key: cord-0029576-64w6p1ke
authors: nan
title: 2021 International Cancer Education Conference Program and Abstracts
date: 2022-04-06
journal: J Cancer Educ
DOI: 10.1007/s13187-022-02141-3
sha: 1aca82bcbdbcdb8d852fb6171a269fb632886fe6
doc_id: 29576
cord_uid: 64w6p1ke

nan

The goal of the ICEC is to facilitate interdisciplinary research and practice/program collaborations among cancer researchers, educators, and students on a national and global level. Educational models, programs and research strategies will be presented to support the development of evidence-based practices in the field of cancer education.

It is estimated that there were 19.3 million new cases of cancer and 10 million cancer deaths worldwide in 2020 (Sung et al., 2021) . Experts predict that between 2020 and 2040 the global incidence of new cancer cases will increase by 47% to 28.4 million cases (Sung et al., 2021) . Population growth, aging populations, and increases in the prevalence of modifiable cancer risk factors, such as smoking and obesity, contribute to the predicted increase of the global cancer burden (Huang et al., 2020; Liutkute et al., 2017; Pinto et al., 2019; Sung et al., 2021; Yang et al., 2021) . In addition, disability and premature death due to cancer will result in significant increases in years of potential life lost among vulnerable populations worldwide (Best et al., 2018; Kihn-Alarcón et al., 2020; Ma et al., 2015; Priyadarshini et al., 2020; Rumisha et al., 2020; Sánchez-Barriga, 2016; Sharma et al., 2018; Trogdon et al., 2020) . Advances in primary prevention and early detection interventions, and cancer treatment strategies, have reduced cancer mortality rates in some countries, such as the United States (Henley, Ward, et al., 2020; Howlader et al., 2020) . However, the lack of health equity has contributed to the inequitable distribution of and access to advanced cancer prevention and control interventions and strategies (Alcaraz et al., 2020) . Disparities in cancer outcomes have persisted among vulnerable populations, including those in high-income countries (Alcaraz et al., 2020; de Souza et al., 2016) . For example, in Romania, disparities in cervical cancer incidence and mortality are attributed to lower screening rates among women with low incomes (Todor et al., 2021) . Disparities in prostate cancer outcomes among African American men are attributed, in part, to nonclinical factors such as the receipt of lower quality cancer treatment (Schmid et al., 2016; Shavers & Brown, 2002) . Furthermore, inequitable access to cancer prevention and treatment services contributes to the growing burden of cancer in countries, such as India, that are experiencing epidemiologic transitions (India State-Level Disease Burden Initiative Cancer, 2018). To eliminate disparities in cancer outcomes, health equity in cancer prevention and control must be achieved. Proposed strategies from leaders in cancer education include amplifying the contemporary focus of culture and literacy in cancer education, practice, and research; and advancing interdisciplinary collaborations to invigorate research methods (Meade et al., 2020) . Concerted efforts for comprehensive cancer control must include the development of culturally relevant programs, policies, systems, and environmental changes (Henley, Thomas, et al., 2020; Platz, 2017; Schüz et al., 2019; Sung et al., 2021) . In addition, there is a need to focus on the equitable dissemination of the latest information about cancer prevention, treatment, and care, and the equitable implementation of evidence-based interventions and treatments (Brownson et al., 2021; Henley, Thomas, et al., 2020; Moore et al., 2019; Schüz et al., 2019) .

This conference will address the following learning gaps among cancer education professionals and students:

1. Develop strategies that explore and address health inequities to alleviate cancer disparities.

2. Identify and support training, interdisciplinary collaboration, and mentorship opportunities for junior investigators and practitioners to support their development as cancer researchers and educators. Shark Tank gameshow framework for students to innovatively address cancer-related challenges. Attendees will implement this framework to develop their own Shark Tank session. 'Shark Tank', a popular reality show, has 'sharks' or experts determine whether contestants justified solutions to stated problems. Game show-inspired learning(1) motivates individuals due to inherent competition and collaboration common in problem-based learning(2). Grounded in experiential learning(3) and culturally responsive pedagogy(4), this workshop will engage attendees to address cancer-related health disparities and community needs. Simultaneously, this experience will enhance professional development skills of collaboration and public speaking(5) to sway public policy and attain hypothetical funding. Beginning with a 'stoke' or ice breaker, participants brainstorm qualities of memorable public speakers and how the audience was engaged. Think-pair-share will encourage comparison of common public speaking strengths and weaknesses and how to foster those among future researchers, policy makers and cancer providers. The facilitators will provide an overview of game show-based learning, its principles, and benefits. Next, using the experiential learning cycle, participants will be guided through the Shark Tank framework with three scenarios of cancer-related health disparities. Small groups will develop innovative solutions and present those to the 'Shark Tank', who will determine which group receives the hypothetical funding. Emphasis will be on use of evocative public speaking skills and proposed solution. The large group will debrief after each presentation to highlight presentation strengths. After completing the session, participants will design their own Shark Tank workshop applicable to their home institutions and unique cancer disparities. Objectives: The participant shall be able to delineate and justify key characteristics and qualities of impactful public speakers. The participant shall be able to apply novel game show-based learning strategies and education principles to engage future learners in developing solutions to address cancer-specific health inequities using communication skills/public speaking skills to aid in obtaining hypothetical grant funding. The participant shall be able to design their own tailored 'Shark Tank' workshop focused on cancer-related health inequities to immerse learners in various programs relevant to one's unique community. References (2), 276-285. 4. Kolb, A. Y., & Kolb, D. A. (2005) . Learning styles and learning spaces: Enhancing experiential learning in higher education. Academy of Management Learning & Education, 4(2), 193-212. 5. Ladson-Billings, G. (1995) . But that's just good teaching! The case for culturally relevant pedagogy. Theory into Practice, 34(3), 159-165.

Filipe Santos-Silva IPATIMUP, Porto, Portugal

Abstract: The success of Cancer Education programs depends largely on patients, emotional, social, and economic contexts, which profoundly affect their health literacy and communication skills. Patients in unfavorable conditions usually present a defensive posture, fearing judgmental attitudes on the part of health professionals and preventing success in the acquisition of information and knowledge. To overcome these difficulties, we propose an innovative methodology (Serious Play®) based upon a concept of participatory practices and co-creation. Serious Play® is a new concept used to facilitate communication and collective problem solving, that could be successfully used to improve cancer education. The methodology is based on many concepts from psychology and behavioral sciences (Piaget and Papert) and offers patients an educational experience (often therapeutic and cathartic) that facilitates cognitive development, emotional expression, and social bonding. The method provides all patients with a shared "language" regardless of culture, academic degree, or social position. The methodology is a facilitated meeting, communication, and problem-solving technique for groups. In the workshop participants will learn the basic concepts and techniques of the Serious Play® Method and how to apply them to the cancer education context. Participants will actively learn about the core process -Question, Construction, Sharing, Reflectionand application techniquesindividual and shared models, making connections, building systemswhile improving their facilitation skills. he serious aspect of the method requires focusing on a task or challenge, while the play aspect emphasizes imagination and creativity (building a 3D model). Together these components are able to foster a deeper learning engagement. Through the proposed questions, model construction, and associated metaphors, the facilitator can discuss with patients the knowledge and perspectives on a given topic. Models can take on new meanings and, eventually, represent abstract concepts, serving as the basis for group discussion and knowledge sharing. Objectives: Participants shall be able to: Reproduce the 4 phases of the core process of the Serious Play® method. Create a cancer education initiative with at least 2 application techniques of the Serious Play® method. Formulate at least 2 deep questions that will challenge participants to use their imagination and creativity while building 3D models that represent their perception/knowledge about a cancer topic. Manage the sharing of the 3D models and facilitate the discussion of associated metaphors/concepts among participants. Use the 3D models to review the information and knowledge about addressed cancer topics. Abstract: The purpose of this Workshop is to provide information on the recently reissued R25 funding opportunities supported by the NCI Center for Cancer Training (CCT). R25 funding opportunities support various types of cancer educational activities that complement and/or enhance the training of a workforce to meet the nation's biomedical, behavioral and clinical research needs. NCI has used the R25 funding mechanisms continuously for several decades to support cancer-focused educational activities vital to the NCI mission. During these continued years of support a very broad range of participants from various backgrounds have benefited from educational opportunities provided by the NCI R25 educational programs. This Workshop will describe the current NCI CCT R25 programs and provide guidance to prospective applicants to help them prepare competitive grant applications. An overview of the current NCI CCT R25 portfolio, which in Fiscal Year 2020 included 48 competing and non-competing awards with a total cost of over $10 million will be provided. The three recently renewed R25 funding opportunity announcements will be described in detail, namely, Curriculum or Methods Development , Courses for Skills Development , and Research Experiences . The Workshop will provide useful tips for prospective R25 applicants. Examples of ongoing successful R25 programs that have been competitively renewed will be presented by their Principal Investigators. Objectives: At the end of the Workshop the participants should be able to understand differences between the different types of the current NCI R25 funding opportunity announcements (FOAs) and select the most appropriate FOA for their cancer education projects. The participants should be able to use the information provided in the FOA together with the discussed tips and suggestions to prepare competitive R25 applications. In addition, it will provide information on the topics of the courses supported through this initiative, the eligibility criteria to take NASDC courses, and the timeline for possible reissuance of the NASDC FOAs, in case they wish to apply for future NASDC funding. NASDC was funded by the NCI Center for Cancer Training in 2020 as a pilot collaborative educational initiative that offers a suite of short courses to NCIfunded junior faculty investigators holding various types of "K", R00, R21, and first R01-equivalent awards. This workshop will describe the program, the courses offered, and some program evaluation data so that the attendees can serve as NASDC ambassadors by promoting the NASDC courses to their NCI-funded junior faculty colleagues. The Workshop will provide an overview of NASDC, introduce the four NASDC courses, and highlight the successes and challenges encountered during the first year of the implementation of the Consortium. The initial offering of the NASDC courses has just completed, and although COVID-19 prevented in-person activities, interest in course participation was very high among eligible NCI grantees. Evaluation data from the first round of courses are being compiled and will be presented. Plans to reissue the NASDC funding opportunity announcements in Spring 2022 are under consideration by NCI.Objectives: The workshop participant shall be able to identify the NASDC goal of helping NCI-funded junior faculty succeed in their academic careers. In addition, the workshop attendees will be able to identify the topics of the courses supported through this initiative and the eligibility criteria to take NASDC courses. Workshop participants shall be able to identify the timeline for possible reissuance of the NASDC FOAs, in case they wish to apply for future

