Albertie, Monica

Abstract Background: The Mayo Clinic Comprehensive Cancer Center (MCCCC) is uniquely positioned to address cancer health disparities globally through the Community Outreach & Engagement (COE) Office and Program’s resources and partnerships in the areas of cancer research, education, and training. The goal of the COE Global Oncology Initiatives (GOI) is to lessen the cancer burden on patients globally by building global capacity through research, education, and training in MCCC impact regions. While MCCCC continues to build institutional relationships worldwide through the GOI, it has specifically increased research collaborations in Africa over the past 5 years. The purpose of this study is to synthesize and report the global oncology reach through scholarly output of collaborative efforts in ongoing research activities with partnering African countries. By analyzing and documenting research outputs within this area, we aim to better understand research priorities and needs, increase inclusivity of African populations, and improve potential avenues for impactful studies in global alliance networks. Methods: Publications were found by using key search terms and by using the map feature on Mayo Clinic’s Elsevier-hosted publication database to locate partner institutions throughout Africa. Only publications in the past 5 years, which included an African researcher as an author, and are relevant to cancer research were included. Duplicate publications were removed from the final dataset. Results: There are 86 unique MCCCC members collaborating with 11 different African countries (Algeria, Egypt, Ghana, Kenya, Morocco, Nigeria, South Africa, Tanzania, Tunisia, Uganda, and Zimbabwe). A total of 50 unique publications have been published, with an African country being represented 72 times. The majority of MCCCC global oncology work is with researchers in Sub-Saharan nations (n=43). Egypt, however, has the largest single country representation (n=22), followed by South Africa (n=14) and Nigeria (n=13). 164 unique African researchers across 133 different institutions have worked with MCCCC members. Prostate and liver cancer were the most represented cancers at 6 instances, respectively. Discussion: Overall, 86 MCCCC members are involved in global research that address cancer health disparities through equal partnership with African researchers, which has resulted in multiple research output. Some of the publications were led by global consortia or cohort studies. These collaborations have been mutually beneficial for MCCCC members and African investigators, elevating cancer research in Africa. This includes increased research scholarship, extramural funding for cancer research in Africa, opening of more clinical trials across the continent, and increase in cancer biomedical workforce. Global research, especially one that is inclusive of the African populations, will foster the understanding of the genetic architecture of cancer, and help shape cancer care and control for Africans and people of African ancestry. Citation Format: Parisa Fathi, Manisha Salinas, Monica Albertie, Folakemi Odedina. Addressing cancer health disparities through global oncology initiatives at a comprehensive cancer center [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A135.

Abstract Background: The National Cancer Institute’s (NCI) Cancer Center Support Grants (CCSGs) encourages Cancer Centers to address health disparities and reduce the cancer burden in their Catchment Area (CA) through an organized Community Outreach and Engagement (COE) structure. COE activities focus on engaging communities to address cancer needs through bidirectional partnership, facilitation of research that meets community needs, and the implementation of evidence-based practices. Methods: Following a 2018 “satisfactory to good” rating for COE, the Mayo Clinic Comprehensive Cancer Center (MCCCCC) developed a transition team to specifically address the critique and create a transformative plan for engaging communities to address cancer burden in the CA. An impact model was developed to illustrate the components of the CCSG and connect those components to short- and long-term COE outcomes. A logic model was developed to track and monitor activities for continuous process improvement for all COE activities. Results: The impact and logic model serve as a roadmap to monitor progress towards short- and long-term COE goals of the MCCCC. The COE operational strategies draw upon bidirectional partnership, evidence-based practices, and research facilitation to respond to the CCSG critique. Conclusion: These strategies demonstrate successful practices in addressing cancer burden, promoting health equity and eliminating cancer disparities in the MCCCC CA. Citation Format: Manisha Salinas, Monica Albertie, Doug Murrell, Folakemi Odedina. Operational strategies for achieving NCI comprehensive cancer center community outreach and engagement objectives: Impact and logic models [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A117.

