Hali R. Robinett

Abstract A83: University of Guam/University of Hawaii Cancer Center Partnership: Twelve years of progress in addressing cancer health disparities in Pacific Islanders

The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) Partnership aims to grow cancer research capacity at UOG; develop cancer health disparities research at UHCC focusing on Pacific Islanders (PI); raise awareness of cancer and cancer prevention in Guam (GU), Hawaii (HI), and the U.S. Associated Pacific Islands (USAPI); and increase the number of cancer and biomedical science researchers of PI ancestry in the United States. An infrastructure comprising 6 principal investigators, over 30 participating faculty, administrative staff, and external and internal reviewers, backed by institutional support and NCI sponsorship, has supported 14 years of research, training, and outreach designed to reduce cancer health disparities and advance health equity among PI in GU, HI, and the USAPI. Since 2009, the Partnership has funded 17 cancer research projects addressing cancer research priorities of global and regional relevance, including cervical cancer and betel nut chewing--a traditional practice associated with oral pre/carcinoma, affecting 600 million users worldwide. Approximately 75 manuscripts have been published, approximately 100 abstracts presented, and 13 grants secured. To address the under-representation of PI in biomedical sciences, the Partnership has supported 30 graduate fellows, including 76 doctoral students at UH. Two PhD graduates are now faculty members at UOG and engaged in cancer health disparities research. UOG9s Micronesian Studies Program now offers a cancer health disparities track, developed by the Partnership and tailored for the Pacific region. In addition, UOG/UHCC faculty, junior investigators, and pre/postdocs receive mentorship, career development, and summer research fellowships; to date, six UOG faculty have participated in the summer fellowship program at UHCC and two have subsequently secured pilot funding. Outreach projects have explored community-based participatory approaches to youth tobacco-use prevention and cessation in Guam, and the use of social networking to reduce tobacco-related cancer risk. Community-based participatory research has also led to landmark tobacco-control legislation in Guam, resulting in decreased tobacco use and increased tobacco taxes, a percentage of which supports cancer programs and patient services in Guam including the Guam Cancer Registry. Current outreach efforts aim to increase cervical cancer screening among Micronesian migrants and build cancer prevention knowledge and awareness among physicians who serve them in Guam and Hawaii. In conclusion, the Partnership has significantly increased research capacity at UOG and cultivated interest in cancer research among under-represented minority students at the partnering institutions. Supported by NCI grants U54CA143727 and U54CA143728. Citation Format: Carl-Wilhelm Vogel, David C. Ward, Neal A. Palafox, Hali R. Robinett, Rachael T. Leon Guerrero, Robert A. Underwood, John A. Peterson. University of Guam/University of Hawaii Cancer Center Partnership: Fourteen years of progress in addressing cancer health disparities in Pacific Islanders [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A44.

Abstract A08: University of Guam/University of Hawaii Cancer Center Partnership: An 11-year partnership to advance cancer health equity in Pacific Islanders