Abstract: The purpose of the presentation is to present NCI's global research training programs and activities. Cancer incidence is increasing in low-and middle-income countries (LMICs), where over 75% of the global cancer burden will occur by the year 2040 (1) . Primary drivers of cancer risk in LMICs are environmental and behavioral risk factors, inadequate primary and secondary prevention, co-morbidities, and poor access to treatment and palliation. Addressing these complex determinants of cancer in LMICs requires a well-trained workforce that receives cancer research education and experiences to appropriately respond to cancer inequities(2). The Workshop will provide an overview of the current NCI Center for Global Health portfolio which includes institutional training grants (D43), career development awards targeting US investigators (K01) as well as investigators from LMICs (K43) Abstract: Cancer morbidity and mortality are significant health issues in the US and worldwide. Research has advanced our understanding of cancer etiology and has highlighted the essential relationship between the laboratory and the clinic in cancer detection and treatment.

Continued progress requires the exposure of aspiring scientists and clinicians to the field of cancer biology at an early stage of their education. Towards this goal, the Nathan Schnaper Intern Program (NSIP) at the University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC) provides a ten-week summer internship that emphasizes translation of laboratory discoveries into clinical applications. Interns are recruited from undergraduate institutions nationwide. Twenty interns are selected based on academics, references and a personal statement. Minority participation and inclusion of students from institutions that lack strong undergraduate research is emphasized. Intern support is provided to enhance economic, racial, and geographic diversity. Interns participate in an integrated program of hands-on cancer research, cancer biology and clinical oncology. A laboratory techniques course prepares the interns for mentored research in diverse areas of cancer biology. Results are presented in a campus-wide retreat. Educational modules highlight ongoing translational cancer research at the UMGCCC to provide a broad perspective of the bench-to-bedside-and-back continuum. New program components engage interns in current areas of cancer research and care. Interns are exposed to clinical oncology through shadowing UMGCCC clinicians. Each component of the NSIP is critically evaluated through intern, mentor, consultant and external Advisory Board assessments; current outcomes will be presented. The professional paths of graduates are tracked as an important metric of program success. NSIP data are disseminated through presentations at national meetings. UMGCC resources and NSIP educational components comprise an innovative program to inspire the next generation of cancer researchers to pursue careers in the battle against cancer and fill the need for skilled physician-scientists.

Objectives: Identify three components of translational cancer research and describe their interrelationships. Provide examples of lab-to-clinic and clinic-to-lab information flow and describe their importance in translational research. Identify educational activities that illustrate the roles of translational research in clinical oncology. References: "ASCO predicts shortage of oncologists as demand grows" Oncology Practice.com March 12, 2014 (http://www.oncologypractice.com/practice-economics/ health-reform/single-article/asco-predictsshortageof-oncologists-as-demand-grows/995da42c6562b9cad9d0afa910fae7f1.html). Abstract: Many Indigenous peoples use the medicine wheel as a holistic model to depict how all elements of life are inter-connected. It is only recently that some Western systems are making space for incorporating these Indigenous ways. The Indigenous Navigator role, within Ontario Health, models such a method. Navigating the cancer system can be a significant challenge for First Nations, Inuit, Métis and urban Indigenous (FNIMuI) patients. The Indigenous Navigators provide support and advocacy for FNIMuI patients and families by facilitating and coordinating access to cancer services for palliative and supportive care, addressing cultural and spiritual needs, and networking with FNIMuI and non-Indigenous partners to make the cancer journey a culturally safe experience for FNIMuI patients and families. Objectives: To describe the scope and potential of the Indigenous Navigator role in Ontario. Examples of the extent of the role include facilitating traditional healing, providing health literacy assistance, alleviating anxiety, and getting patients to the right support at the right time.

We recommend other cancer agencies and health entitles at large implement this or a similar approach towards improving the physical, mental, spiritual, and emotional wellbeing for the Indigenous peoples they support. 

Abstract: Non-technical skills (or soft skills such as communication with patients and colleagues, team work, decision making in cancer treatment, situation awareness, problem solving, disclosure of medical errors, leadership, and coping with stress) have an immense impact on outcomes such as the effects of treatment, quality of life, and quality of health care professionals and medical students. Although very important, soft skills are rarely addressed in the medical curriculum. In this presentation, the presenter will review non-technical skills of value in several areas of cancer education. Abstract: By viewing health disparities through the lens of social and racial justice, we are able to understand the structural barriers that perpetuate these inequities. Although biology plays a role in all types of cancer, a person's "ZNA," or the zip code where they live, is just as important to consider and may play an even greater role in health outcomes than the genes they were born with. A person's ZNA contributes to whether they have access to clean water, healthy food, accessible transportation and social support systems. Recognizing these underlying issues is the first step toward addressing structural causes of health disparities. It's imperative to ensure that those who live in underserved areas have the same type of treatment and access to medical breakthroughs as those who live in favorable communities. Objectives: After this lecture, the student should be able to: Understand the difference between DNA and ZNA as well as how the two interact. Identify the historical causes and structures that continue to reinforce health disparities to this day. Explain the difference between trust and trustworthiness and why trust in medicine and science matters. to promote initial FIT screening, and examined sociodemographic and psychosocial predictors of FIT screening. Participants were ages 50-75 (n = 326), at average CRC risk, not up-to-date with colorectal cancer (CRC) screening, able to read, speak, and understand English or Spanish, and recruited from two federally qualified health center systems. System-level components (e.g., electronic medical record system and reminders) were leveraged. Following informed consent and baseline interview, participants were randomized to either C-CARES or C-CARES Plus and received intervention materials based upon randomization and in the language in which informed consent was performed. The primary outcome was a completed FIT returned up to 1 year post-intervention. Primary outcome analyses were performed using logistic regression. Fifty-nine percent of participants were female, 47% identified as White, and 53% identified as Hispanic/Latino. The majority of participants reported household incomes less than $25,000 (75%) and being uninsured (62% Abstract: African Americans experience CRC health disparities due to screening underutilization and issues with quality healthcare access. The objective of this study is to test a community health advisor (CHA) intervention for promoting the easily accessible FIT as a priority screening test in an under-screened population. Formative research using focus groups was used to adapt a CHA intervention to increase stool-based CRC screening in African Americans. Recruitment methods for the subsequent behavioral clinical trial include community health centers sending recruitment messages through texts and emails to eligible participants and posting flyers in waiting rooms. The CHA was recruited from community contacts and trained by the researchers with a structured curriculum on various topics like cancer, CRC, CRC screening, health education, skills for conducting motivational interviewing, and maintaining intervention fidelity. The study employs block randomization, stratified by two community health centers, for randomization of study participants. Focus groups generated qualitative data about CRC education, resources, and text messages to better adapt the intervention. The researchers met with each community health center and developed a plan that enables participants to be recruited and followed longitudinally to determine FIT completion. Interested individuals contact the study coordinator to ascertain eligibility, consent to participate and schedule baseline surveys, after which they are randomized into the treatment or control arm. The CHA contacts intervention arm participants to schedule the CRC educational presentation, which is followed by CHA phone calls and text messages. Follow-up surveys are completed at 3 and 12 months. Focus group participants mostly relied on accurate CRC information from their healthcare providers. Negative attitudes to CRC screening were discussed in terms of lack of insurance, fear, embarrassment, and discomfort. Engaging the community is essential for planning and implementation of behavioral research focused on increasing CRC screening by fostering trust.

Objectives: The participant shall be able to: Identify preferences for patient education materials on colorectal cancer screening among African Americans in north Florida. Understand how formative research methods can be used to design a community health advisor (CHA) intervention to increase stool-based CRC screening in African Americans.

