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Objective: Assess consumer experience and health impact among under-resourced individuals who were enrolled into longitudinal navigation to address social determinants of health (SDOH) needs and health goals related to cancer primary and secondary prevention. Background: The Yale Cancer Disparities Firewall Project is a multi-tiered initiative to address the social determinants of health (SDOH) and other challenges that prevent at-risk communities from receiving the full benefit of the many available cancer prevention and cancer screening options. A community-facing health navigation program, staffed by community members who have received extensive multidisciplinary training is a central component of this program. Methods: Of the 61 currently enrolled individuals (all of whom are either African American/Black or Hispanic/Latinx), we collected questionnaire data from 24 individuals (39% response rate). In general, participants are enrolled for a minimum of 1 year, but most have been followed for 2 years. Respondents were similar to non-respondents with respect to race (60% were Black/African American vs 61.2%, respectively) and age (mean = 44.8 vs 47.2 years, respectively). Respondents were more likely to be female (85% vs 71.4%, p =.009), Hispanic/Latinx (35% vs 42%), but significantly less likely to be foreign-born (15% vs 26.5 %, p = .021). We assessed satisfaction with assigned navigator(s), uptake of referred services, knowledge gained, health behavior change, and self-rated health (SRH). Results: Per self-report, 79.2% of participants agreed and a further 12.5% somewhat agreed that they were overall satisfied with their experience with the health navigation program. Importantly, two-thirds (66.7%) agreed and a further 20.8% somewhat agreed that they changed their behavior to improve their health and well-being because of the program. Of the 5 health focused services offered, the most commonly reported uptake was physical activity (87.5%), followed by learning how to eat healthier and losing weight. Additionally, one third (33.3%) of participants received assistance with reducing or stopping smoking. In terms of secondary prevention, 62.5% of clients received assistance with cancer screening. Of the 5 SDOH focused services offered, the most common was assistance with finding food to eat (66.7%) followed by assistance with paying utilities (45.8%), a shift from the priority needs at baseline (40% needing food assistance, and 35% with housing concerns), presumably reflecting the additional strains associated with the COVID-19 pandemic. Conclusions: Against the backdrop of COVID-19, these findings suggest that addressing SDOH barriers through individual navigation is an important add-on service when facilitating access to services to maintain healthy lifestyle and adhere to cancer screening guidelines. Although this was a pilot program, we foresee the opportunity to utilize trained non-clinical navigators and/or community health workers and to promote cancer prevention in at risk communities. Citation Format: Monique K. Stefanou, Sakinah C. Suttiratana, Denise Stevens, Eduardo Reyes, Jonathan Colon, Eiman Ibrahim, Roy L. Herbst, Beth A. Jones. Impact of health navigation program on healthy lifestyle and cancer screening in population with significant social determinants of health (SDOH) barriers [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-264.

Purpose: Employing a social determinants of health (SDOH) framework including race/ethnicity, socioeconomic status (SES) (education, income) and barriers related to housing stability, food security, ability to pay utilities, transportation, and personal safety, we: 1) Describe the impact of COVID-19 on high risk, mostly minority communities (Black/African American and Hispanic/Latino) in New Haven, CT; and 2) Determine how SDOH barriers (numbers and types) impact needs, knowledge and beliefs, and adherence to pandemic control measures, as well as cancer prevention behavior and intentions. Background: As is well recognized from previous pandemics and epidemics, the burden of disease falls disproportionately on those individuals with fewest resources. It is now clear that the COVID-19 associated death and disease burden in minority and low socioeconomic communities is disproportionate to their numbers in the general population. In addition to the disproportionate acute impact of the COVID-19 on vulnerable communities, the long-term impact may be lost ground with respect to cancer prevention due to disruption, distrust and misinformation. Additionally, the recent news events and public discussion around police violence and systemic racism likely potentiates the disparities that were due to COVID-19 alone. Methods: We conducted a Qualtrics survey assessing all aspects of COVID-19 impact, with extensive SDOH measures, including everyday racism, medical mistrust, cancer prevention and screening, access to health care, and intentions regarding future vaccination uptake, adherence