Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Columbus, Ohio, USA.
Oncologist. 2011;16(8):1072-81. doi: 10.1634/theoncologist.2011-0145.
There are meaningful cancer-related disparities in the Appalachian region of the U.S. To address these disparities, the Appalachia Community Cancer Network (ACCN), a collaboration of investigators and community partners in five states (Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia), is involved in increasing cancer education and awareness, conducting community-based participatory research (CBPR), and creating mentorship and training opportunities. The primary objective of this paper is to describe cancer-related disparities in the Appalachian region of the U.S. as an example of the disparities experienced by underserved, predominantly white, rural populations, and to describe ACCN activities designed to intervene regarding these disparities. An ACCN overview/history and the diverse activities of ACCN-participating states are presented in an effort to suggest potential useful strategies for working to reduce health-related disparities in underserved white populations. Strengths that have emerged from the ACCN approach (e.g., innovative collaborations, long-standing established networks) and remaining challenges (e.g., difficulties with continually changing communities, scarce resources) are described. Important recommendations that have emerged from the ACCN are also presented, including the value of allowing communities to lead CBPR efforts. Characteristics of the community-based work of the ACCN provide a framework for reducing health-related disparities in Appalachia and in other underserved white and rural populations.
美国阿巴拉契亚地区存在有意义的癌症相关差异。为了解决这些差异，阿巴拉契亚社区癌症网络（ACCN）是由来自五个州（肯塔基州、俄亥俄州、宾夕法尼亚州、弗吉尼亚州和西弗吉尼亚州）的研究人员和社区伙伴合作的组织，致力于增加癌症教育和意识，开展社区参与式研究（CBPR），并创造指导和培训机会。本文的主要目的是描述美国阿巴拉契亚地区的癌症相关差异，以此为例说明服务不足、主要为白人、农村人口所经历的差异，并描述旨在干预这些差异的 ACCN 活动。为了提出在服务不足的白人人群中减少与健康相关的差异的潜在有用策略，本文介绍了 ACCN 的概述/历史以及参与州的多样化活动。还描述了 ACCN 方法中出现的优势（例如，创新的合作关系、长期建立的网络）和仍然存在的挑战（例如，不断变化的社区、稀缺资源的困难）。还提出了 ACCN 提出的重要建议，包括让社区主导 CBPR 努力的价值。ACCN 的社区基础工作的特点为减少阿巴拉契亚地区和其他服务不足的白人及农村人群中的与健康相关的差异提供了一个框架。