Background For individuals living with chronic conditions like diabetes mellitus and obesity, there is a need for sustainable behavioral strategies and physiologic tools. These tools support identifying and addressing barriers to healthy eating, reducing body mass index (BMI), and building increased physical resilience in real time. Objective To evaluate whether a 12-week learning management system designed to combine nutritional intervention with education and coaching on improving emotional intelligence (EI) could alter cardiometabolic outcomes. Methods This pre-post prospective study enrolled 37 adult volunteers with BMI greater than 25 to participate in a 12-week learning management system. Primary (BMI, systolic blood pressure, diastolic blood pressure, low-density lipoprotein [LDL], high-density lipoprotein, and fasting glucose levels) and secondary self-reported outcomes were assessed at baseline, 12 weeks, and 6 months after enrollment using Short Form-36, Emotional Quotient Inventory (EQi), and Whole Health Index (WHI). Linear mixed-effects regression models with random effect were used to estimate changes in primary and secondary outcomes. We adjusted for multiple testing using Holm step-down method. Results BMI and LDL were the only primary endpoints lower at program completion and 6-month follow-up compared to baseline levels (−1.63 and −17.77 mg/dL, respectively; P < .001). Secondary outcomes showing statistically significant improvement from baseline to 6-month follow-up included energy/fatigue (Short Form-36), self-regard (EQi), decision-making (EQi), impulse control (EQi), stress management (EQi), Whole Brain – Form A (WHI), Whole Food – Form C (WHI), and Whole Body – Form D (WHI). Conclusion This study provides preliminary evidence that lifestyle programs combining nutritional interventions and EI can have a significant impact on BMI and LDL. Our study highlights the potential importance of both nutrition and EI in programs targeting diet and lifestyle modification.

Abstract Background: Wellness Rx is a community-academic partnership program developed through a community engagement and participatory model (CEP) framework, to improve health disparities in an under-resourced predominantly Black community. This program addresses health disparities in chronic disease and social determinants of health through interactive health education, empowerment, and neighborhood support. This program aims to increase access to resources, increase capacity and strengthen relationships with local organizations for sustainable health outcomes. Wellness Rx ran in the community for 4 years with financial and logistical support from an academic medical center. In year 5, the community participated in sustainability training to shift and transfer ownership to community members. Methods: A sustainability training program was developed and delivered to community members to allow for Wellness Rx to be community-led and self-directed. A core group of 12 community members volunteered to serve as the taskforce that would ultimately lead and direct Wellness Rx after the sustainability training. This training included Information sharing of program materials, key partnership contacts, resource lists, skills training on program implementation, volunteer management, grant writing, partnership development and leadership. Results: Since the adoption of the training program, the community has tailored the Wellness Rx to meet their needs and priorities, and encompasses topics within and outside of behavioral health. As leaders of the program, they have expanded their partnerships beyond existing networks and have secured funding for activities. Conclusion: Wellness Rx demonstrates the potential for a program to become self-directed after initial support from an academic medical center. Core components of Wellness Rx can be replicated and implemented as a power-sharing model for long-term sustainability. Citation Format: Manisha Salinas, Monica Albertie. Sustainability plan for Wellness Rx: A community-led initiative to reduce disparities and improve healthy lifestyles in an under-resourced Black community [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B030.

