COMMUNITY-BASED RESEARCH to Address African American and White DISPARITIES IN BREAST CANCER Mortality

Background: Cancer disparities exist by race/ethnicity, gender, age, sexual orientation, socioeconomic status, and geography and can occur in screening, incidence, mortality, survivorship, and treatment. To date, disparities by race/ethnicity have received the most attention. Alarmingly, the gap between race/ethnic groups continues to increase through time. Although cancer mortality decreased between 1975 and 2004 for the U.S. population as a whole, for example, significant African-American and white gaps persist for both women and men. Although health disparities have received much attention, little progress has been made in developing interventions to reduce them. These interventions are crucial for social workers attempting to provide services for persons with cancer. In a meta-analysis of interventions developed to reduce racial/ethnic disparities, Chin et al. conclude that too few interventions have been launched based on rigorous empirical studies, and that “multi-factorial, culturally-tailored interventions that target different causes of disparities hold the most promise (2007, p. 2).” Culturally-tailored interventions can only be achieved when academic researchers draw upon the knowledge and resources of communities vulnerable to adverse health conditions. Community-based participatory research (CBPR) holds great promise in achieving this goal. Method: This presentation will focus on the long-term, multi-level CBPR approach employed since 2003 in the NIH-funded, social work-led Center for Interdisciplinary Health Disparities Research (CIHDR), in which investigators from a variety of disciplines and community stakeholders from the South Side of Chicago work in concert to address African-American and white disparities in breast cancer mortality. We outline the step-wise process by which community input informed the research process via increasing levels of engagement, as follows: (1) a series of structured focus groups with 503 persons prior to the inception of research; (2) a large breast cancer conference at which the groups of academics and community members turned focus group findings into action steps; (3) an active and engaged community advisory board established in CIHDR's second year; (4) a 2.5 hour video created in partnership with our inner-city summer high school interns that is now in all Chicago public high schools; (5) the Chicago-wide Chicago Breast Cancer Mortality Reduction Task Force that was created in the third year of funding and includes local and state policy makers. Results: We discuss how this phase of our CBPR work set the groundwork for partnerships with three community-based organizations (CBOs) in Chicago and three CBOs in the rural Boot Heel region of Missouri that are informing the next phase of research. Conclusions and Implications: We discuss the implications of our work for addressing the inevitable challenges to academic and community partnerships and make suggestions specific to social work researchers engaging in CBPR.