to COVID-19 preventive practices, lifestyle behaviors associated with cancer prevention, and cancer screening. Participants (n=300) are from New Haven, are primarily African American/Black and Hispanic/Latinx, and include a subset of cancer survivors. With 26% of the population living below the federal poverty level, we are able to identify long-term impact of Covid-19 on cancer prevention and screening in a high-risk population. Analysis includes descriptive and multivariate adjusted logistic regression findings predicting maintenance of healthy lifestyle (primary cancer prevention) and cancer screening. Results: Descriptive data demonstrate high levels of SDOH and the impact of COVID-19 on many aspects of life for this study population. We present predictors of healthy lifestyle behaviors and intention to adhere to cancer screening guidelines going forward as well as intent to vaccinate against COVID-19 when vaccine becomes available. Conclusion: The unique challenges of this urban community of primarily African American/Black, Hispanic/Latinx (HL) and/or low socioeconomic status (SES) individuals stem from the disproportionate burden of SDOH and will impact cancer prevention behavior. Findings will inform community level interventions in the event of continued COVID-19 (or similar) public health challenges, while identifying opportunities to advance cancer prevention long-term. Citation Format: Beth A. Jones, Sakinah Suttiratana, Roy Herbst, William Eger, Eiman Ibrahim, Hannah Behringer, Eduardo Reyes, Nailah Hutchinson, Shua Kim, Jonathan Colon, Jose DeJesus, Sarah Alsup, Rachel A. Clare, Monique Killins. COVID-19 and social determinants of health (SDOH): Impact on cancer prevention in vulnerable populations [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-263.

Background The Yale Cancer Disparities Firewall Project addresses racial/ethnic minority and low socioeconomic status disparities in cancer screening and outcomes by translating evidence-based practices and guidelines into wrap-around support for these populations. Tailoring cancer disparities activities to local needs requires community engagement and participation (CEP). Operationalizing CEP is challenging though its value as a tool to adapt scientific and behavioral knowledge into acceptable patient-level interventions and programs has been recognized. We explored a range of CEP activities implemented within our project to understand and classify the use, outcomes and limitations of community engagement. Methods Comparative qualitative methods highlight variations in how CEP is operationalized. Data from group interviews (n=58; 66% Hispanic and 31% African American) and archival documents were synthesized based on models defined by Popay et al (2006) and Brunton et al (2017). Purposive samples of church-goers, members of a university-convened, community liaison group and a community action network (CAN) established to advise and promote CEP around healthy lifestyles and cancer screening were interviewed. Documents included minutes from a community research engagement subcommittee and supervision meetings for a lay health leader. The research team thematically coded data considering the process, timing, activities, expectations and power dynamics of community engagement. Gaps in community knowledge and access to cancer screening and services were also noted. This poster includes an electronic polling station that collects reader experiences. Results Empirical themes and process maps demonstrate the utility of different types of CEP. Most commonly, community members requested that cancer experts share more information with local populations. CEP generated voluminous suggestions about the outreach process, cancer communications content and channels, and potential barriers to reach and uptake. Additionally, we identified four ways of operationalizing CEP: a) operations advising, b) community knowledge assessment, c) program/intervention planning, and d) document development. Using quotations and visual data, we describe the range of CEP activities, the extent of engagement and institutional capacity required to facilitate each type. A framework for iterative CEP and bidirectional education to advance cancer risk reduction and screening objectives is proposed. Conclusion CEP encompasses diverse activities and can provide practical guidance for project implementation. By examining institutional context and CEP history, researchers may implement CEP more intentionally by presenting scopes of work, degree of engagement and output integration plans to CEP participants. Additional research is needed to demonstrate whether fit-for-purpose use of CEP results in different outcomes. Citation Format: Sakinah C. Suttiratana, Monique Killins, Denise E. Stevens, Jose DeJesus, Roy Herbst, Beth A. Jones. Operationalizing community engagement and participation: Experiences of the Yale Cancer Disparities Firewall Project to impact lifestyle change and cancer screening [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B045.