Abstract Background: Inclusion of historically underrepresented populations in research has been a problem existing for many years. The recent Covid pandemic has exposed the significant cost of gaps in access to care. There remains a need to reevaluate current research paradigm frameworks to consider tailored approaches that accommodate any location that would ease participant burden and maintain retention. Current decentralized research models include home and mobile options. However, barriers exist, and certain demographics remain elusive to recruitment into research studies. Aim: In this paper, we aim to identify a theoretical framework that will allow for more inclusivity in research. Methodology: Current utilized community-based decentralized research models are compared, barriers in recruitment and retention of interested participants are examined, and a framework individualized to study participants is offered. Results: The proposed framework expands upon the complex adaptive systems theory to incorporate community-based research which considers dividing studies into individual study visit components that may differ in location. It allows for ease of research participant access to care and mutual collaboration among providers and institutions. This new theoretical model expansion outlines a novel approach to community-based participatory research for increased representation and inclusion. Conclusion: Investigators should carefully consider creative and effective solutions to overcome barriers to research participation access, increase diversity and representation, and provide tailored public health interventions. Minimally risk study intervention visits may occur in multiple community-driven locations such as: community resource centers, local physician offices, mobile research units, remote electronic visits, home settings, and a combination of the above (hybrid model). Breaking studies into individual study visit components expands the reach of science into the communities that have long been difficult to reach. Citation Format: Jennifer M. Crook, Manisha Salinas, Parisa Fathi, Jessica Otero Machuca, Emelina Asto Flores, Monica Albertie, Noreen Stephenson, Chelsea Reeves, Folakemi Odedina. Expanding current decentralized research model concepts for targeted community health interventions [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A060.

Introduction: The COVID-19 pandemic has disproportionally affected historically marginalized populations and their access to resources and healthcare. In times of crisis, authentic community engagement is more important than ever. This study was Phase 1 of a larger 3-phase study to conduct timely community-engaged research with community members to understand the disproportionate impact of COVID-19 on historically underserved communities. The objective of this work was to conduct key informant (KI) interviews (1) to understand community organizations perspectives about the role that large academic health centers play as they interface with community organizations to support their work, (2) to leverage KI’s expertise to identify needs and assets within the community, and (3) to inform both Phase 2 (focus group qualitative research) and Phase 3 (survey) of the broader study. Methods: A total of 24 key informants were identified through purposeful sampling and one-on-one semi-structured interviews were conducted across 4 states using video conferencing. Results: Barriers to access and lack of transparency were highlighted as major issues requiring reform—in particular, aggressive billing practices and insurance barriers exacerbated local distrust of medical institutions. KIs recognized the health institution’s support for testing and vaccination during the COVID-19 pandemic, but noted other significant gaps in care, especially regarding mental health support. Although communication with the health institution was consistent for some KIs, others experienced unsustained communication efforts that hindered cooperation and relationship building. Conclusions: Leaders in the community as key stakeholders can provide unique insights into the challenges and potential solutions required to promote health equity, and foster understanding between local communities and healthcare institutions.

A dementia friendly community allows people with dementia and their care partners to remain engaged in their community well into the disease. This study presents the results of primary research aimed at exploring perceptions regarding building a dementia friendly community in an African American neighborhood in northeast Florida. Twelve focus groups and five interviews were conducted with people living with dementia, informal and formal care partners, community stakeholders and neighborhood residents, and analyzed using a grounded theory approach. Three main themes emerged from the analyses, including (1) perceived needs, (2) facilitators and barriers to being dementia friendly, and (3) opportunities for the community to become more dementia friendly. Study findings highlight the unique needs of a single African American neighborhood and the importance of culturally tailoring the dementia friendly model to diverse communities.

While genetic research (GR) is fueling discoveries in fields like precision medicine, there is a growing concern that underrepresentation of racial and ethnic populations in GR will limit access to its benefits and subsequently worsen health disparities. This study aimed to understand GR perceptions among members from underrepresented communities by studying discourse and language use in focus group discussions. Nine focus groups were conducted with adults from three populations: African American, Hispanic/Latino, and Native American; 53 women and 15 men participated. Data were analyzed using methods of discourse and content analysis. Discourse analysis highlighted how conceptualization of science and family—rooted in historical experiences—can influence views on GR risks and benefits to self and others. The use of focus group discourse in particular provided an opportunity for group sense making around the science and ethics of GR. Content analysis highlighted differences between the language use of focus group moderators, who spoke about scientific discovery and research oversight, and that of participants, whose talk highlighted ancestral bloodline, personal risk, and ethical concerns. The findings can inform efforts to bolster GR participation, including recruitment and educational campaigns. However, they also challenge researchers to consider areas of discordance between their own and community members’ conceptualization of the risks and benefits of GR participation, including the notion of future and family benefit.