2022 COE Annual Report FlipBook

UVA Comprehensive Cancer Center

Community Outreach & Engagement

Annual Report 2022

Table of Contents 3

Message for the Associate Director of COE

4

Community Outreach & Engagement Team

5

COE Mission, Aims, and Objectives

6

AIM 1 Overview

7

Catchment Area Profiles

8

Charlottesville Listening Sessions

9 10 11

AIM 2 Overview Research and Community Connections AIM 3 Overview

12

Community Advisory Council

14

Southwest Virginia Community Advisory Board

15

Community Grant Recipients

16

Screening Highlights

17

Education Highlights

19

Policy Highlights

20

Acknowledgements

UVA COMPREHENSIVE CANCER CENTER COE | ANNUAL REPORT 2022

Message from our Associate Director “Thank you to our partners for working toward eliminating cancer and cancer related disparities across Virginia.”

University of Virginia Cancer Center was awarded Comprehensive Cancer Center designation as of February 1, 2022 by the National Cancer Institute (NCI), the largest

"Our recent achievement of comprehensive designation would not have been possible without the collaboration and innovative ideas of our community partners across Virginia and West Virginia."

funder of cancer research in the world.

This level of recognition sets apart cancer centers through rigorous standards moving the cancer center into an elite group of 56 of the most outstanding cancer programs in the nation and the only Comprehensive Cancer Center in Virginia.

UVA Comprehensive Cancer Center celebrates its designation by awarding community grants of up to $10,000 to nonprofits, local governments, hospitals and other community groups to address

~Wendy Cohn, MEd, PhD UVA Cancer Center’s associate director for community outreach and engagement

cancer-related health disparities. The community grant program is a way to say thank you for the partnership and hard work our community has put into eliminating cancer and cancer related disparities across Virginia.

UVA Comprehensive Cancer Center COE | Annual Report 2022

UVA COMPREHENSIVE CANCER CENTER COE | ANNUAL REPORT 2022

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Community Outreach and Engagement Team Our COE team lives and works in communities across the UVA catchment area, developing trusted relationships and networks that result in understanding the regional needs of each community. Our team works to represent the strengths and opportunities in their community while setting realistic expectations of both our community and academic partners to ensure mutually beneficial collaboration.

COE Faculty Leadership

Wendy Cohn, M.Ed., Ph.D.

Randy Jones, Ph.D., M.S.N.

Jamie Zoellner, Ph.D., R.D.

Associate Director, Community Outreach & Engagement

Faculty Assistant Director Community Health Equity for Research

Faculty Assistant Director Community Advisory Council

COE Staff Lindsay Hauser, MS, MTTS

Keyri Lopez-Godoy, BA

Director, Office of Community Outreach and Engagement

Navigation Outreach Specialist/Every Women's Life Charlottesville, VA

Iqra Haji, MPH

Bryan Price, BS

Manager, Cancer Education

Outreach & Engagement Specialist Danville, VA

Joyce Miller, PhD

Brenna Robinson, MEd, MS

Project Manager Scientist

Outreach & Engagement Specialist Remote- Southwest, VA

Claudette Grant, MUEP

Tiffany Jacobs

Health Equity Research Outreach Specialist

Resource Navigator Wise, VA

Charlottesville, VA

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COE Mission, Aims and Objectives Our mission is to reduce the cancer burden in the community by fostering strategic and collaborative partnerships that promote health equity for all. We achieve this through evidence-based education and interventions, supporting advocacy efforts, building capacity, and providing inclusive research opportunities that address the unique needs of communities.