The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) Partnership aims to build capacity to reduce cancer health disparities (CHD) in Guam, Hawaii, and the US-associated Pacific Islands (USAPI) through cancer research, training, and outreach. Since 2003, the UOG/UHCC Partnership has provided scholarships and training in CHD research to a growing number of graduate students at UOG and UHCC with a special focus on Pacific Islanders who are underrepresented in the fields of cancer research and healthcare. UHCC investigators provide mentorship to early stage investigators (ESI) at UOG through annual meetings and workshops, monthly video teleconferences, electronic communications, and summer fellowships at UHCC. A system has been established to review, award, and evaluate new and ongoing pre-pilot, pilot, and full research projects. Outreach activities draw upon the principles of community-based participatory research to increase tobacco cessation, reduce cancer risk, and strengthen tobacco control policy. Since Fall Semester 2009, 16 master9s degree students at UOG have received fellowship support, and two UOG graduates are enrolled in doctoral programs at US mainland institutions. Two PhD students at UHCC are currently receiving fellowship support, and three master9s degree students have graduated from UH. One scholar is now in a tenure track faculty position at UOG and engaged in the Partnership. Over the past five years, UOG developed a cancer health disparities curriculum tailored for the Pacific region, now a permanently sustained track in UOG9s Micronesian Studies Program. In addition, mentorship and career development is provided to ESI at UOG: UHCC investigators have mentored 10 UOG ESI since 2009. Four UOG faculty received summer fellowships at UHCC; two subsequently secured pilot funding. Research of regional relevance and global importance is jointly conducted by investigators at UOG and UHCC, including six betel nut related pilot projects that are exploring the associations of betel nut use and health related conditions and behaviors among users in Micronesia; sociocultural factors affecting betel nut chewing in Guam; the influence of betel nut use on the oral microbiome; the identification of alkaloids present in the varieties of betel nut on Guam; identification of salivary biomarkers in betel nut consumption; and the functional assessment of molecular components of betel nut involved in pro-inflammatory mechanisms of immune cells. Other research projects are addressing CHD-related research questions around cancer risk and risk perception: health information trends and needs in the Pacific among adults and youth; feasibility of electrical breast densitometry in assessing breast cancer risk; and breast cancer risk factors for Pacific Islander women. Outreach projects are exploring community-based participatory approaches to youth tobacco use prevention and cessation in Guam, and the effectiveness of a social network-based approach to reducing tobacco-related cancer risk. Outreach activities have also contributed to the introduction and passage of significant public health legislation in Guam, resulting in decreased tobacco use and increased tobacco taxes, a percentage of which supports patient services in Guam as well as the Guam Cancer Registry. Almost 50 papers have been published, and at least 7 grants have been awarded to members of the partnership as a result of the work of the partnership. In conclusion, the unique multi-ethnic, sociocultural, and geographic characteristics of the UOG/UHCC partnership provide for many unique and important cancer research, training, and outreach opportunities with regional and global relevance. The Partnership has significantly increased research capacity at UOG and cultivated interest in cancer research among minority students attending the partner institutions. Outreach has resulted in model tobacco control policy in Guam. A regional research infrastructure has been established and resources have been leveraged to address Pacific Islander cancer health disparities in Guam, Hawaii, and the USAPI. Supported by NCI awards U54CA143727 and U54 CA143728. Citation Format: Hali R. Robinett, Rachael T. Leon Guerrero, Robert A. Underwood, Neal A. Palafox, David C. Ward, Carl-Wilhelm Vogel. University of Guam/University of Hawaii Cancer Center Partnership: An 11-year partnership to advance cancer health equity in Pacific Islanders. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A08.

Abstract A82: University of Guam/University of Hawaii Cancer Center Partnership: Celebrating 10 years of research, training, education, and outreach to reduce cancer health disparities among Pacific Islanders

Americans of Pacific Islander ancestry are highly underrepresented within the cancer research community. Critical to reducing cancer health disparities in Hawaii, Guam and the neighboring US-affiliated Pacific Islands (USAPI) is research designed and conducted by, for, and with Pacific Islanders. Similarly, dedicated efforts are required to provide education and training opportunities for Pacific Islanders to prepare them for future careers in health disparities research. Currently, eleven jointly-conducted U54-supported projects are addressing research questions: the associations of betel nut use and health related conditions and behaviors among users in Micronesia; sociocultural factors affecting betel nut chewing in Guam; the influence of betel nut use on the oral microbiome; the identification of alkaloids present in the varieties of betel nut on Guam; identification of salivary biomarkers in betel nut consumption; the functional assessment of molecular components of betel nut involved in pro-inflammatory mechanisms of immune cells; community-based participatory approaches to youth tobacco use prevention/cessation in Guam; the effectiveness of a social network-based approach to reducing cancer risk; health information trends and needs in the Pacific among adults and youth; and breast cancer risk factors among Pacific Islander women. Approximately 30 papers have been published, and several new grants have been received as an outcome of this partnership. Since 2003, a growing number of Pacific Island graduate students have received education and training in cancer health disparities research at the University of Guam (UOG) and University of Hawaii Cancer Center (UHCC). Over the past four years, UOG has developed with U54 support a cancer health disparities curriculum unique to the Pacific region, now permanently sustained by UOG. Multiple masters degree students at UOG have received support from the U54, and two UOG graduates are enrolled in doctoral programs at US mainland institutions. Two PhD students and one masters degree student at UHCC are currently receiving U54 support, and one U54-supported masters degree student recently graduated from UH. In addition, mentorship and career development is provided to early career faculty/investigators at UOG. In conclusion, our partnership has significantly increased over the past decade the research capacity at UOG and cultivated interest in cancer research among minority students attending the partner institutions. Outreach has resulted in model tobacco control policy in Guam, including new tobacco taxes that provide funds to support the Guam Cancer Registry and a Guam Cancer Trust Fund. A regional research infrastructure has been established and resources have been leveraged to address Pacific Islander cancer health disparities in Guam, Hawaii, and the USAPI. Supported by the National Cancer Institute of the National Institutes of Health under Award Numbers U54CA143727 and U54CA143728. Citation Format: Hali R. Robinett, Helen J.D. Whippy, John A. Peterson, Rachael T. Leon Guerrero, Robert A. Underwood, Neal A. Palafox, David C. Ward, Carl-Wilhelm Vogel. University of Guam/University of Hawaii Cancer Center Partnership: Celebrating 10 years of research, training, education, and outreach to reduce cancer health disparities among Pacific Islanders. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A82. doi:10.1158/1538-7755.DISP13-A82

