Abstract #3715 Increasing Access for Disparate Women to Participate in Breast Cancer Research

1. Abstract #3715 Increasing Access for Disparate Women to Participate in Breast Cancer Research Kristina L. Bondurant, Ph.D., Melanie Goodell, MPH, Martha M. Phillips, Ph.D., MPH, MBA, Susan Kadlubar, Ph.D., Suzanne Klimberg, M.D., Ronda Henry-Tillman, M.D. The University of Arkansas for Medical Sciences, Little Rock, AR Demographics Comparison of Southeast Delta to other regions in Arkansas Abstract Hypothesis The purpose of our study is to increase recruitment of rural and disparate populations within the Spit for the Cure Breast Cancer Cohort. The Spit for the Cure Breast Cancer Cohort being established at the University of Arkansas for Medical Sciences provides a repository of information and DNA samples to study breast cancer in Southern women. Currently, over 19,000 women from Arkansas and surrounding states have been recruited into the cohort. Demographics of the cohort closely match the demographics of the state of Arkansas, though our cohort is better educated and younger on average than the state’s overall female population. One of our goals is to over-sample disparate populations in rural areas, which presents many challenges; these areas tend to have sparse populations which are located in largely agricultural areas of Arkansas. Furthermore, it has been reported in literature that a lower percentage of minority populations and rural populations participate in biorepositories and cancer research. These are the same populations that suffer from limited access to health services. The assumption is that these populations are not willing to participate in cancer research; however, we hypothesize that disparate populations would enroll in research studies if given access to research opportunities. As a novel method for reaching underrepresented populations, Spit for the Cure recruiters collaborated with a mobile mammography unit, the Mammovan, based out of the Winthrop P. Rockefeller Cancer Institute at the University of Arkansas for Medical Sciences. We compared the demographics of participants recruited through community events in Southeast Arkansas, whose residents live in the rural Delta region, to recruitment from the Mammovan in that same region. Mammovan participants from Southeast Arkansas had a lower education level compared to women in that same area recruited through community events; 53.7% of Mammovan participants had no education beyond high school, compared to 25% of community participants (p-value <0.0001). Also, a greater proportion of African American women were recruited through the Mammovan (40.3%) compared to community events (31.1%) within the southeast region (p-value 0.01). Overall, the recruitment of Mammovan participants more closely reflects the actual demographics of the population of Southeast Arkansas. Interestingly, a high proportion of the Mammovan participants (81.8%) reported having had a mammogram prior to their Mammovan experience; indicating that these marginalized groups with limited access to health care facilities, are still able to leverage available resources in order to address their health needs. In conclusion, traveling with the mobile mammography unit is a valuable resource for the Spit for the Cure Breast Cancer Cohort to recruit disparate populations, who are in fact willing to participate, in order to more accurately mirror the demographics of Arkansas women. We hypothesize that disparate populations would enroll in research studies if given access to research opportunities. Results • Education and racial distributions of the Mammovan participants more closely resemble the distribution in the general population. • A higher mammography screening rate was observed in Mammovan participants. • Participation rates of Mammovan patients were high. • Statistics for the general population were obtained from the 2008 county census for race and the 2000 census for education. • The Delta is characterized with higher breast cancer mortality rates, a large African American population, and higher poverty levels when compared to other regions of the state. • The percent of residents residing in rural areas is similar to other portions of the state. • Age-adjusted death rates for breast cancer death rate per 100,000 women were obtained from the Arkansas Department of Health. The percent of African American population was obtained from the United States Census Bureau 2009 estimate. The percent of population under the poverty line in 2007 obtained from the United States Census Bureau 2008 estimate. Data for the percent of the population classified as living in rural areas was obtained from the 2000 United States Census database. * p=0.01, ** p<.001, *** p-0.2. Statewide Recruitment for the Spit for the Cure Breast Cancer Cohort Conclusions Recruitment in the Southeast Delta Region of Arkansas • Recruitment of Mammovan participants more closely reflects the actual demographics of Southeast Arkansas. • The participation rates by Mammovan patients was high. • A high proportion of Mammovan participants reported having had a mammogram prior to the Mammovan screening; indicating that these marginalized groups with limited access to health care facilities, are still able to leverage available resources to address their health needs. • Collaboration with the UAMS mobile mammography unit led to the recruitment of willing disparate populations who more accurately mirror the demographics of Arkansas women. Non-Mammovan Participants Mammovan Participants • Map represents enrollment from September of 2007 through October 31, 2010 • Over 19,000 women from Arkansas and surrounding states have been recruited into the cohort • Demographics of the cohort closely match the demographics of the state of Arkansas, though our cohort is better educated and younger on average than the state’s overall female population. • Maps illustrate the recruitment numbers of non-Mammovan community events compared to the collaborative Mammovan events. • The Mammovan began screening in February of 2010. • Data for non-Mammovan events includes community participants recruited to the Spit for the Cure cohort from September 2007 through October 31, 2010. Data for Mammovan events includes participants recruited from February 24, 2010 through October 31, 2010. Acknowledgements • We would like to give special thanks to Shelly Quick, the Spit for the Cure team of recruiters, and the Winthrop P. Rockefeller Cancer Institute Cancer Control staff for all of their efforts. • Spit for the Cure is supported by funds through the Arkansas Breast Cancer Research Program (ABCRP) of the Winthrop P. Rockefeller Cancer Institute at UAMS.