AIM 1: Monitor and share cancer burden, risk and disparities with internal and external partners Monitor incidence, mortality, cancer risk factors and social determinants of health for the catchment area Identify and report cancer related disparities across the catchment area Conduct catchment wide and community level needs assessment and listening sessions to identify gaps and set priorities Create and disseminate clear communication of cancer priorities and research outcomes

AIM 2: Foster collaborative, bi-directional research to address catchment priorities and enhance health equity Increase research on catchment related priorities across research programs Increase capacity to engage and conduct research with the community Increase engagement of catchment residents, including vulnerable and underrepresented populations, in cancer research, including clinical trials

AIM 3: Implement and disseminate evidence-based interventions and policies to reduce cancer burden and increase health equity Cultivate, expand and engage partnerships, which are representative of the communities we serve and that guide COE priorities Prioritize cancer screening to address gaps in targeted geographic areas within the catchment area and with vulnerable populations Implement priority aligned, community engaged evidence-based educational activities and programs Inform, guide and disseminate local, state and national cancer control guidelines and policies Address identified cancer related disparities through targeted screening, education activities and policy efforts

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AIM 1 Overview Monitor and share cancer burden, risk and disparities with internal and external partners Monitor incidence, mortality, cancer risk factors and social determinants of health for the catchment area Identify and report cancer related disparities across the catchment area Conduct catchment wide and community level needs assessment and listening sessions to identify gaps and set priorities Create and disseminate clear communication of cancer priorities and research outcomes

UVA Cancer Center Catchment Area

87 Counties and independent cities across central and western Virginia and West Virginia 81.8% White 10.7% Black or African American 5% Hispanic

3.2 Million community members with 30% living in a rural community 11.7% Community members have less than a high school degree 13.7% Of individuals live 150% below the poverty line UVA Comprehensive Cancer Center COE | Annual Report 2022

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Aim 1 | Community Snapshots In 2019 the UVA Cancer Center conducted a catchment wide needs assessment to better understand the impact of social determinants of health on communities and their cancer burden. In 2022, COE developed regional snapshot infographics for community partners, translating these findings into accessible visual formats.

To see the full snapshots, visit the COE website.

REGIONAL OVERVIEW

1 6

Community Cancer Burden Profile

2

3

4

5

Northern (1), Central (2), Valley (3), Southside (4), Southwest (5), West Virginia (6)

Cancer Screening Breast Cancer Screening

Colorectal Cancer Screening

Cervical Cancer Screening

Recommendation: Mammogram every 2 years for women ages 50-75

Recommendation: Colonoscopy every 10 years or stool based test every year beginning at age 50*

Recommendation: Pap Test completed within past 3 years beginning at age 21

Northern

Central

Valley

Southside

Southwest

Northern

West VA

Valley

Southside

Southwest

Northern

73%

78%

Valley

79%

76%

60

76%

Southside

Southwest

100

Target: 74.4%

85%

Central

West VA

80

Target: 80.5%80

60

Central

West VA

100

77%

70% 62%

77%

67%

61%

Target: 84.3%

80

81%

84%

80%

60

76%

75%

74%

40

40

40 20

20

20

0

0

Breast

Colorectal

0

Cervical

*Colorectal screening is now recommended starting at age 45

Cancer Risk Factors Not meeting Physical Activity Guidelines

Overweight or Obese

Northern

Northern

Central

Valley

Southside

Southwest

Central

Valley

Southside

West VA

Southwest

West VA

81%

67%

85%

69%

93%

72%

93%

76%

90%

79%

90%

76% 0

20

40

60

0

20

40

60

80

100

80

Overweight: Body Mass Index is 25 to <30 Obese: Body Mass Index is 30+

Recommendation: At least 150 minutes a week of moderateintensity aerobic physical activity.

In 2020, 34.8% of adults were overweight and 31.9% were obese for a total of 66.7% of Americans being overweight or obese.

In 2019, 48.5% of adults in the US did not meet the physical activity guidelines.

Centers for Disease Control and Prevention, 2020

Health and Human Services, Physical Activity Guidelines for Americans; Centers for Disease Control and Prevention, 2019

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Aim 1 | Charlottesville Listening Sessions One way we assess cancer burden and needs is through listening sessions in the community.

Listening sessions allow COE to better understand specific issues and barriers in the community and together with the community develop solutions. Below is one example of a listening session held in the Blue Ridge Health District (BRHD).

Cancer disproportionately affects Black community members living in BRHD. Disparities exist for all of the top cancers, including breast, prostate, lung, and colorectal. For example, compared to the US, BRHD overall has a lower breast cancer incidence rate. However, despite the low incidence rate, the death rate among Black individuals is higher than in the US. Blacks have higher incidence and mortality for colorectal cancer compared to Whites in the US. When looking specifically at prostate cancer, mortality is nearly double for Black men.

