Internal Medicine

Selected Research Projects

Appalachia Community Cancer Network (ACCN)
Principal Investigator: Mark Dignan, PhD
Funding Agency: National Cancer Institute (NCI)

The Appalachia Community Cancer Network (ACCN) is a team of community partners and academic collaborators from Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia working together to reduce cancer health disparities in the Appalachian region. The ACCN is one of 23 Community Networks Program Centers across the country funded by the National Cancer Institute Center to Reduce Cancer Health Disparities to conduct community-based participatory research (CBPR), education and training activities to reduce  the cancer burden in minority and underserved communities.   The Network consists of an Administrative Core, Research Program, Community Outreach Program, Training Program, and numerous community partners throughout central and northern Appalachia.  The specific aims of the ACCN are to:  1)  maintain community partnerships to facilitate cancer health disparities research; 2) conduct CBPR to address cancer health disparities in Appalachia, including a region-wide research project; 3) develop a training program in CBPR for junior investigators/postdoctoral scholars; and 4) disseminate research findings to community and scientific partners.  Currently, the ACCN is conducting a region-wide research project focusing on two well-established, highly prevalent cancer risk factors - obesity and physical activity.  Addressing these risk factors is critical to reduction of the cancer burden in the region.  

ACCN Website
http://www.accnweb.com/

Faith Moves Mountains: A CBPR Applachian Wellness and Cancer Prevention Program
Principal Investigator: Nancy Schoenberg, PhD
Funding agency: National Center on Minority Health and Health Disparities

This is a five-year, community-based intervention that extends the successful faith-based, trained lay health advisor tailored intervention, "Faith Moves Mountains," (R01 CA 108696) to administer a culturally appropriate CBPR intervention. Working in partnership with 70 faith-based institutions in rural Southeastern Kentucky, investigators will administer, evaluate, and disseminate a tailored wellness and cancer prevention program focused on four of the most common prevention activities that have the potential of greatly preventing and reducing cancer morbidity and mortality. These prevention activities include smoking cessation (targeting all chronic diseases, cervical and lung cancer); energy balance including dietary modification and physical activity promotion (targeting all chronic diseases and colorectal cancer (CRC)), and cancer screenings (targeting CRC, cervical, and breast cancer). Consistent with the “Faith Moves Mountains” and cancer control approach, faith-based organizations will sponsor a "kick off event" or health fair in which participants will undergo a health risk appraisal (baseline). Participants will then select one or more wellness activities (smoking cessation, energy balance, cancer screening); then, trained lay health advisors will offer modules on each of these wellness activities. Smoking cessation will include the culturally relevant Cooper-Clayton method (outcome: smoking abstinence). For those targeting dietary modification and physical activity, a rural Appalachian modified Healthy Body/Healthy Spirit program will be administered (outcome: dietary change and physical activity participation).

Faith Moves Mountains Website
http://www.faithmovesmountains.org/

Increasing Colorectal Cancer Screening in Rural Kentucky
Principal Investigator: Mark Dignan, PhD
Funding agency: National Cancer Institute

This is a five-year, community-based, participatory project focusing on increasing colorectal cancer screening in rural Appalachia. Specific aims of the project are to: 1) recruit primary health care providers, conduct a baseline assessment, and implement an educational intervention using academic detailing methods; and 2) evaluate the effectiveness of the intervention in increasing colorectal cancer using a stratified, randomized design involving primary care practices assigned to intervention or control based on a readiness to change score and conducting qualitative key informant interviews and process evaluations.

Patient Navigation for Cervical Cancer in Kentucky
Principal Investigator: Mark Dignan, PhD
Funding Agency: National Cancer Institute

This is a 5-year, community-based project focused on reducing the disproportionate cervical cancer burden experienced by rural Appalachian women by increasing adherence with recommendations for follow-up treatment after abnormal results. Specific aims of this project are to: 1) utilize lay health workers as patient navigators in local health department cervical cancer screening programs; 2) train patient navigators and establish working relationships between navigators and local health department personnel, including designated nurse case managers; 3) link patients with abnormal findings after cervical cancer screening in local health departments with a well-trained patient navigator; 4) develop and implement an effective patient tracking and data collection system; and 5) shorten the time intervals between the finding of abnormal screening results and establishment of a diagnosis, and between diagnosis and initiation of treatment.