Cancer Prevention and Control
The overall goal of the Cancer Prevention and Control Program (CPC) is to sustain a nationally-recognized program of innovative research by developing, rigorously testing, and disseminating evidence-based interventions and policy approaches that can improve cancer outcomes in North Carolina and beyond. The Program has developed strength in translational science and is committed to collaborations (e.g., between oncology, social and behavioral science, epidemiology, and genetics/genomics) that can lead to new discoveries, conceptual models, and strategies to reduce the burden of cancer in diverse populations and across the cancer continuum.
Areas of excellence that have been Program themes over the last decade include: cancer communication and decision making (including use of new technologies); health promotion and health disparities; cancer survivorship; and dissemination research. In addition, we have identified health outcomes as an important area for development as a Program theme, in terms of faculty recruitment and research aimed at identifying, measuring, and evaluating the impact of health interventions and policy changes on cancer care, morbidity, mortality, and related indices. These areas of emphasis organize the program conceptually, drive research themes and institutional commitments, and constitute strategic directions for the next five years. This program is led by Kurt Ribisl, Co-Director of the Cancer Control Education Program and Professor of Health Behavior at the UNC Gillings School of Global Public Health.
Health Promotion and Health Disparities
Goal: To define and improve adoption of lifestyle factors associated with cancer prevention and control and to reduce the disproportionate burden of cancer among minority and underserved populations experiencing health disparities.
Health behaviors that are the main focus of this goal include preventing obesity and fostering optimal nutrition and physical activity; tobacco prevention and cessation, and cancer screening and vaccination. Program members are national leaders in designing and rigorously evaluating culturally appropriate, theoretically informed interventions that address issues at various levels of change among populations at risk. Research directions include: a major focus on diet, weight, and physical activity across the lifespan and among diverse populations; prevention of obesity; tobacco control; development evaluation of novel interventions to reduce risky behaviors among youth, and tailoring and targeting interventions to address within-population variations and issues related to cancer health disparities. In addition, investigators have an emerging interest in pursuing trans-disciplinary research on links between behavioral and genetic/genomic factors that may help elucidate mechanisms producing phenomena such as obesity/weight gain and response to interventions, and how these factors may be incorporated into the design and analysis of interventions to reduce cancer risk and to enhance cancer treatment and survivorship. Program faculty have participated in cross-program collaborations focused on translational research, with colleagues in Programs such as Cancer Epidemiology and Cancer Genetics.
Cancer Communication and Decision Making
Goal: To develop and test effective cancer communication strategies to improve cancer outcomes across the cancer continuum.
Program members are known for their research on cancer communication and decision making, especially the use of emerging technologies and new media to reach broad populations as well as specific subgroups. In the past core grant cycle, program members have played a key role in establishing a university-wide certificate program in Health Communications and are in the process of developing a master’s degree program in this area. They are participating as PIs and co-investigators in two different Centers of Excellence in Cancer Communication Research, as well as participating on expert panels and NCI working groups focused on cancer communication. Members’ research has focused on issues such as the efficacy of web-based decision aids and e-interventions such as e-counseling and tailored web-delivered programs for promoting cancer screening, weight loss and maintenance, and treatment decisions. As a major Program area of strength, we have continued to expand research on tailored and interactive health communications using traditional and new technologies such as mobile phones, podcasting, and texting. Research includes both efficacy and mediator/moderator studies of cancer communication and media effects among various populations, including cancer survivors; understanding risk communications, and the role of the internet and mass communications in cancer-related policy and advocacy, such as for tobacco control. In addition, Program members have also been involved in emerging areas relevant to health care reform, such as personal health records (PHR) and cost effectiveness.
Cancer Survivorship Research
Goal: To conduct research aimed at improving the quality of cancer care and to promote improved long-term outcomes, wellness, and quality of life for cancer survivors and caregivers.