Age-Adjusted Cancer Incidence Blue Ridge Health District

Age-Adjusted Cancer Mortality Blue Ridge Health District

Cancer Type

Black

White

US

Cancer Type

Black

White

US

Breast

106.3

103.2

125.2

Breast

22.8

19.3

20.6

Colorectal

46.3

29.1

38.7

Colorectal

25.1

11.7

14.2

Prostate

139.9

80.0

111.3

Prostate

42.4

16.7

18.9

60.9

46.4

59.2

Lung

50.6

42.3

41.9

Lung

Key Themes Trust and Attitude

Communication & Awareness

Health Literacy

Access

The listening sessions brought together key community voices to highlight the existing cancer disparities and together discuss root causes and needs. Together, bringing an actionable plan to life to have a bigger impact to address the existing disparities. The themes from the listening sessions will be addressed throughout 2023.

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AIM 2 Overview AIM 2: Foster collaborative, bi-directional research to address catchment priorities and enhance health equity Increase research on catchment related priorities across research programs Increase capacity to engage and conduct research with the community Increase engagement of catchment residents, including vulnerable and underrepresented populations, in cancer research, including clinical trials

COE fosters collaborative, bi-directional research in numerous ways. Highlighted below is a snapshot of different COE activities that work towards increasing research that addresses catchment priorities and enhances health equity.

Grant Reviews The UVA Cancer Center Community Advisory Council took part in the Cancer Control and Population Health internal pilot funding grant reviews. During this review process, Council members were paired with a UVACC reviewer to evaluate internal pilot grant applications.

The CAC reviews are then taken into consideration for the overall scoring and selection of proposals to fund. COE aims to extend this process to other internal grant reviews in 2023.

Research Consult Highlights Impact of SmartPhone Apps to Reduce Symptoms of Depression and Anxiety

Feasibility of Quit Aid Tobacco Cessation in FQHC Pharmacies

PI: Phil Chow, PhD

PI: Melissa Little, PhD, MPH

COE worked with the study team to develop an action plan to raise awareness of the project in the community with partners across the catchment area including: Dan River Taskforce, SWVA CAB Cancer Action Coalition of Virginia Virginia Breast Cancer Foundation

COE worked with the study team to develop a geographical map of FQHCs with pharmacies, provided and connected the study team to potential partners, and connected to the SWVA Community Advisory Board Tobacco Action Team for additional project guidance.

IMPACT: Increased enrollment in Virginia for this nationwide study.

IMPACT: Study was funded by a CPH Seed Grant

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AIM 2 | Research and Community Connections During a day and a half summit, the UVA Cancer Center Community Advisory Council came together with researchers from across the Cancer Center to learn and ask questions about how the work of UVA Cancer Center impacts the greater community. The first day focused on high impact priority research across the catchment area and the second day highlighted the work of each research program at the Cancer Center.

Day 1: Priority Related Research

Day 2: Research Program Highlights

Lung Cancer

Cancer Biology

Non-tobacco exposure and genetic susceptibility of lung cancer patients in Virginia

Presenter: John Bushweller, PhD

Presenter: Yuh-Hwa Wang, PhD

Tobacco Control Pharmacist-delivered medication therapy management cessation among smokers in Appalachia Presenter: Melissa Little, PhD, MPH

How cancer cell differs from a normal cell and the properties of cancer cells that act as Achilles heels What proteins are good targets for cancer therapy and the best way to develop drugs to target these proteins

Molecular Genetics and Epigentics Presenter: Todd Stuckenburg, PhD Develop tests that sequence data for each patient to pick a treatment choice Identify ways tumors change their DNA repair and transcription to identify new treatments

Breast Cancer

Cancer Therapeutics

A pilot assessment of utilities for cancer related health states to inform treatment decisions of older women with early-stage breast cancer

Presenter: Kim Kelly, PhD

Presenter: Shayna Showalter, MD

Breast Cancer Exercise for maintenance of physical cardiovascular function during breast cancer chemotherapy Presenter: Becca Kruskowski, PhD