Abstract: Men are at increased risk of developing skin cancer compared to women, and sexual minority men are at greater risk. This qualitative study explored suggestions of sexual minority men who report intentional tanning or no intentional tanning (indoor or outdoor) in the past, on potential skin cancer prevention intervention approaches. Thirty participants (mean age: 27.93 years, SD age: 3.27) were recruited from Community Marketing and Insights, an LGBTQ+ focused U.S. research panel, using purposeful sampling. Participants who identified as gay or bisexual and reported engaging or not engaging in tanning behaviors were included in the study. Multiple theories were used to develop a semistructured interview guide and interviews were conducted via videoconferencing. As part of the interview, participants provided suggestions for potential skin cancer prevention interventions. Interviews were audio recorded, transcribed verbatim, and coded by study authors using a codebook. Code schemes were used to summarize the data. Participants suggested several intervention strategies including providing the community with statistics on skin cancer rates among LGBTQ groups or by gender, educating on risks, prevention, and symptoms of skin cancer, and sharing testimonials of individuals who have experienced skin damage.

Participants recommended that the intervention information be delivered through interactive media such as videos, posts, or advertisements in public places or online and sun-protective products be distributed at social events or gatherings, by an individual from the LGBTQ community who has experienced a skin cancer diagnosis, or a well-known LGBTQ celebrity or Drag Queen who has a large public following. Skin cancer prevention interventions should be educational, non-judgmental, and delivered by someone who is relatable to sexual minority men. The findings of the present study could be used to inform the development of interventions to reduce skin cancer risk behaviors and enhance skin-protective behaviors among sexual minority men. Objectives: The conference audience will be able to identify at least one intervention approach for a skin cancer prevention program and one preference for interventionists to deliver such a program, as suggested by sexual minority men. Abstract: Primary care clinics in Appalachian Kentucky have been greatly impacted by COVID-19 due to state mandates, health system regulations, and changes in patient preferences. This presentation describes our ongoing colorectal cancer (CRC) screening interventions in these clinics and the processes by which we selected and implemented adaptations due to COVID-19. Through a series of key informant interviews with primary clinic staff and providers, we identified multilevel barriers to CRC screening and presented clinics with a menu of evidence-based interventions (EBIs) from which to choose that addressed CRC screening barriers at patient, provider, and clinic levels. However, shortly after selecting EBIs, clinics experienced numerous changes to workflow and operations due to COVID-19 that necessitated adaptations to the selected EBIs. Through a series of virtual meetings facilitated by members of the research team, clinic champions selected feasible adaptations that could enable continuation of project activities despite limitations due to COVID-19. Clinic staff cited multiple workflow changes that decreased CRC screening, including parking lot visits for most appointments, patient concerns about paper educational tools, and a state-mandated pause in elective procedures-including colonoscopy. From 1st to 2nd quarter 2020, our project clinics reported half the number of in-person visits but 23 times higher telehealth visits. Clinics selected adaptations to project activities responsive to these changes, including providing online CRC screening information, promoting screening via telehealth visits, and prioritizing stool-based tests for average-risk patients. Across project clinics, FIT and FIT-DNA orders increased substantially by the third quarter of 2020. Despite many Appalachian Kentucky clinic providers preferring colonoscopy as a first-choice CRC screening modality, our clinics showed adaptability by promoting stool-based testing for average risk patients. Rural health systems researchers should communicate with clinic staff to identify and address local COVID-19 barriers so clinics can continue to promote CRC screening. Objectives: The participant shall be able to identify methods by which clinics were able to select timely and responsive adaptations to colorectal cancer screening practices as a result of unplanned barriers (i.e., those related to . References:

Abstract: The NCI Awardee Skills Development Consortium (NASDC) is a novel, multi-institutional, collaborative, educational project funded by the National Cancer Institute. NASDC will enhance the training of junior NCI grantees and deliver specialized courses to refine their skills in areas that are critical for establishing and maintaining successful independent academic cancer research careers. The long-term goal is to develop the next generation of research leaders to meet the nation's biomedical, behavioral and clinical cancer research needs. The NASDC started in 2020. NASDC has a Coordinating Center (U24 mechanisms, (RFA-CA-19-011)) to support logistics and evaluations; and short courses (UE5 mechanism, (RFA-CA-19-010)). NASDC leadership (NCI, U24, and UE5s) meet regularly to develop the new consortium's infrastructure.

