, Metro Health hospital system, the local public school system, and community members
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The Breathe Free Committee acted as community advisors on various CPCRN related projects. Dr. Erika Trapl, the CPCRN Principal Investigator in year 5 of the SIP, was the chair of the committee.
Timeline & History:
2015-2018:
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- Years 1-4 were focused on implementing the Ask-Advise-Connect model into primary care clinics within FQHCs, and developing a new function in the Electronic Health Record system for health providers to document smoking history and referrals to smoking cessation services through the 2-1-1 Quitline. The aim of the project was to increase smoking cessation uptake among populations served by FQHCs.
- The AAC model was pilot tested and revisions were made to the process based on feedback from key stakeholders in the community. The AAC model was implemented in ten primary care practice sites. Healthcare providers were trained on using the AAC model, referring patients to the 2-1-1 Quitline for smoking cessation services, and documenting referrals in the EHR. Lessons learned were taken from evaluating the implementation of the AAC model in two primary care clinical settings.
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2018-2019
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- Upon change of the PI and Project Director in year 5, CWRU continued to focus on smoking cessation services in FQHCs.
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- A secondary analysis was conducted using patient level data from FQHCs nationwide, and recommendations were provided on the best practices for supporting low-income patients in their desire to quit smoking. Recommendations included the need for better integration of cessation services into routine clinical care and tailored treatment for patients interested in quitting smoking.
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- Research in year 5 also examined the tobacco retail environment in Cleveland. A partnership was developed with Counter Tools, a non-profit organization that created a tool to conduct store audits in order to assess the tobacco retail environment.
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- Store audits were conducted in the Cleveland area to collect data on the availability of tobacco products both flavored and unflavored, tobacco product placement, tobacco product pricing, and tobacco advertisements displayed in stores.
- The store audit findings were used to educate policymakers on tobacco accessibility particularly in regards to youth in the community.
- The store audit findings also played a significant role in the Tobacco 21 legislation.
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- A database of tobacco licensed retailers provided by Counter Tools became the foundation from which the city of Cleveland would be able to conduct compliance checks at various stores to ensure that youth under 21 years old are not able to purchase tobacco products.
- Upon change of the PI and Project Director in year 5, CWRU continued to focus on smoking cessation services in FQHCs.
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- Other work coming from the last year, CWRU was a collaborative investigative study with CPCRN partners. The study examined ways to improve patient navigator services in rural cancer facilities. The from these studies can be used to inform cancer care facilities, policy makers and community members on gaps in access to cancer care among rural populations and provide recommendations on the role of patient navigators in filling these gaps in cancer care.
Dissemination
Counter Tools
In this work, a partnership was formed with Counter Tools, a non-profit organization that developed a tool to conduct store audits to assess the tobacco retail environment by examining tobacco availability, accessibility and product placement within stores. The store audits were conducted by community members and students at Case Western Reserve University. Community members were involved in the store audits collecting data as well as a debriefing afterwards to discuss the impact of the findings. The findings were disseminated through a community advisory group consisting of key stakeholders from the Cleveland area.