Clinical trials to look at new drugs, drug combinations and imaging that may improve outcomes Preclinical development and testing of image guided and drug-delivery treatment

Cancer Control and Population Health Presenter: Jamie Zoellner, PhD, RD Identifying behavioral and socioeconomic factors that drive cancer disparities Develop new ways to reduce cancer risk in diverse populations

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AIM 3 Overview

AIM 3: Implement and disseminate evidence-based interventions and policies to reduce cancer burden and increase health equity Cultivate, expand and engage partnerships, which are representative of the communities we serve and that guide COE priorities Prioritize cancer screening to address gaps in targeted geographic areas within the catchment area and with vulnerable populations Implement priority aligned, community engaged evidence-based educational activities and programs Inform, guide and disseminate local, state and national cancer control guidelines and policies Address identified cancer related disparities through targeted screening, education activities and policy efforts

Our reach in numbers

6,625 People reached through Outreach Events

1,446 People Reached through Community Screenings

150+

125+

Unique Partners

Community Events

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AIM 3 | UVA Cancer Center Community Advisory Council About the Council Convened in 2020, the Council is made up of over 20 community members from a multitude of sectors across Virginia and West Virginia that collectively represent the UVA catchment area. The Council meets quarterly and participates in additional subcommittees that review grants and participate in strategic planning.

GOALS OF THE COUNCIL Provide input on the cancer control needs of residents in the UVA Cancer Center catchment area Advise the UVA Cancer Center on the applicability of their generated research and outreach efforts to residents in the catchment area Recommend options for integrating the UVA Cancer Center research and outreach efforts into appropriate health care and community-based organizations Help facilitate the visibility and credibility of the UVA Cancer Center research and outreach efforts across the spectrum of basic, clinical, and population science

COMMUNITY ADVISORY COUNCIL MEMBERS Christina Benton Virginia Comprehensive Control Program

Shirley Knox Sisters Conquering Cancer Cancer Survivor

Jessica Brantley Charlottesville City Schools

Annie Martinie Danville Regional Foundation

Michelle Brauns Community Health Center of the New River Valley Howard Chapman Tri-Area Community Health Annika Dean American Cancer Society

Jessica Deering Cancer Action Coalition of Virginia

2022 CAC Activities Meetings

Grant Reviews

SOAR Analysis

Three CAC meetings Crossover meeting with research programs First in-person retreat

Nine Community Grant Reviews One Population Health Grant Review Priority Cancer Recommendation Disseminated Risk Factor SOAR initiated for obesity and tobacco (to be finalized in 2023)

Brian Donohue ACS Cancer Action Network Cancer Survivor Ericca Facetti Virginia Health Catalyst

Lauren Hixenbaugh West Virginia University, Mountains of Hope Jenny Ostien West Virginia University Cancer Institute Scott Schriefer Kingsport Methodist Caregiver Peggy Scott Community Advocate Autumn Smith Community Advocate Pediatric Cancer Survivor

Anjanette Farmer Piedmont Access to Health Services

Julie Speasmaker UVA Cancer Center Advisory Board Cancer Survivor

Lee Grinnan Community Advocate Pediatric Cancer Survivor

Mindy Thrope Virginia Rural Health Association

James Hiter Streak for a Cure Cancer Survivor

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Andrew Wolf UVA Health

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AIM 3 | Community Advisory Council Recommendations Throughout 2021 and 2022, the UVA Cancer Center Community Advisory Council completed a SOAR analysis for priority cancers and risk factors in the UVA catchment area. The SOAR analysis is a powerful tool for uniting stakeholders by recognizing an organization's potential and creating a shared vision of the future. Below is a summary of the top three priority recommendations for each cancer type.