Courses are innovative, state-of-the-art, and deliver evidence-based scientific and educational content. Participants apply for these courses through the NASDC portal (nasdc.osu.edu). Evaluations are collected for all courses and participants. Infrastructure includes a web portal with a public site and a restricted site for storage of curricula and evaluation data. A steering committee and 5 working groups, each with a specific charter, attend to the portal, the recruitment of participants, curriculum review, evaluations, and publications. As of May 2021, four courses were taught to participants. Of 495 eligible individuals, 134 (27%) applied and 83/134 (62%) were selected to attend a course. First evaluations are yielding very supportive preliminary data that will be reported at the meeting. The success of junior grantees will be compared to national known metrics. NASDC will impact NCI junior grantees in various fields and teach leadership skills and cutting edge technologies needed for the next grant applications. Trainees must be first time recipients of "K" career development mechanisms, R00, R21, and first R01-equivalent awards. An in-depth evaluation survey assess specific outcomes of success. Objectives: The participant shall be able to build at least one new skill in their research area that will benefit their future research projects. Abstract: Artificial Intelligence (AI), although already being used in practice, is continuously progressing into the Radiation Oncology field, potentially changing how radiation professionals interact with both patients and other professionals in the field. This study investigated radiation oncology professionals' perceptions of AI, and how AI will affect the radiation oncology specialty. Following an in-depth scientific review of existing literature, a 29 Likert-scale questionnaire was developed using Google Survey. The questionnaire was piloted and distributed through national organizations including the Canadian Association for Radiation Oncology (CARO), the Canadian Association of Medical Radiation Therapy (CAMRT) and the Canadian Organization of Medical Physicists (COMP), initially in February, and again March 2020. Radiation oncologists, radiation therapists, medical physicists and radiation trainees voluntarily participated in this study. 159 responses were received from 10 Canadian provinces. Knowledge about AI was moderate, with an average of 5/10, but 91% responded interest in learning more about it. The negative implications of AI were related to fear of losing jobs and shift of practice. 84% percent of the respondents agreed additional training for the use of AI should be mandatory regardless of years of experience. The majority of participants agreed AI would positively impact patient treatment. This work has been published in the Journal of Medical Imaging and Radiation Sciences (JMIRS). Radiation oncology professionals believe AI will be an important part of patient treatment in their future practices. The fear about AI may be mitigated with further education programs about AI, which can gain more confidence in acceptance of AI. Objectives: The participant will be able to identify three current attitudes and perceptions held by radiation oncology professionals towards artificial intelligence. As this was a pilot study, the scope of the study was very broad to get a general understanding of the perceptions of AI from radiation oncology professionals which can be used to conduct future studies in the future which may be more targeted. To address these issues, we developed an application within our electronic medical record (EMR) to provide patient education and save it to the chart. It also encourages nurses to provide education by making the tool easily accessible and streamlining the process. The goal of this project was to increase nurse-driven patient education using the application. This represented a change in workflow. To support this change, we launched a 4 week "Education Madness" competition across 9 radiation sites at Penn Medicine. The goal set for each location was to provide education via the application to 85% of patients being seen on treatment. We identified champions at each location to provide workflow tips and encouragement for new users. Baseline use was an average 79 documents created per week across all sites. During the competition, this number increased to 294 per week. To keep the momentum going, weekly status reports were sent. An environment of collegial competition appeared to incentivize use. Some teams far exceeded the 85% goal, with a range of 34%-111% for all sites. A few teams did not increase use at all. At the end of the competition, we continued to track use to see if the changes to workflow continued. Overall use continues to be high but is trending down (average 222 documents per week). A competition to create excitement about a workflow change increased use of this EMR-based patient education application; some teams were not responsive to the competition. Going forward, we will continue to provide training and workflow discussions. We continue to track statistics for nursing management to aid in increasing use. Abstract: To improve the experience of a Toronto Cancer Centre's website, a two-part evaluation is underway. Last year, a health literacy audit was completed, indicating a strong need for plain language editing of the site content. This year, content organization is the focus, with the aim to redesign the homepage and help people find what they need. One challenge of organizing web content at an academic health centre is the need to consider many stakeholder groups. Card sorts and tree tests are well-established tools to support website development with stakeholder engagement. Like other modes of communication for patients and the public, websites need to be usable, straightforward and clear. This project endeavours to redesign the homepage primarily to help patients and families, but also for family physicians making referrals, collaborators, potential students, clinical staff and researchers. Testing has been completed with a mixed group of stakeholders, including 25 patients. Findings will be used to inform content organization and redesign efforts to improve the navigation of the website. The findings will be considered together with web best practices and data from an environmental scan of websites for equally complex audiences from healthcare and other industries. A key resource for the public, the Princess Margaret website must meet its users' needs. The website can be used to promote trusted information and improve health outcomes. Assessment data will help clarify user demographics, focus improvements, and ensure that users can find what they need when they need it. Objectives: The participant shall be able to: Describe a process for performing an environmental scan and baseline assessment for the purposes of improving digital products (like websites). Discuss the ways in which the principles of user experience and information organization could be employed in their own work to improve the digital experience. This aim of the 90-minute session is centered around mentoring of public health graduate students in their research in special populations (global and minority populations in the U.S). The session will include global mentors, domestic mentors, and students who participated in the Cancer Epidemiology Education in Special Populations (CEESP) Program. CEESP has been funded by an R25 grant from the National Cancer Institute since 2006 (R25CA112383) to train public health graduate students in cancer research in special populations. The session will include 3-minute comments/presentations by each participating student and mentor about his/her experience as a mentor or mentee and recommendations for optimizing the mentoring experience. The moderators will summarize the presentations, conclude themes and areas for improvement, and outline future directions for improving learning in cancer education and mentoring in this program and others focused on research training and cancer education in special populations. Abstract: Language barriers in the healthcare setting are linked to less health education, lower interpersonal care and lower patient satisfaction. The purpose of this quality improvement project was to investigate alternate methods to enhance patient education for patients receiving radiation therapy with limited English proficiency (LEP). At the time of the project, professional over-the phone interpreters were used infrequently and LEP patients relied heavily on family members or bilingual staff members to be ad hoc interpreters. A needs assessment was conducted by surveying staff about their perspectives on current LEP education practice coupled with semi-structured interviews. Patients were surveyed to determine their comfort in communicating with their treatment team and preferred interpretation methods. After collating the results of the needs assessment and examining interpretation options, professional video interpretation was implemented in February 2020. Interpreter usage has been tracked and postimplementation evaluation conducted with staff and patients. According to the staff survey (n=69), professional over-the-phone interpreters were used least at 8% compared to other methods. Family members (59%) and bilingual staff (62%) are most commonly used for convenience. Patient surveys (n=12) indicated that the preferred interpretation methods for daily interactions were bilingual staff members (35%), professional face-to-face interpreters (30%), and family members (22%). With the implementation of professional video interpretation, professional interpreter usage increased two-fold after COVID-19 visitor restrictions were enforced. Positive feedback has been received by both patients and staff. Sustainability will be addressed by embedding video interpretation education into new staff orientation. Video interpretation is a convenient tool that allows the healthcare team to use professional interpreters to communicate with patients virtually face-to-face and accurately provide education in their preferred language. Sharing project data with policy makers and communication services will inform wider implementation within the organization and community. Abstract: In the ÁRBOLES Familiares training program, we train bilingual (English/Spanish) community outreach professionals working with Latinx communities to identify and refer individuals at increased risk of hereditary breast and ovarian cancer (HBOC). Our original program consisted of a 2.5 day in-person training flanked by online modules. In response to the COVID-19 pandemic, we transitioned to a completely virtual training program. We share lessons learned and initial outcomes. Adapting ÁRBOLES for virtual delivery included a focus on cultural and linguistic preferences of bilingual (Spanish/English) trainees. We mapped the training content, adapted sessions for online delivery, reviewed materials that could be shared electronically or via mail, and created skill building activities amenable to virtual implementation. We invited trainees from a postponed 2020 hybrid workshop to attend the virtual training or defer to a future in-person training; we also conducted additional national recruitment. Our adapted virtual program consists of 8 sessions (5 synchronous; 3 asynchronous): welcome/overview, genetics 101, family history, genetic counseling and testing, community communication strategies, risk assessment and navigation, an Action Project and wrap-up celebration. Of 32 trainees in the postponed 2020 cohort, 17 opted to participate virtually and we recruited 28 additional individuals (N=45 total cohort). In 4 sessions to date (2 synchronous, 2 asynchronous), lessons learned included: additional time for questions and handson activities (e.g., taking a family history), reminders to use mailed materials (e.g., whiteboard for pedigree activity) and virtual 'office hours' Abstract: American Indians in the Indian Health Service Northern Plains region experience higher death rates for multiple cancers compared to American Indians in other regions. One community in this region participated in a community readiness assessment that found a low level of readiness to address cancer and little knowledge about community efforts and resources to address cancer. We evaluate this community's strategic approach of employing the arts to share visuals and stories that present information about cancer to improve readiness. We describe a unique partnership between a cancer research education program, a university library, a public school's Title VI Indian Education program, and local artists that facilitated co-curation of four public art exhibitions that promoted awareness of community resources and efforts to address cancer in this urban American Indian community. Field notes, observations and surveys associated with these exhibitions were triangulated to evaluate the creation and showing of these exhibitions. Four art exhibitions, Portraits of Care, Buckskin Buddies, Suzanne's Story and The Body and Mind of Cancer, engaged students, educators and local community in cancer education. For each of the four exhibits, we conducted a focus group with one curator, one presenting artist, one educator and one community member who attended the exhibit to assess how much community knowledge and attitudes towards cancer may have changed as a result of the exhibitions. Community-academic partnerships that employ culturally relevant approaches to share cancer information have potential to improve community readiness to address cancer in diverse communities. Engaging community in the creation and exhibition of art is a promising practice for raising urban American Indian communities' knowledge of cancer and awareness of cancer resources and efforts. Objectives: The participant shall be able to examine relationships among art, cancer, community and American Indian culture and spirituality. The participant shall be able to behold and explore the meaning and purpose in cancer-related artworks created by American Indian community members. The participant shall be able to identify individuals who could contribute to a strong art-based community-academic partnership. The participant shall be able to recognize ways to apply the arts in implementation of stage-specific strategies to increase community readiness to address cancer. tribes have implemented cultural healing techniques incorporating traditional medicine derived from natural herbs, plants, and minerals. These indigenous communities relied heavily on the healing properties of naturally derived remedies that could cure or treat symptoms and illnesses. This was an experiential workshop that provided American Indian traditional healing, guidance, and support to cancer survivors. The program provided survivors, who were at different stages of treatment, with American Indian traditional medicine as an alternative or additional healing processes to their Western medical treatment. Services offered through the program included working with clay, mask making, storytelling, talking circles, smudging, and traditional ceremonies. An evaluation was conducted to measure beneficial elements of the program and the impact of the traditional American Indian practices implemented. Qualitative surveys were distributed twice to participants of the program. The outcome of program was to improve overall health outcomes of cancer survivors. Plans to incorporate this model were discussed with Tribal Behavioral Health programs. Findings indicated that participants reported the program was helpful and contributed to positive aspects such as increased restful sleep, appetite, and energy levels in their life. The program also show that participants were more happy and less angry, depressed, anxious, and sad. Abstract: Healing Arts Programs, i.e., music, art, movement, and poetry/ writing experiences, have been offered for patients/family members in major medical centers, often on cancer units and/or palliative care units, since the mid to late 1990's. The efficacy of these programs has been demonstrated through both practice and research projects. The missing link is that education in healing arts is not routinely offered in graduate health professional cancer education programs. Presentation will include a brief sharing of the common healing arts modalities and how they are used in cancer care settings. Literature related to how cancer patients have responded to these programs will be shared. A brief discussion of how this content might be included in graduate health professional cancer education courses will be shared. Participants will be asked to share their experiences with healing arts in cancer education/practice. Ways to measure outcomes from healing arts modalities used in caring for cancer patients will be shared from the literature. Gaining knowledge related to healing arts and their use in practice is valuable for future cancer health care professionals. He/she will have knowledge to encourage the use of these practices in patient care understanding their relationship to aid physical/spiritual care of cancer patients in diverse settings and communities. Objectives: After attending this session, the participant will be able to: Abstract: Adherence to adjuvant endocrine therapy (AET) is a critical problem in the treatment of hormone receptor-positive (HR+) breast cancer (BC) (1). Despite its proven benefits of reducing recurrence by 40% and improving mortality by 31%, AET adherence is suboptimal. This study examined the experiences of women who prematurely discontinued AET(2). A mixed-methods study was nested within a larger observational trial (N=594) of women with HR+ BC. Women who discontinued therapy were systematically identified over 1.5 years; quantitative surveys and in-depth interviews were conducted. Paired t-tests were used to compare the mean difference in psychosocial factors and medication-related symptoms between baseline and discontinuation time-points.

In-depth open-ended interviews were audio-recorded, transcribed verbatim, and analyzed using the NVivo software program Participant (N=37) ages ranged from 46 to 78 years old (m=60.1); 62.2 % were White and 29.7 % were Black. Quality of life decreases significantly between baseline and discontinuation (19.9 vs. 17.8, p=0.0047). A majority of women reported AET side effects (87.1%) and physician recommendations (25.8%) as their reason for discontinuation. In-depth qualitative data suggested frustration with strategies to address symptoms, being unprepared for the intensity of symptoms, and a desire for better patient-provider communication as reasons for discontinuation. Educational interventions that prioritize patients, physicians, and other medical team members may support better symptom management and ultimately adherence.