Abstract B24: Stimulating the development of research and training in cancer health disparities through the University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) partnership.

a) Americans of Pacific Islander ancestry are highly underrepresented among cancer researchers and cancer health care professionals. Research designed and conducted by, for and with Pacific Islanders is critical to reducing cancer health disparities (CHD) and effectively delivering cancer health advances in Hawaii, Guam, and the neighboring US-associated Pacific Islands (USAPI). b) Graduate students are provided education and training in cancer health disparities research at both partner institutions. A CHD curriculum at UOG addresses cancer health outcomes and challenges unique to the Pacific region. Summer fellowships and annual workshops provide opportunities for faculty mentorship and development. The partnership9s scientific and administrative leadership provides mentorship and consultation in the development of research projects with regional importance. c) Many Master9s students at UOG have benefitted from the partnership, including several UOG graduates now enrolled in PhD programs at mainland universities. Three PhD students at UHCC are currently receiving mentorship and graduate student assistantships. All student scholars are involved in cancer research at both partner institutions. A cancer health disparities track established by the UOG9s Micronesian Studies Program is now sustained by UOG. Approximately 20 peer-reviewed publications have resulted from the partnership since its inception, and a growing body of faculty at UOG and UHCC is participating in the partnership. Eight jointly-conducted projects are addressing research questions identifying: the associations of betel nut use and health related conditions and behaviors among users in Micronesia; sociocultural factors affecting betel nut chewing in Guam; the influence of betel nut use on the oral microbiome; the presence of alkaloids in the varieties of betel nut on Guam; the functional assessment of molecular components of betel nut involved in pro-inflammatory mechanisms of immune cells; community-based participatory approaches to youth tobacco use prevention/cessation in Guam; health information trends and needs in the Pacific; and breast cancer risk factors unique to Pacific Islander women. d) Over the past decade, this partnership has increased research capacity at UOG and among minority students attending the partner institutions, and increased research involvement, expertise, and resources at UHCC and UOG to address research priorities and cancer health disparities in Guam, Hawaii, and the USAPI. Supported by NIH U54 CA143727 and U54 CA143728. Citation Format: Hali R. Robinett, Helen JD Whippy, Carl-Wilhelm Vogel. Stimulating the development of research and training in cancer health disparities through the University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) partnership. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B24.

Abstract B26: Building capacity in cancer research, training, and outreach through a Partnership to Reduce Cancer Health Disparities in Guam, Hawaii, and the U.S.-associated Pacific Island jurisdictions