Lung

Colorectal

Melanoma

1 MARKETING & OUTREACH

1 PROVIDER EDUCATION

1 OUTREACH

2 PROVIDER EDUCATION

2 ACCESS

2 ACCESS

3 COMMUNITY EDUCATION

3 POLICY

Media campaigns (including social media) to educate community members about FIT testing. These should also include costs of the tests and positive patient stories

Education to emphasize colonoscopy is not the only available test

3 POLICY

Work at state level to change current policy that colonoscopy cannot be reimbursed after a positive FIT test (for most insurances)

Breast

Education for healthcare providers to update on expanded lung cancer guidelines and corresponding insurance coverage

Pursue a mobile low dose CT unit to access populations at highest risk for lung cancer

Educate on lung cancer prevention and screening opportunities early

Support engagement activities with a broad array of organizations and partners to increase and enhance education efforts in low access, high burden areas Increased access to dermatology through specialty training for nurses and PA, mobile screening sites, and telehealth

Advocate for Medicaid coverage to include skin screenings

Obesity

Tobacco

1 SCREENING ACCESS

1 TREATMENT ACCESS

1 YOUTH EDUCATION

2 AWARENESS

2 ENVIRONMENT & ACCESS

Collaboratively address breast cancer screening needs using a data-driven approach

Increase visibility of successful UVA Cancer Center research, clinical trials, and resources

3 SURVIVORSHIP

Coordinate efforts and emphasis on breast cancer survivorship resources across the catchment area

Increase availability of and access to comprehensive, evidence-based obesity treatment programs, including behavioral and pharmacological options

Work with community partners to increase access to healthy foods and utilization of physical activity resources

3 WEIGHT MANAGEMENT

Utilize culturally relevant weight management messages and programs, including raising awareness on the relationship between obesity and cancer.

UVA COMPREHENSIVE CANCER CENTER COE | ANNUAL REPORT 2022

Integrate comprehensive youth tobacco prevention education and cessation within schools and beyond

2 POLICY

Support existing and future legislation related to stronger tobacco control policies (cigarette tax, retail licensing, tobacco free spaces)

3 ACCESS

Provide comprehensive and accessible cessation support delivered through models in and beyond the clinical setting

13

AIM 3 | Southwest Community Advisory Board About the SWVACAB Formed in 2013 by the UVA Cancer Center with the support of key stakeholders from the Southwest Region, over 30 representatives from Lenowisco, Cumberland Plateau, and Mount Rogers Health District now sit on the CAB to address cancer disparities and the lack of healthcare access in rural Appalachia.

3

30+

3

Co-Chairs

Members

Action Teams

Priority Areas

Human Papillomavirus

Lung/Tobacco Cessation

Colorectal

Our reach in numbers 2022 SWVA CAB Impact

5

11

24

Funded Projects

Outreach Projects

Media Projects

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AIM 3 | 2022 Comprehensive Community Grants To address cancer-related health disparities across Virginia, UVA Comprehensive Community Grants provide community grants of up to $10,000 to nonprofits, local governments, hospitals, and other community groups. Each application is rated according to the community impact, project feasibility, and the ability to address cancer-related health disparities equitably.

Charlottesville Free Clinic’s Cancer Prevention Program Our reach in numbers Organization: Charlottesville Free Clinic Focus : Cancer Screening, Colorectal Cancer Goal: Improve cancer screening and awareness for uninsured members of the Charlottesville area through the Cancer Prevention Program

Increasing Nutrition Literacy Among Cancer Patients in Southwest, VA Our reach in numbers Organization: Mountain Empire Older Citizens Focus : Nutrition for Survivors of Cancer Goal: Increase access to nutritional education as well as one-on-one nutrition counseling for survivors of cancer served by MEOC nutritional services to improve nutrition literacy

Southern Virginia LGBTQIA+ Access Initiative Our reach in numbers Organization: Virginia Rural Health Association Focus : Cancer Screening for LGBTQIA+ Goal: Equip primary care providers with skills and resources to serve individuals who identify as LGBTQIA+ to ensure that everyone in rural Virginia has access to healthcare in a safe and affirmative manner

"Can We Talk" Colorectal Cancer Education Organization: Hitting Cancer Below the Belt Focus : Colon Cancer Goal: Raise the level of awareness around colorectal cancer by stimulating conversation in ways that are both interactive and entertaining. As a result, we aim to break through the silence surrounding this disease and move more people towards timely colorectal cancer prevention and early detection

Cancer Survivorship Task Force OurVirginia reach in numbers

Organization: Cancer Action Coalition of Virginia Focus : Cancer Survivorship Goal: Develop a task force dedicated to improving survival and quality of life for cancer patients. The task force will be to identify needs, prioritize strategies, and create an action plan to address the Virginia Cancer Plan survivorship goals and objectives

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AIM 3 | Screening Highlights Mobile Prevention Our mobile mammography coach brings comprehensive screening services to women at workplaces and community locations throughout Virginia. The elegant, self-contained coach offers on-site breast cancer screenings using the latest technology, including 3D imaging, and has the capacity to perform up to 25 exams in one day.