Opportunities to capture women's experiences while on treatment and their discontinuation in real-time may help women prevent discontinuation, enhance the quality of life and prevent worsening of medicationrelated symptoms. Objectives: The participants shall be able to learn about the possible intensity of the symptoms of side effects and they should have the necessary support to be able to discuss and get help to minimize the symptoms. Key objectives are to identify at least three barriers to get the satisfactory depth of details about the possible symptoms and to identify at least three barriers to honest communication with providers about the side effects and how to minimize them. Interview data is to be analyzed to identify themes related to recommending and obtaining follow-up care. Data collection is ongoing. Summaries and analyses of provider and patient key informant interviews will be presented, in addition to data on recruitment, interview completion and demographic characteristics. Interpretation of the data and comparison with existing literature will be presented as well as plans for a pilot intervention. The discussion will describe locally-relevant patient and provider perspectives of assets and barriers to receiving adjuvant therapy. We will discuss how these themes have guided the development and implementation plan for an intervention to address the low rate of follow-up for patients with LACC in Appalachian Kentucky. Abstract: Surgery is the main treatment for breast cancer, however, the majority of women electing surgery feel that they are not well enough informed about their breast cancer treatment options.1 Surgical instructions need to be actionable by both patients and caretakers and meet the needs of all health literacy levels to address health disparities in breast cancer treatment and provide interventions that can significantly improve outcomes. Your Breast Cancer Surgery patient education program includes a patient practice guide, videos, exercise guides and logs, discharge and survivorship checklists and an evaluation tool to support the surgical community. Scientifically derived skill development techniques and plain language guide patients through every step of their surgical prep, procedure, and recovery. A discharge and survivorship treatment plan follows the guidelines for routine wellness and tests and follow-up care to monitor for breast cancer recurrence. Associations reviewed the validity of the current standards; reviews by surgeons for best practice; reviews by patients and caretakers to assure clear understanding, and reviews for usability by laypersons. The data include behavioral outcomes (pre-op prep, and home care compliance); affective outcomes (confidence, satisfaction by patients); and clinical outcome data (complication rate, and frequency of use of additional services post-operatively). 84% of laypersons found it clear what a patient should do, and 96% felt the program was helpful, increased their confidence, would recommend to friends and family and would be satisfied if their surgeon referred them to the program. The program will help standardize surgical breast cancer treatment, support gaps in care and screening, improve health outcomes, reduce morbidity, and promote an equitable and cost-effective delivery system for women undergoing breast cancer surgery. The program will be used as a credentialed course for training surgical professionals.

Objectives: 1. The participant shall be able to explain the different types of breast cancer and the stages involved in the disease. 2. The participant shall be able to participate in creating an appropriate treatment plan for breast cancer and identifying the best choice for surgical intervention as part of the health care team. 3. The participant will be able to demonstrate the skills necessary for post-operative home management of the surgical site and exercise and self-care guidelines. 4.The participant will be able to identify their need for ancillary treatments such as chemotherapy, Abstract: Blacks and African Americans are twice as likely to be diagnosed with multiple myeloma. [1] It has been reported that Blacks and African Americans with multiple myeloma incur barriers to treatment and that one of the reasons for this is the lack of awareness about the disease within the community.

[2] Understanding the information needs of this population can support the development of culturally-sensitive programs and the consequent reduction of racial health disparities in multiple myeloma. In 2020, Cancer Support Community facilitated six 2-hour small group discussion sessions with Black and African American multiple myeloma survivors (N=13) and their caregivers (N=6). The purpose was to explore the challenges of living with multiple myeloma and gain insights on knowledge, attitudes, and education needs related to multiple myeloma. Findings will assist in the development of educational materials aimed at enhancing patient awareness about multiple myeloma among African American communities in the U.S. Results were derived via qualitative analysis of group recordings. Findings from this analysis illustrated areas of patient and caregiver education needs. In particular, all patients and caregivers believed there is a lack of awareness and education about multiple myeloma in the African American community. Participants emphasized the need for culturally-appropriate education and support materials that explain multiple myeloma, risk factors, and clearly describe the most common warning signs of the disease. Education and support materials should be developed in different formats, such as videos and brochures, and delivered through religious leadership, community centers, and community leaders. These findings suggest the need to construct culturally-appropriate messaging to raise awareness about multiple myeloma and to carefully design efforts to reach Black and African American communities. These results are currently informing the development of a comprehensive patient educational program about multiple myeloma. Objectives: The participant shall be able to identify: Two ways to increase patient awareness about multiple myeloma among African American communities in the U.S. Two culturally sensitive methods that can be applied to education materials about multiple myeloma. Two barriers to accessing cancer education among Blacks and African Americans. Abstract: While trust is critical to HPV vaccine decision-making [1] , little research has explored this topic among Asians or immigrants [2] . Using a sample of U.S. Vietnamese parents, this study investigates 1) trust in the HPV vaccine and related medical and regulatory authorities and 2) how pre-migration and migration-related experiences shape such From April 2020 to February 2021, we conducted an explanatory sequential mixedmethods design. In Phase 1, 408 U.S. Vietnamese parents of adolescents aged 9-18 completed a cross-sectional, online survey. In Phase 2, 32 U.S. Vietnamese mothers (selected from survey respondents in Phase 1) participated in semi-structured interviews. We summarized survey data using descriptive statistics and analyzed interview data using a thematic qualitative analysis approach. Almost all surveyed parents indicated "moderate to high/complete trust" in scientists developing adolescent vaccines (94%), federal government agencies (94%), CDC (95%), and FDA (94%). In interviews, U.S. Vietnamese mothers discussed experiences with the Expanded Program on Immunization in Vietnam and U.S. immigration-related requirements for vaccination, all of which shaped their trust in governmental vaccine regulatory systems and vaccine effectiveness. Trust in healthcare providers encouraged HPV vaccine acceptance and uptake. At the same time, some mothers expressed safety concerns regarding the HPV vaccine and believed that the HPV vaccine is different or less extensively tested compared to other vaccines. U.S. Vietnamese parents expressed high level of trust in medical and authorities involved in the development and recommendation of the HPV vaccine. Findings point to the need to strengthen patient-provider trust and relationship to encourage HPV vaccine uptake. Misconceptions or concerns about HPV vaccine safety should be clarified and addressed.

Objectives: The participant shall be able to describe U.S. Vietnamese parents' trust in the HPV vaccine and related medical and regulatory authorities. The participant shall be able to describe how pre-migration and migration-related experiences shape such trust. Abstract: Many women with breast cancer in high-income countries are cured with breast-conserving surgery. Globally, more women are treated with mastectomy despite access to systemic therapies such as tamoxifen or chemotherapy that have been shown to offer equivalent survival when added to lumpectomy. Varying resources and patient factors impact the relative benefits of treatment modalities and contribute to wide disparities in outcomes. A nomogram that applies available resources to outcomes is needed. Resource-stratified guidelines provide an opportunity to modify treatment in low and middle income countries (LMIC's). Data from early breast cancer trials and geriatric oncology, provide a rationale for a shared decision-making approach whereby a woman may choose lumpectomy rather than mastectomy for improved quality of life. A data collection tool to apply important variables in resources and patient specific factors can lead to development of an international nomogram for breast cancer treatment options. Prediction tools demonstrate that a 65-year-old woman with T2N1 breast cancer has a 68% 10-year survival with surgery and radiation, compared to 87% without cancer. Survival is improved by 11% with systemic therapies. To apply this tool to an LMIC there are several variables known to impact these predictions such as life expectancy, systemic therapy, and nutritional status. The benefit of radiation is reduced due to competing co-morbidities and improvements in systemic therapy suggesting little to no survival advantage to mastectomy over lumpectomy. A data collection tool for creating a nomogram for LMIC's will be presented. To improve quality of life after breast cancer globally, data on site-specific resources, life expectancy and patient specific factors are needed to develop a nomogram. The participant will be able to identify critical variables that impact breast cancer treatment risks and benefits in variable resource settings. Objectives: Lack of highquality care skews patterns of care, health care-seeking behaviors, and outcomes of breast cancer treatment. By the time most women in low-or middle-resource settings pursue medical care, breast cancer is often locally advanced or metastatic. Radical or modified radical mastectomy is still "king" in many places, often as the only option when access to radiation is limited, or when the tumors are too large or too locally advanced for breast conservation. The participant will be able to identify at least 2 critical variables that impact breast cancer treatment risks and benefits in variable resource settings Abstract: U.S. Vietnamese have high cervical cancer incidence; perhaps relatedly, they also have rates of low human papillomavirus (HPV) vaccine uptake. This study qualitatively explores healthcare practice-provider-, and patient-level influences on U.S. Vietnamese mothers' HPV vaccine decision-making for their adolescents. From November 2020 to February 2021, we conducted qualitative interviews among 32 U.S. Vietnamese mothers. Using the P3 model [1] , questions explored influences at the practice-level (e.g., clinic-based HPV vaccine materials, ease of making vaccination appointments), provider-level (e.g., content of provider's HPV vaccine recommendation, trust in providers), and patient-level (e.g., perceived benefits and risks). A hybrid approach was used for thematic analysis. Two researchers independently coded 32 transcripts, compared results, and resolved discrepancies. Practice-level barriers included a lack of healthcare utilization and difficulties in tracking appointments for multiple HPV vaccine doses. Mixed perspectives emerged about the utility of clinic-based materials about HPV vaccine, with several mothers voicing a desire for materials in Vietnamese. Provider's recommendation and trust in providers highly encouraged HPV vaccine uptake; however, several Vietnamese mothers also mentioned receiving either no recommendation or low-quality recommendation. Regardless of recommendation quality, several did not immediately accept vaccination upon receiving recommendation. Most common patient-level barriers included perceived child's sexual inactivity and safety concerns. All Vietnamese mothers with unvaccinated children are open to future vaccinations. Interventions should improve reminder systems, deliver high-quality provider recommendation, and educate about vaccine safety and the need for age-based vaccine initiation [2] . Attention to cultural emphasis on preventive care and in-language vaccine promotion materials is needed. These strategies can improve vaccine uptake and reduce HPV-related cancer burden among U.S. Vietnamese.