The Program identified a major focus on developing excellence in survivorship in the last renewal, and this area of research has grown tremendously over the past five years. In collaboration with multiple other Programs of the Cancer Center, including epidemiology, basic and clinical scientists, Program members are studying factors that may predict cancer outcomes and quality of life across various populations and disease types. A landmark project represented by this collaboration is the UNC Health Registry/Cancer Survivorship study, a planned 10,000-patient prospective cohort study of cancer survivors. This project, launching its pilot phase in January 2010, grew out of a collaborative vision of the Population Sciences Program to enhance the science of survivorship research. The Registry study builds on UNC Lineberger’s designation in 2008 as a LiveSTRONG/V Foundation Center of Excellence in Cancer Survivorship (PI Campbell). Research includes understanding and responding to information and communication needs of cancer survivors from diagnosis to long-term survival; developing interventions to assist individuals and families with treatment decisions, symptom management, and lifestyle-related health behaviors such as physical activity and weight management. New recruitment to the Program has added investigators with expertise in intervention, health services, and health outcomes research. This important research area includes studies focused on issues such as geography and access to oncology specialists, patterns of care, insurance coverage, and other systems issues that may strongly impact patient outcomes and policies related to cancer care and survivorship.
Dissemination and Implementation of Evidence-Based Programs
Goal: To move proven strategies into wide-spread practice as quickly as possible in order to have a positive impact on best practices and policies to reduce cancer incidence, morbidity, and mortality locally, nationally, and internationally.
Dissemination research is a major theme of the CPC Program, and since the last renewal a number of key accomplishments have highlighted UNC Lineberger’s expertise and leadership in this growing area of NIH interest. Supported by the pioneering Dissemination Core, Program members received two of the seven R01s funded under the NCI’s Dissemination and Implementation Research PAR. In addition, our focus on dissemination and community engagement has directly enabled Program members to successfully leverage major grant funding such as the Carolina Community Cancer Networks and CTSA grants, both of which include dissemination as major foci. With University Cancer Research Fund support, a dissemination research infrastructure, NC SPEED , has been established in key areas across the state of North Carolina to enable researchers to collect data and engage community partners for translation and dissemination of evidence-based programs and research on the process and outcomes of dissemination. In addition, UNC’s role as the national coordinating center for the CDC-funded Cancer Prevention and Control Research Network has fostered national collaborations in multiple areas including dissemination. Program members have collaborated with CPCRN sites on papers and conferences focused on developing theoretical models and core methods and best practices for dissemination research in cancer control.
Health Outcomes (Developing Theme Area)
Goal: To study patterns of cancer care, screening, and prevention in order to improve cancer outcomes and to inform broad-based intervention and policy initiatives aimed at patients, providers, and health systems that are most likely to be effective and cost effective in reducing the burden of cancer.
Outcomes research has been prioritized as a major developing theme area for the Program in terms of recruitment and infrastructure investment. We recognize that building resources, faculty expertise, and capacity in this area is vital to our overall mission to reduce cancer burden and improve outcomes in our State and beyond. The Cancer Center is using institutional funds to create a data warehouse and IT infrastructure that will support complex databases and informatics expertise and methods to capture information such as patient treatment data, provider and workforce data, geographic information, and link to other important data sources such as Medicare and Medicaid claims data to answer important questions about cancer care and outcomes as well as disparities in these outcomes.
Strengthening health outcomes is a key component of the Cancer Center’s University Cancer Research Fund strategic theme area of Optimizing Cancer Outcomes. Existing expertise in the Program will be enhanced by increased collaboration with Centers on campus such as the Sheps Center for Health Services Research , and faculty in the Department of Health Policy and Management . New and planned recruitments to the Cancer Center will further strengthen expertise in this area, in addition to institutional investment in data resources and infrastructure that can lead to new research grants and opportunities. This program is led by Kurt Ribisl, Co-Director of the Cancer Control Education Program and Professor of Health Behavior at the UNC Gillings School of Global Public Health.