The University of Guam(UOG)/University of Hawaii Cancer Center (UHCC) Partnership aims to: a) increase the cancer research activities and the number of faculty involved in cancer research at UOG; b) increase the number of minority scientists of Pacific Island ancestry engaged in cancer research while providing them with pertinent undergraduate, graduate and post-graduate education and training opportunities; c) further strengthen the research focus at UHCC on cancer health disparities (CHD) with particular emphasis on aspects unique to Guam and the Pacific region; and d) enhance the awareness of cancer and cancer prevention, and ultimately reduce the impact of cancer on the Territory of Guam, neighboring U.S.-associated Pacific Island jurisdictions, and Hawaii. The Partnership9s Cancer Health Disparities Seminar Series enhances education and training made available to minority students at the undergraduate, graduate, and postgraduate levels. Funding is available at UOG to support new faculty recruitment, and summer fellowships and annual workshops provide opportunities for faculty mentorship and development. Concepts for pilot and full research projects and programs are cultivated through a developmental process involving significant mentorship and consultation provided by the Partnership9s scientific and administrative leadership. Partnering investigators with well developed concepts are invited to submit proposals for initial peer review conducted by the Partnership9s Internal Advisory Committee, followed by an external peer review process. Scientific evidence and Guam Cancer Registry data are presented by the Partnership to influence public health policy and resource allocation. Cancer related research was nonexistent at UOG prior to 2003 with the establishment of the UOG/UHCC Partnership. Today, 10% of the UOG faculty participate in the Partnership. Four faculty have been recruited to UOG and 3 faculty have enjoyed summer fellowships supported by the existing grant. Over 20 students have benefitted from the training, education and mentorship provided through the collaboration; 7 master9s and 3 doctoral students are supported by the current grant. Four jointly conducted projects are addressing research questions of particular relevance to Guam and the neighboring Pacific islands. Funded projects are identifying: breast cancer risk factors unique to Pacific Islander women; the associations of betel nut use and health-related conditions/behaviors among users in Micronesia; sociocultural factors affecting betel nut chewing among Pacific Islanders on Guam; and community-based participatory approaches to tobacco use prevention and cessation among youth on Guam. The Partnership has made a positive impact on cancer awareness and public health policy, having advised the Territory9s legislature in establishing Guam9s comprehensive smoke-free legislation and, more recently, model tobacco tax legislation. Tobacco tax revenues now support cancer screening, treatment and support services as well as the Guam Cancer Registry. Twenty-four peer-reviewed articles have been published over the history of the Partnership. A stable, longstanding partnership between the University of Guam and the UH Cancer Center supports the recruitment and development of a new and growing body of faculty investigators at UOG, and an expanding emphasis on cancer health disparities research at UHCC. Students and faculty are exploring and addressing cancer research priorities in the region while delivering cancer advances to ethnically diverse communities served by the partnering institutions. The visibility and credibility of the Partnership will continue to positively influence public health policy and cancer prevention and control services in Guam and, ultimately, in neighboring Pacific Island jurisdictions. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B26.

Abstract B45: Partnering to reduce cancer health disparities in Guam, Hawaii, and the U.S.-associated Pacific Islands through research, training, and outreach

Significance: Americans of Pacific Islander ancestry are a highly underserved minority with a significant burden of cancer health disparities (CHD). Pacific Islanders are also highly underrepresented among cancer researchers and cancer health care professionals. Progress has been slow to increase the pool of minority scientists with interests in CHD research. Methods: Since 2003, the University of Guam (UOG) and the Cancer Research Center of Hawaii (CRCH) at the University of Hawaii have been engaged in a partnership designed to develop research capacity at UOG and direct interest, expertise and resources to address CHD unique to Hawaii, Guam and the US-associated Pacific Islands. Education and training at the undergraduate, graduate, and postgraduate levels for minority students, combined with faculty development at UOG, is expected to grow the number of minority scientists in cancer research. Funding is available to support investigator-initiated research and programs designed to reduce CHD in the region. Results: Prior to establishing the UOG/CRCH Partnership, there was no cancer related research conducted at UOG. Today, nearly 10% of the UOG faculty participate in the Partnership, and over 20 students have benefitted from the training, education and mentorship provided through the collaboration. Additionally, the Guam Cancer Registry and a Cancer Research Center of Guam have been established on the campus of UOG. At CRCH, an increasing number of faculty are addressing cancer health disparities in the Hawaii/Pacific region. Jointly conducted projects have addressed issues of particular relevance to the populations served by the Partnership, including chronic disease risk factors for adults in Guam, and the associations of betel nut use and health-related conditions/behaviors. An outreach pilot addresses tobacco and youth prevention and cessation. The Partnership has made a positive impact on cancer awareness and public health policy, leading in 2006 to UOG9s smoke-free campus and the Territory9s comprehensive smoke-free legislation. In 2010, model tobacco tax legislation for the region resulted in the largest single-time tobacco tax increase in the entire US. Guam9s tobacco tax revenues now support cancer screening, treatment and support services as well as the Guam Cancer Registry, a full member of the North American Association of Central Cancer Registries. Over 15 peer-reviewed publications have resulted from the Partnership. Discussion/Conclusions: Reducing cancer health disparities is an important and integral component of our nation9s effort to improve the health of all Americans. Funding from National Cancer Institute9s (NCI) Center to Reduce Cancer Health Disparities has successfully teamed researchers from NCI-designated cancer centers with faculty members at a minority-serving institutions to address cancer health disparities through research, training/education and outreach. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B45.