Objectives: The participant shall be able to describe practice-, providerand patient-level facilitators of and barriers to U.S. Vietnamese mothers' HPV vaccine initiation and completion for their adolescents. 

Olufunmilola Abraham University of Wisconsin-Madison, Madison, WI, USA

Abstract: There are limited cancer prevention education programs designed for adolescents in the United States. Few studies have examined adolescents' knowledge about cancer prevention and preferences for cancer education. This study sought to directly engage a diverse group of adolescents to understand their perceptions and preferences for receiving cancer prevention. The study team developed an online survey consisting of closed-ended questions and Likert scale responses. Survey questions were designed to explore adolescents' perceptions and knowledge of cancer and cancer prevention, including cancer-related health behaviors. Survey questions related to behavior were adapted from the Youth Risk Behavior Survey, a validated survey instrument. Other survey questions explored adolescents' information sources and their preferences for receiving cancer prevention education. The survey also collected demographic information. Middle and High school aged students from urban and rural Wisconsin were recruited. Selection criteria included students who could speak, read, and understand English. Data were statistically analyzed using SPSS. Participants (82%) reported that cancer did not include only one disease, and majority (89%) recognized that cancer cells grew at random. Awareness of cancer risk factors was highest for tobacco use (91%), poor diet (80%), and physical activity (80%). Most participants (95%) stated that cancer prevention is important. Only 37.3% understood how to lower their risk of cancer, and 50% reported they made lifestyle choices to lower their chances of getting cancer. Online websites such as google were the most reported resources used for cancer education by adolescents, followed by discussions with parents and doctors. Serious games were the most preferred form of cancer prevention. In order to help reduce cancer risk, it is essential that adolescents understand information regarding cancer origins, risk factors, and health behaviors that can be modified to reduce cancer risks. It is necessary to identify adolescents' preferences for receiving clear, interactive, engaging, and easy-to-understand information about cancer and cancer prevention.

Objectives: The participant shall be able to identify adolescents' perceptions about cancer and cancer prevention and classify their preferences for receiving cancer prevention education. Asking adolescents questions about their cancer knowledge, awareness of cancer risks, attitudes towards cancer, and favored sources of cancer information, allowed researchers to recognize and categorize their perceptions and preferences for receiving cancer prevention education, and will allow participants to create a tailored cancer education intervention. Attendees can use the information learned from this presentation in their own research to further examine ways to reduce cancer risk among adolescents. References: Abstract: The COVID-19 pandemic has caused enormous strain on public health. The SARS-CoV-2 virus has a high degree of transmissibility, with cancer patients particularly vulnerable to the disease, in addition to having their treatment plans threatened by public health restrictions designed to contain the spread. This study examined the effects of the pandemic on cancer patient's treatment and psychology, as well as their knowledge, attitudes and practices concerning COVID-19 via an online survey sent by email to approximately 5,800 patients of an urban, academic cancer centre in Toronto, Canada. Descriptive results were summarized. To examine for potential associations, regression models were tested for the outcomes of patient psychological well-being, knowledge, attitudes and practices, against several predictors. Qualitative feedback was coded and summarized. A total of 1631 surveys were completed and returned. Most patients saw their appointments made virtual and for a substantial minority there was no change. The majority (62.4%) of patients expressed fears about contracting the virus. There were no independent predictors of knowledge regarding COVID-19. Fears were more pronounced among patients who do not speak English and those who use social media more often. Women, those who scored higher on knowledge questions, and those who used cancer centre materials were more likely to take preventative measures against infection. The results of this study provide a snapshot of the state of cancer patient treatment and psychological well-being, as well as their knowledge, attitudes and practices during the first summer of the pandemic. The study's results can inform our understanding of adaptation to conditions during the outbreak.

Objectives: The participant shall be able to identify the extent of treatment changes for cancer patients during the COVID-19 pandemic. They will also be able to describe the characteristics related to the practice of preventative measures for containing the virus among cancer patients. Participants will also be made aware of the role of language proficiency and social media use in patient psychology with respect to the pandemic. Abstract: Multiple myeloma is the second most common hematologic malignancy in the US and the most common in African Americans. [1] It has been studied and reported that African American multiple myeloma patients incur significant barriers to accessing care.

[2] It is important to understand patients' perceptions and identify specific barriers to care in order to best address the disproportionate impact of the disease on this population and improve health equity. In 2020, Cancer Support Community (CSC) facilitated six 2-hour small group discussion sessions with Black multiple myeloma survivors (N=13) and their caregivers (N=6). The discussion guides were designed to explore the challenges of living with multiple myeloma and gain insights into the perceptions and barriers to access to care in this population. Results were derived via qualitative analysis of group recordings. Findings will inform the development of support resources aimed at addressing these barriers. Findings from the qualitative analysis suggest that Blacks and African Americans with multiple myeloma face significant barriers to accessing care. Specifically, participants reported that the main barriers to getting an early multiple myeloma diagnosis and accessing care are: Mistrust in the medical community and lack of cultural diversity and competence among physicians. Issues understanding and communicating with their care team. Limited awareness about the disease and understanding of risk factors and common warning signs. Limited access to health care. Financial barriers including transportation and inability to take time off work to attend doctor appointments These findings suggest that distrust towards the healthcare system is still present in Black and African American communities. They also emphasize the importance of improving cultural competency in provider-patient relationships and raising awareness about multiple myeloma to ultimately improve health outcomes for Blacks and African Americans with multiple myeloma. Objectives: Participants shall be able to: Identify barriers in access to health care among Blacks and African Americans with multiple myeloma. Pinpoint key steps in the development of education and support programs that are centered on the specific needs of Black and African American communities with the goal of improving health equity. Abstract: Effective leaders in healthcare settings create a motivating work environment, initiate changes in practice, and facilitate interdisciplinary collaboration to advance patient-centered care. Health professionals in cancer education need leadership development to meet the continued increase in cancer cases, to keep up with the rapid biomedical and technological advances in global cancer care, and because leadership development in cancer education requires a specific team-based skillset not adequately addressed in existing systems. The identified gap in leadership development in cancer education led to the creation of a unique interactive leadership workshop titled "Essential Skills in Cancer Education: Leadership, Leading, and Influencing Change in Cancer Education", held at the International Cancer Education Conference in October 2020. The workshop utilized lectures from global leaders in cancer education, mentorship opportunities, interactive case studies, and individual projects to develop core leadership skills in medical and allied health professionals in oncology. Pre-and post-workshop surveys confirmed that participants who attended the workshop felt their knowledge regarding topics in leadership in cancer education increased following completion of the workshop.

Answers to the open-ended questions and the feedback provided in workshop surveys showed that participants were able to reflect on their learning and consider ways to apply what they learned in their careers in cancer education and at their institution. Areas where participants reported an increase in knowledge included how to use different leadership styles, how to initiate changes in practice, and how to apply their leadership skills. Feedback from participants on postworkshop evaluations was overwhelmingly positive and demonstrated both an interest and a need for more leadership development opportunities in cancer education. This workshop shows that leadership is a valuable and teachable skill that will benefit both healthcare professionals and patients in the field of cancer education. Objectives: The participant will be able to identify three reasons why cancer education is an area that would benefit from leadership development opportunities. The participant will be able to identify three teaching tools that can be utilized to make a leadership development program effective. Oncology (CARO). The 82-item survey was adapted from the validated Stanford Acute Stress Reaction and Ways of Coping Questionnaires. The survey addressed the impact on residents' ability to travel/network for the purpose of their career, the impact of virtual patient contact on their learning, the level of social support from mentors and medical staff, the impact on planned research and academic activities, and unplanned clinical and oncology activities such as redeployment. The survey was developed using best practices including peer-review and cognitive pretesting. Thirty-four trainees responded. 46%(n=15) indicated the overall impact of COVID-19 on training was negative/very negative. Majority of trainees agreed/strongly agreed with the following statements: "I had difficulty concentrating on tasks" (n=17; 52%), "I had fears about contracting COVID-19" (n=17; 52%), "I had fears of family/loved ones contracting COVID-19" (n= 29; 88%), "I felt socially isolated from friends and family" (n=23; 70%) and "I was concerned that my personal safety was at risk if/when I was redeployed"(n=20; 61%). 67%(n=22) reported severe (>50%) reduction in ambulatory clinical activities, 16(49%) reported a moderate ( < 5 0%) reduction in new patient consultations. Significant changes to radiation oncology training were wrought by the COVID-19 pandemic and roughly half of trainees perceive that these changes had a negative impact on their training. Safety concerns for self and family were significant and strategies to mitigate these concerns should be a priority. Objectives: The participants will be able to describe the degree to which post-graduate trainees in radiation oncology perceive their education has been impacted by Our multidisciplinary team developed responsive programming that aimed to address the spiritual, psychosocial, existential, and community needs that COVID-19 heightened for our patients, their caregivers, and the medical community. We will present four specific programs, including a patient group led by our interfaith chaplain, a caregiver group grounded in compassion-focused mindfulness, an educational lecture series presented in Spanish, and a culturally-adapted intervention for families facing advanced disease. Our discussion will highlight how each program attended to patients' spirituality, cultural identities, and drive for interpersonal connection and will expound on how each effort was designed, implemented, and received.

