CARE

A team of investigators from The Ohio State University and the University of Michigan will collaborate on the OSU Center for Population Health and Health Disparities, which focuses on an important health disparity among an underserved Appalachian population, cancer. The Center (CARE II) builds upon results of CARE I and continues to focus on the goal of understanding why cervical cancer incidence and mortality rates are higher in Appalachia Ohio and West Virginia. This goal will be accomplished using 4 core principles:

1) the Social Determinants of Health Framework

2) community-based participatory research

3) multi-level framework (“from cells to society”)

4) transdisciplinary team of researchers and community members

Four inter-related projects, an Administrative Core and a Shared Resources Core will support the work of the Center, and will examine factors related to the high rates of cervical cancer from genetic to policy/access issues using a range of studies from observational to randomized designs. A Training and Career Development Program will train the next generation of transdisciplinary health disparities researchers. All studies will be conducted in community-based settings which represent the more underserved population of women in the region. We will utilize the Center’s advisory committees, community partners, and participating clinics to facilitate the accomplishment of the Center’s goals.

Project 1 – will recruit 2300 women to a case-control study to investigate multi-level (genetic, behavioral, and environmental) correlates of invasive cervical cancer.

Project 2 – will interview 400 women to examine smoking behaviors among their social networks, and a smoking cessation intervention will be designed using the influence of social networks.

Project 3 – will recruit 438 women to participate in a cohort study where women will receive the HPV vaccine and be followed for 12 months to assess the effect of stress (self-reported and biological) on the ability of the host immune system to mount an immunological response to HPV.

Project 4 – will test a multi-level intervention (parents, providers, system-level) in a group randomized trial in 12 health departments (HD) to see if HPV vaccine rates increase among females aged 9-17 who attend HD’s randomized to receive the intervention program.

Projects will use a “core” set of survey measures and directly address results found in CARE I. The Center has institutional commitment (personnel, funds and space) and is dedicated to focusing on the problem of health disparities in the Appalachian region. Team members have worked together in CARE I and have an established relationship with Appalachian communities for the purpose of fulfilling the vision of the Center- to reduce cancer health disparities in Appalachia.