Sheppard, Vanessa B.

Abstract Introduction: COE has become the gold standard in addressing health disparities. COE’s value is emphasized by NIH and leading cancer-related organizations e.g., AACR. The Alliance for COE (The Alliance) mission is to advance the art, science, and impact of COE; promote community health and wellness; and reduce cancer burden and disparities. Methods: This abstract builds on the Alliance’s Science of Community Outreach and Engagement (SoCOE) Conference a NCI R13 funded series. SoCOE Conference is organized by 10 NCI-designated Cancer Centers to provide a platform for COE academic-clinical-policy-community stakeholders to share best practices for solution-focused community responsive cancer prevention, diagnostics, therapeutics and survivorship research and practice. Results: > 500 researchers, clinicians, policymakers, healthcare administrators, with >12% being survivors and/or advocates, participated in our SoCOE Conferences. The delegates’ recommendations are: Decentralize who/entities that hold all the power in science and clinical research (trials). Communities hold valuable, necessary wisdom and resources to inform and guide science Include multisectoral partners early and always Community capacity building and compensation with gratitude Mentoring of junior COE researchers, clinicians, policymakers, healthcare administrators, survivors and advocates with humility is a must Develop virtual communities to share best practices across cancer centers and within regions Develop working groups to identify and explore commonalities across COE work in rural/urban, diverse/homogenous spaces Publish Science of COE papers on various topics related to COE Frameworks and evidenced-solutions Provide community reports on best practice guide that can be widely available to be shared locally and in-person, and digitally Partner and learn from COE teams working with other cultural/ethnic groups Attend to, measure and remedy societal/social drivers of health disparities that mirror barriers to care, and research engagement and participation. Discussion: Informed by our community advisory boards and the findings for our SoCOE Conferences, we present the pillars of the Alliance to tackle population cancer burden and disparities: Training future COE leaders/advocates, Advocating for public health policies/guidelines, Increasing access to cancer prevention and care that will also increase access to studies, Engaging and partnering with multisectoral stakeholders and communities, Building community capacity, Advancing COE science through catchment-relevant research, and Leading bi-directional communication and information and resource sharing between catchment area communities and cancer centers. The expectation and impact of COE can only be achieved if COE teams are valued, supported cancer center members with community advisory boards and community as cancer centers’ priority population. Citation Format: Kimlin Ashing, CHARNITA ZEIGLER-JOHNSON, Hayley S. Thompson, Kim Rhoads, Nadine Barrett, Lisa Carter Bawa, Timiya S. Nolan, Monica Baskin, Vanessa B. Sheppard, Marvella E. Ford, Erica Phillips, Lorna H. McNeill, Folakemi T. Odedina. Advancing the science, practice and impact of COE [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 7577.

Community Outreach and Engagement (COE) ought to be prioritized, resourced, and supported to appropriately fulfill the Cures Act and tackle Catchment Community cancer burden and disparities. COE is not a person but the vision of community/public cancer prevention and control that surpasses both political and institutional leaders.

Abstract The requirement of community outreach and engagement (COE) as a major component of the National Cancer Institute (NCI) Cancer Center Support Grant has had an enormous impact on the way NCI-designated cancer centers identify, investigate, and address the needs of their catchment area (CA) communities. Given the wide-ranging diversity of our nation, COE’s scope of work (SOW) is extremely demanding and complex. Yet, COE is often marginalized and viewed as void of scientific methods when, in fact, it requires specialized scientific knowledge and a broad range of proficiencies. Black COE scientific directors may be particularly attuned to this marginalization as they have often confronted workplace inequities that resemble the health inequities observed within their cancer center’s CA. Thus, Black COE leaders are uniquely positioned to offer insight on the past, present, and future of COE. Key areas discussed include the low involvement of minoritized group members and those with appropriate expertise in national COE leadership; the lack of established, consistent criteria for evaluation of COE components and qualifications of evaluators; the need for substantial financial investment in COE; potential misalignment of community priorities and cancer center objectives; professional development and growth of COE staff and leaders; the expanding scope of COE across their respective cancer centers and CAs; and the need for center-wide involvement in COE and an “all-hands-on-deck” approach. These areas warrant thoughtful dialogue as COE evolves, for the benefit and success of all COE leaders. However, this dialogue must include diverse voices representing similarly diverse stakeholders at every level.

Abstract Background: Adjuvant endocrine therapy (AET) improves outcomes in women with hormone receptor–positive (HR+) breast cancer. Suboptimal AET adherence is common, but data are lacking about symptoms and adherence in racial/ethnic minorities. We evaluated adherence by race and the relationship between symptoms and adherence. Methods: The Women's Hormonal Initiation and Persistence study included women diagnosed with nonrecurrent HR+ breast cancer who initiated AET. AET adherence was captured using validated items. Data regarding patient (e.g., race), medication-related (e.g., symptoms), cancer care delivery (e.g., communication), and clinicopathologic factors (e.g., chemotherapy) were collected via surveys and medical charts. Multivariable logistic regression models were employed to calculate odds ratios and 95% confidence intervals (CIs) associated with adherence. Results: Of the 570 participants, 92% were privately insured and nearly one of three were Black. Thirty-six percent reported nonadherent behaviors. In multivariable analysis, women less likely to report adherent behaviors were Black (vs. White; OR, 0.43; 95% CI, 0.27–0.67; P < 0.001) and with greater symptom burden (OR, 0.98; 95% CI, 0.96–1.00; P < 0.05). Participants more likely to be adherent were overweight (vs. normal weight) (OR, 1.58; 95% CI, 1.04–2.43; P < 0.05), sat ≤ 6 hours a day (vs. ≥6 hours; OR, 1.83; 95% CI, 1.25–2.70; P < 0.01), and were taking aromatase inhibitors (vs. tamoxifen; OR, 1.91; 95% CI, 1.28–2.87; P < 0.01). Conclusions: Racial differences in AET adherence were observed. Longitudinal assessments of symptom burden are needed to better understand this dynamic process and factors that may explain differences in survivor subgroups. Impact: Future interventions should prioritize Black survivors and women with greater symptom burden.