Kauser Ahmed, Elizabeth Cleary Simms/Mann UCLA Center for Integrative Oncology, Los Angeles, CA, USA Abstract: Parents with cancer express anxiety about communicating their diagnosis to their minor children. When the diagnosis is terminal, specific guidance to assist the family is needed, but resources are limited. COVID-19 introduced additional challenges including isolation from family, especially those overseas, and barriers to engaging in culturally meaningful rituals that allow for healthy grieving. The Center's supportive care to families with distinct cultural practices addresses these gaps in end of life care. Consultations are provided to parents from diagnosis through treatment trajectory using a unique psychoeducation model that facilitates parents' ability to communicate meaningful change, including imminent death, to their minor children in developmentally and culturally appropriate ways. During COVID 19, this guidance, entirely via telehealth, was critical to offset the loss of familial support. An overview of the consultation model through a case presentation highlights culturally thoughtful supportive care for an Asian American family. The Center provided psychosocial support to 3018 patients with cancer in 2020-2021. Of these, 472 had an advanced cancer diagnosis and were under the age of 55, with minor children. 20% percent of care was to family members of patients, including minors from the age of 4 to 17, and 23 % to ethnic minority patients. Qualitative statements from parents include "These were the single most important conversations for our family through the cancer process". Beyond COVID-19, as we expand to more diverse regions, we will evaluate our model and incorporate telehealth to give access to more remote communities. The consultation model for facilitating communication between parents and minor children can be readily modified to meet the needs of diverse communities, and can be learned and incorporated into the practices of different health care professionals in the oncology setting including nurses, social workers, chaplains and psychologists. Objectives: Participants will be able to name 2 barriers and 2 facilitators of effective communication for parents at end of life with minor children. 

