Asian American and Pacific Islander (AAPI) communities face enormous health disparities, with tobacco use contributing to high rates of cancer and heart disease. There is growing interest nationwide on the influence of environmental factors on tobacco use. AAPI communities have been found to have higher exposures to tobacco company marketing compared to the general population. The authors describe the use of Photovoice (a qualitative needs assessment technique) to empower AAPI youth to identify and understand environmental characteristics associated with tobacco use in four AAPI communities in California and Washington. Of the six major environmental themes identified from the photos, three themes were found across all four communities. Debrief sessions with youth and community leaders underscore the relevance of Photovoice for identifying community needs and motivating community organization for change. Despite some logistical challenges, Photovoice exemplifies the power and potential of this community-based methodology to capture how the environment influences youth on tobacco use.
We discuss several study design and implementation limitations that could have influenced the study's results.
A gap exists between cancer prevention research and its translation into community practice. Two strategies to reduce this gap are community-based participatory research (CBPR) and dissemination research. CBPR offers an avenue to engage academic and community partners, thereby providing mechanisms for joint learning and application of knowledge. Dissemination research examines the movement of evidence-based public health and clinical innovations to practice settings. While applying these approaches may reduce the gap between research and practice, the cancer prevention workforce may be inadequate in size, insufficiently trained, lack resources and incentives, or face structural barriers to effectively participate in CBPR and disseminate evidence-based research findings into practice. Information on translating cancer prevention information to communities and workforce implications was obtained from a panel of experts and through a review of the literature on CBPR and dissemination research. The expert panel and literature review identified major barriers to successfully conducting CBPR and dissemination research in community settings. Barriers included inadequate policies; insufficient networking and communication infrastructures; unsupportive research cultures, climates, and mindsets; inadequate researcher and practitioner education; and limited CBPR and dissemination research with adequate study designs. No specific estimates of the cancer prevention workforce were found; however, indirect evidence for a shortfall were identified. We recommend expanding CBPR training for academic and community partners; increasing funding for dissemination research and practice; supporting proven partnerships; and providing strategic coordination for government agencies, research institutions, nongovernmental organizations, and the private sector to foster better dissemination of information and integration of community-based cancer prevention and control programs and practices. Specific challenges and needs that must be addressed to improve the translation of cancer prevention research into community settings were identified.
Recent efforts to assess the future workforce in oncology have elicited concern and action from several agencies and organizations; however, none have specifically focused on the workforce in cancer prevention or addressed the impact that prevention activities could have on the future burden of cancer in the United States. As the potential for prevention to reduce such burden is substantial, and because disparities in cancer still exist, which could be reduced by efforts in prevention, the necessity to consider the readiness of the current and future cancer prevention workforce to meet cancer prevention needs in clinical and public health practice is urgent.At The University of Texas M. D. Anderson Cancer Center, a symposium was organized on October 17 and 18, 2009, to begin characterizing the state of the cancer prevention workforce, both employed and in training. Our objectives included describing gaps and anticipating needs of the workforce, and identifying data needed for accurate characterization, even if currently unavailable. In preparation, organizers considered different models for evaluating workforce needs through an iterative process with experts from cancer prevention and cancer education and training. Eventually, five topic areas were organized into working groups that served as the structure for the symposium: (a) health policy and advocacy; (b) translation to the community; (c) implementing cancer prevention into clinical practice; (d) health services infrastructure and economics; and (e) discovery, research, and technology.At the symposium, attendees gathered for a keynote address that highlighted the progress of cancer education throughout the past 50 years and was followed by a poster session with
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