Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States; Department of Family Medicine and Community Health, Duke School of Medicine, Durham, NC, United States; Duke Clinical and Translational Science Institute, Duke University School of Medicine, Durham, NC, United States.
Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States.
Adv Cancer Res. 2020;146:167-188. doi: 10.1016/bs.acr.2020.01.009. Epub 2020 Mar 19.
Achieving cancer health equity is a national imperative. Cancer is the second leading cause of death in the United States and in North Carolina (NC), where the disease disproportionately impacts traditionally underrepresented race and ethnic groups, those who live in rural communities, the impoverished, and medically disenfranchised and/or health-disparate populations at high-risk for cancer. These populations have worse cancer outcomes and are less likely to be participants in clinical research and trials. It is critical for cancer centers and other academic health centers to understand the factors that contribute to poor cancer outcomes, the extent to which they impact the cancer burden, and develop effective interventions to address them. Key to this process is engaging diverse stakeholders in the development and execution of community and population health assessments, and the subsequent programs and interventions designed to address the need across the catchment area. This chapter describes the processes and lessons learned of the Duke Cancer Institute's (DCI) long standing community partnerships that led to Project PLACE (Population Level Approaches to Cancer Elimination), a National Cancer Institute (NCI)-funded community health assessment reaching 2315 respondents in 7 months, resulting in a community partnered research agenda to advance cancer equity within the DCI catchment area. We illustrate the application of a community partnered health assessment and offer examples of strategic opportunities, successes, lessons learned, and implications for practice.
实现癌症健康公平是国家的当务之急。癌症是美国和北卡罗来纳州(NC)的第二大死因,在这些地区,传统上代表性不足的种族和族裔群体、居住在农村社区的人、贫困人口以及医疗服务不足和/或健康状况不佳的癌症高危人群受到该疾病的不成比例的影响。这些人群的癌症预后更差,参与临床研究和试验的可能性也更低。癌症中心和其他学术医疗中心必须了解导致癌症预后不良的因素、这些因素对癌症负担的影响程度,并制定有效的干预措施来解决这些问题。这一过程的关键是让不同的利益相关者参与社区和人口健康评估的制定和执行,以及随后旨在满足整个集水区需求的项目和干预措施。本章描述了杜克癌症研究所(DCI)长期社区伙伴关系的过程和经验教训,这些伙伴关系促成了“PLACE 项目”(Population Level Approaches to Cancer Elimination)的实施,该项目是由美国国立卫生研究院(NCI)资助的社区健康评估,在 7 个月内有 2315 名受访者参与,从而制定了一个社区合作的研究议程,以推进 DCI 集水区内的癌症公平。我们展示了社区合作健康评估的应用,并提供了战略机会、成功案例、经验教训以及对实践的启示的示例。