1100+

22

84

Mammogram provided

Unique screening sites

Screening days

Every Woman's Life Every Woman’s Life provides high quality breast and cervical screenings and follow up services to low-income, uninsured women in the most cost efficient manner.

Women need to be uninsured and at or below 250% federal poverty level to qualify for the program.

114

49

9

Mammograms provided

Diagnostic testing referrals

Cancers detected

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AIM 3 | Education Highlights For over two decades, COE has delivered evidenced-based education to the residents of Virginia and beyond through strategic partnership, cultivating healthier communities by assisting community-based organizations in creating culturally appropriate cancer programs to address disparities. We are committed to enhancing well-being by offering diverse educational initiatives, including programs such as Understanding Cancer, FamHealth, Sunbeatables, and Walks with Heart.

Understanding Cancer

802

78

People reached

Workshops

The Understanding Cancer curriculum informs community members, healthcare professionals, cancer survivors, caregivers, students, and community groups about the cancer disease. The curriculum was designed from reliable and evidence-based sources to introduce cancer through an equitable and inclusive lens by addressing the disease’s topics. We hope by sharing this knowledge, we can help communities better understand how to prevent cancer.

FamHealth Impact A L

T H

F A

M

#Taco 'bout it

L Y B

F A

M

E

I

H

T I

O N

A S E D

Classroom Lessons

People Reached

Community Events

B

A

C C

O

P R

N

3

O

E

566

T

If in Doubt, Taco 'bout it

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FamHealth : Family-Based Health Promotion to Prevent Tobacco Use project is a VFHY funded community innovation grant in collaboration with Coeburn Middle School, University of Virginia at Wise, Virginia Cooperative Extension, and UVA Cancer Center.

The project aims to enhance communication of health information to families, with a focus on tobacco prevention. Through hands-on experiences, middle school students craft health messages for their school community under the guidance of peer mentors through innovative physical activity lessons.

E

V

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AIM 3 | Education Highlights Sunbeatables Building upon the successful role out of Sunbeatables in 2021, the program expanded to two additional classrooms in 2022. The curriculum is adapted from Ray & the Sunbeatables®: A Sun Safety Curriculum, University of Texas MD Anderson Cancer Center. The sun safety program was adapted to educate two new preschool classrooms on sun protection and promote sun safety behaviors to reduce children’s lifetime risk of developing skin cancer.

2 New classrooms 34 New Students and Parents Reached

Sun Safe Communities COE staff worked with community partners, including local baseball teams and churches, to bring sun safety education out to the community.

3 Community Events 340 People Educated on Sun Safety

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AIM 3 | Policy Highlight Eliminate Tobacco Use Virginia Initiative The Eliminate Tobacco Use Virginia Initiative, led by the University of Virginia Cancer Center and Virginia Commonwealth University (VCU) Massey Cancer Center, along with partnerships in higher education, aims to establish tobacco-free campus cultures across Virginia. The ETU Virginia summits, held annually since 2019, focus on best practices in developing tobacco-free policies, organizing a comprehensive tobacco-free campus policy, and advancing tobacco treatment and cessation efforts. h e re

New 2022 Activities

C o lle

ge

Launch of Tobacco Policy Report Cards Partnership with Virginia Department of Health Tobacco Control Program to provide policy technical assistance to college and universities

Eliminate Tobacco Use Impact

73

50

Participants at the Annual State Summit

Policy Report Cards Disseminated

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Acknowledgements We thank all of our partners for their continued support in our efforts to contribute to reducing the cancer burden in and around Virginia.

Contact Lindsay Hauser Director, Office of Community Outreach & Engagement lh7yn@virginia.edu 434-243-0433

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