Supplement: University of Kentucky Markey Cancer Center - Cancer Center Support Grant

Based on national surveillance data (2014), Kentucky (KY) ranks first in both cancer incidence and cancer mortality for all cancer sites combined. Kentucky's elevated cancer rates are primarily attributable to disparities present in the 54-county region of Appalachian KY. Indeed, the region is recognized as one of the most rural, economically disadvantaged, medically underserved, and disease-burdened areas in the nation. Appalachian KY residents carry a disproportionate burden of cancer, including malignances that are preventable and screenable such as lung, colorectal, breast, and cervical cancer. In particular, Appalachian KY faces a perfect storm of rurality - 82% of the region is classified as rural as defined by 2013 USDA Rural-Urban Continuum Codes (RUCC) 4-9 - and low socioeconomic status (SES), as measured by education and income. Despite the magnitude and complexity of disparities in rural eastern KY, the University of Kentucky's Markey Cancer Center's (MCC) 40-year history of conducting Appalachian-based cancer control research - in collaboration with the community - suggests that many of these challenges can be addressed through increased surveillance, research, education, communication, and adoption of culturally appropriate, evidence-based cancer control interventions. Through this proposed P30 administrative supplement, we have the opportunity to capitalize on and add value to MCC's existing community-based, multilevel cancer control efforts in Appalachian KY. The overall goal of this supplement is to leverage a strong and storied program of community outreach and engagement at the MCC and build capacity for developing, implementing, and sustaining cancer control research in collaboration with well-established clinical and community partners in rural, Appalachian Kentucky. Therefore, our specific aims are to: (1) Establish and convene a Community Advisory Board (CAB) to provide critical guidance and support of supplement activities, identify community assets, and connect MCC investigators to new clinical and community partners in the Appalachian region; (2) Conduct formative evaluation to identify and describe the barriers and facilitators to collaborative cancer control research among community and clinical partners in Appalachian KY; and (3) Develop, implement, and evaluate a multilevel pilot project in collaboration with clinical and community partners to assess capacity, infrastructure, personnel, and resources needed for future cancer control research implementation and sustainability. The outcomes of the supplement are to increase rural communities' capacity to participate in and conduct cancer control research and strengthen and expand collaborations between MCC and rural community and clinical partners. Accomplishment of these outcomes will lead to the development of partnerships that are actively engaged in addressing rural cancer disparities through innovative research activities, and ultimately, improved cancer outcomes in Appalachia. The supplement will be conducted in collaboration with the Northeast KY Area Health Education Center, a well-established community partner covering 17 counties in Appalachian KY.