Simms/Mann UCLA Center for Integrative Oncology, Los Angeles, CA, USA Abstract: Those touched by cancer: patients, family, and the bereaved often struggle with spiritual questions to find meaning in their circumstance-a struggle intensified by the isolation imposed by the COVID-19 pandemic. Spiritual support during the pandemic can offer a pathway to meaning making. (Gonçalves et al, 2020 .) The Circle of Reflection, facilitated by an interfaith oncology chaplain is an opportunity to reflect and explore these themes, and to build community as well. The Circle meets virtually each week for one hour and draws 14-18 participants. Meetings begin with a reflective reading to spur the discussion. The group spans varying spiritual viewpoints, across generations and cultures, as well as vastly different relationships to cancer. That mix inspires deeper individual reflection as well as an affirmation of self and each other. The Circle creates a sustaining sense of community and safety amidst the uncertainties of cancer and the pandemic. Participants completed an anonymous survey after 12 months of the virtual Circle of Reflection. Participants (N=21) unanimously gave the group the highest ratings on a 1-5 scale for all five items that assessed the group's efficacy in understanding the intersection of spirituality and cancer, as well as the value of this community in coping during the pandemic. Qualitative data includes the feedback, "we know that we are not alone in this struggle," and that the group is, "a steady source of support and spiritual grounding." One writes, "It is like pure oxygen when we are feeling...cancer is strangling us." The background and need for this kind of support is universal within the larger cancer community. With a skilled facilitator, this model could have equal outcomes in any number of cancer settings, with equally diverse communities of participants. Evaluations reflect unanimous recommendation of this group to those touched by cancer. Objectives: The participant shall be able to identify the spiritual needs of those affected by cancer: patients, family, and the bereaved as they often struggle with questions to find meaning in their circumstance-a struggle intensified by the isolation imposed by the COVID-19 pandemic. The participant shall be given the tools to addressing that struggle via a virtual spiritual reflection group. . These needs were heightened by COVID-19, which disproportionately impacted the Latino community. These issues were addressed through culturally-responsive, Spanish-language educational programs. A health disparities grant allowed us to target more geographically remote Spanish-speaking communities to extend the scope of our outreach. Through the development of these programs, we are able to provide presentations and discussions on Nutrition in Cancer Care, How to Prepare for an Effective Clinic Visit with your Doctor, and The Emotional Challenges of Cancer, presented by a transdisciplinary team of social work, medical and nutritional professionals in Spanish. By conducting these programs on a virtual platform, we utilize accessible programming and eliminate the need for in-person gathering in light of COVID-19. In October 2020, we reached 105 Spanish-speaking breast cancer patients through these webinars. Of those participants, 65% surveyed reported that the presentations stimulated them to think and motivated them to learn more. Another 55% reported that the presentations motivated them to do something different and increased their confidence/ morale. From this, we saw the opportunity to expand these programs, and will conduct two additional webinars in 2021. Through our secured grant funding, we will further our reach into outlying/agricultural regions of Southern California through partner agencies. We will evaluate our impact through participant feedback and post-presentation surveys. Through providing virtual Spanish-language educational services with our partner agencies, we aim to positively impact cancer education disparities among Latino populations. We also aim to learn more about what the needs are within these communities and further ways to promote cancer literacy to Spanish-speaking Latinos. Objectives: The participant shall be able to name strategies for providing accessible virtual education programs to Spanish-speaking populations. The participant shall be able to identify barriers that exist related to making cancer education available to Latino populations, and tools to combat these barriers. References: Yanez, B., (Sannes, Yeh. Gray, 2021) . The development of self-compassion through mindfulness meditation is a practice that has evidence to suggest efficacy in reducing the distress of caregivers and in fostering self-care. (Neft, Kristen and Germer, Christopher, 2018) The Self-Compassion Workshop was held virtually for 90 minutes weekly for six weeks. 10 participants attended. Two facilitators, a chaplain and a social work intern began each session with a short didactic followed by a meditation that progressively deepened participants' experience of compassion. Through group reflection upon these experiences, participants began to recognize the power of the present moment, freedom from selfcriticism, the embrace of fear, and the life of compassionate self-care and shared community. Participants completed an anonymous 5-item survey at the conclusion of the workshop. Unanimously, participants (N=5) gave the workshop the highest ratings on a 1-5 scale for all five-items that assessed for workshop efficacy at teaching skills and fostering meaningful connections. Qualitative data from participants included the feedback "being compassionate toward myself helps me be more compassionate to my loved one" and "the meditation skills help me be calmer and better equipped to handle stress every day". One participant expressed how good it was, "to see the interconnection and compassion that caregivers shared with one another". Targeting self-compassion through mindfulness meditation has the potential to ameliorate some of the notable stressors of caring for someone with cancer. The virtual group format also provides an opportunity for caregivers who may be isolated and unable to leave their loved one to connect with others and receive social support. Objectives: The participant shall be able to articulate the theoretical rational for a caregiver group grounded in mindful self-compassion and identify specific advantages for caregivers to a virtual group format. Participants will be given insight into the difficulties caregivers experience as they begin their practice of meditation, as well as into the remedy that the group's reflection process provides individual caregivers and the ways it enables them to grow emotionally and spiritually. References Abstract: About a third of practicing oncologists are women; the number of women in academic roles in medical oncology, radiation oncology, and surgical oncology average 35.5%.1 In research, only 19% of tenured senior faculty appointments are held by women.2 Representation continues to decline in leadership positions such as department chairs and medical school deans. Early educational interventional programs like SHE address the disparity of women in oncology by introducing oncology and research to high school students. The Summer Health Experience (SHE) in Oncology is a program offered by the Livestrong Cancer Institutes of the Dell Medical School that introduces high school juniors and seniors who identify as female to a wide range of cancer-related career experiences and opportunities including research, clinical care, survivorship, and community support. The immersion program offers activities, discussions and leadership training, all through the lens of the challenges women face in their careers Students are required to complete a patient action/care plan using information gained during each lecture and activity throughout the program. Using the information in a specific patient case, and from lecture and activities, students create what they feel is the best action plan for the patient, their family and their caregivers. The care plan demonstrates the completion of the learning objectives and outcomes of the course. Students complete knowledge and impact surveys at the start and end of the program. Students and Austin Independent School District administrators also provide feedback through numerous surveys throughout the program. Students gained a better understanding of cancer and research, and the related career opportunities available to them. With consistent mentorship from female leaders, students were empowered to consider oncology and research as a potential career. In 2021 SHE will be expanded to include four cancer centers and one medical school. Objectives: Address the disproportionate number of women in cancer and research. Through SHE, students: Demonstrate a general knowledge of cancer biology; Function as a researcher in a laboratory and field setting using basic tools and equipment; Gain an understanding of how cancer is treated in the clinic, including the approach to patient-centered care; Understand the challenges cancer patients and their families face from the moment of diagnosis; identify community resources to meet their unique set of needs Depending on the mentor and their COVID-19 institutional policy, the mentorship experiences will be offered in-person, hybrid, and remote. Given that some mentors (n=7, 28%) cannot receive students in their institutions, workspaces were assigned for these participants within the UPRCCC (primary CAPAC site). Although these mentors will be working remotely with students, they will be virtually meeting with them regularly throughout the program. Given limitations in field-based and laboratory activities in some institutions, most research activities proposed for trainees will include quantitative and qualitative data analysis and manuscript writing, for which access to appropriate analysis programs will be provided. Despite the COVID-19 pandemic, CAPAC successfully recruited 25 students for its 2021 program in PR, representing the first cohort of trainees. Nonetheless, accommodations had to be made with a bigger focus on data analysis and scientific writing activities of previously collected data from cancer research studies in PR. Hispanic/Latino, 56% current master students, and 56% were from PR institutions. While 60% plan to apply to a PhD/DrPH program in the future, 48% are unsure if they will pursue a career in cancer research. Nonetheless, 84% are confident that they will pursue a career in health disparities research, and 100% want to reduce health disparities in their communities. The main reason why they may not pursue a PhD/DrPH degree is they prefer to get a professional degree (MD/PharmD/DMD, 52%), followed by financial constraints (16% . This program was designed to increase participants' scientific professional identity. In 2020, our initial conversion of the EI SURP to an online program created challenges in participants identifying as scientists. For summer 2021, we created an asynchronous Canvas-based course that utilizes videos, infographics and discussions to create a more interactive and engaging educational experience. Each participant was paired with a graduate student mentor on whose research project they will consult, and the participants also attended virtual laboratory meetings and seminars while completing the Canvas course. All EI SURP participants complete pre-program and post-program surveys and a post-program interview to determine the influence of the program on development of scientific professional identity. SURP participants from other departments within UNMC that will be having in-person research experiences will also be invited to participate in the Canvas-based course. These students were given the surveys and any student that participated in aspects of the Canvas course will be interviewed. The levels of professional identity of the two groups were assessed to analyze the difference in effect of the Canvas-based course on virtual only students compared to the course plus in-laboratory experiences. This online model has potential to be broadly applicable for increasing the scientific professional identity of students. It could serve as a guide for institutions that desire to supplement traditional laboratory-based undergraduate research experiences, and could benefit students from minoritized populations that may not thrive in a traditional research experience. Objectives: Participants will be able to identify two ways in which scientific professional identity can be increased in undergraduate students through participation in a research-based experience program. Participants will also be able to identify the portions of a Canvas (or other online platform) based course can be used to increase the scientific identity of undergraduate students. Additionally, participants will be able to identify components of an online course that are essential to scientific professional identity. Greater Baltimore Medical Center, Baltimore, MD, USA Abstract: Summer internships are important for training the next generation of cancer researchers and oncologists. The SARS-CoV-2 outbreak precluded implementation of interactive summer program curricula and led to the cancellation of internships across the US. However, pivoting the Nathan Schnaper Intern Program in Cancer Research (NSIP) to a virtual format created opportunities for trainees to engage in remote research, online learning platforms and multidisciplinary topics as part of a robust institutional COVID response. Nine summer programs consolidated resources to identify mentors with online research projects, adapt training modules to a virtual format and develop novel educational components. Online research provided trainees with a skillset highly relevant in their paths toward professions in which virtual interfaces occupy an increasingly mainstream role. The implementation of virtual programs as part of an institutional response to COVID exposed trainees to the innovation and resilience that are essential components of the biomedical profession. Outcomes evaluation of new components and feedback from participants provided insights into the utility of online platforms to add flexibility and content as a potential mechanism to complement in-person curricula. Comparing outcomes in which identical modules were delivered in-person and online provided information on the impact of COVID restrictions on program implementation and trainee engagement. Pre-and post-session surveys used a Likert scale to assess content learning by participants in different modules. Questionnaires and informal discussion with program leaders provided mechanisms to collect feedback on program format, organization, delivery and trainee-specific components (e.g. research projects and mentoring). Implementation of a virtual NSIP identified approaches to augment content and learning in traditional in person modules that will be retained in future programs. Increased focus on trainee wellness in an online setting revealed best practices that enhance engagement to continue in subsequent curricula. Abstract: While the area of cancer prevention and control increasingly requires a transdisciplinary approach, there are few training opportunities for students interested in pursuing a career in cancer prevention research, and even fewer opportunities for early career professionals gain valuable mentoring experiences. The Cancer Prevention Education Student Research program aims to grow the field of cancer prevention research through mentored research opportunities designed for undergraduate, graduate, and health professional students interested in career cancer prevention research. To broaden the field, the NCI-funded Cancer Prevention Education Student Research program at MD Anderson recruits and exposes summer undergraduate, graduate and health professional students to cancer prevention through mentored research opportunities. As part of this program, early career professionals, including postdoctoral fellows, gain valuable experience as part mentoring teams. From the perspective of an early career mentor, this abstract describes the learning processes, needs, resources, and mentoring strategies developed and used over the 10-week program. The mentoring team included one postdoctoral trainee and one senior faculty, who co-mentored two undergraduate students. Students were assigned research project looking at colorectal cancer disparities using SEER registry data. Mentors created a series of step-by-step video tutorials detailing how to use SEER*stat software to obtain data and statistics for their respective projects. The recorded trainings enabled students to learn at their own pace, allowing them to pause, rewind, relisten, or review content as needed. Mentors learned how to create effective instructional videos that can be used to train future students. Co-mentors met weekly to plan learning activities, share advice, and review-Mentored summer research experiences that provide valuable research and professional development opportunities for students interested in careers in cancer prevention can also provide excellent opportunities for early career investigators (including graduate and postdoctoral fellows) to gain valuable mentoring experience. Objectives: The participant shall be able to describe the overall purpose of the Cancer Prevention Education Student Research program at MD Anderson. The participant shall be able to the learning processes, needs, and mentoring strategies developed as part of a mentored research experience. This symposium will discuss the reproductive health needs of sexual and gender minority (LGBTQ) adolescent and young adult (AYA) with cancer and showcase the development of a training module to improve allied health professionals communication skills regarding fertility, contraception, and sexual health. LGBTQIA youth and AYA cancer survivors provided feedback on the module to increase relevance and accuracy. The LOvE module was built to educate, engage and motivate. An interactive glossary teaches shared language followed by a lecture on skills for creating a welcoming environment, discussion topics and other practical tips. The 3 case studies allow learners to "choose their own adventure" for how they would respond based on presented information. The action plan invites learners to identify activities they will initiate now and later. Abstract: Hereditary cancers account for 5% of breast and colorectal, 10-15% of ovarian cancer cases. Current rates of genetic counseling indicate unaddressed determinants for specific populations that disproportionately impact the rate at which people are accessing genetic services. The current study utilized a community engagement framework of multilevel stakeholders across Colorado to identify specific determinants of accessing genetic cancer screening. Key community stakeholders were recruited to represent a statewide, grass-roots organization of patient navigators, physicians, and community health workers whose members represented healthcare systems and community-based organizations reaching the medically under resourced. The stakeholders participated in multiple ranking surveys of determinants. Determinants were identified through recent literature and a survey of stakeholder community needs. Through the ranking stages, determinants ranked with the highest priority were considered in future rounds. The final determinants were confirmed during a stakeholder meeting discussion. The determinants were utilized in implementation mapping to identify potential evidence-based approaches to increase access to genetic counseling. Thirteen organizations ranked 32 determinants identified from a literature review. Two rounds of ranking identified four determinants: patients lack access, patients experience barriers, providers lack a systemic way to identify eligible patients, and lack of system level supports to address barriers to care. During the confirmation, stakeholders emphasized the importance of education to inform ways to address barriers and to identify eligible patients. Through implementation mapping, education objectives should use evidence-based approaches on multiple levels. Education should focus on self-efficacy, perceived susceptibility, and social detereminants of health for patients and complexity and perceived advantage of genetic counseling for providers and system. The findings of the current study will be used in implementation mapping to identify an evidence-based approach to address the determinants to increase hereditary cancer screening. Current education practices will be evaluated to address identifying patients and reducing barriers to care through a multilevel approach. Objectives: The participant shall be able to explain the impact of barriers to genetic cancer screening on multiple levels. The participant shall be able to identify education objectives that address community identified determinants to improve genetic cancer screening. The participants shall be able to name the different levels education will impact genetic cancer screening. Psycinfo, Scopus and GIM. Search terms included "neoplasms", "caregiver, "immigrants", "linguistic" and "barrier". The review considered only original peer-reviewed research and publications written in English. This scoping review employed the Joanna Briggs Institute methodology; two independent reviewers conducted title, abstract and full-text review of publications using Covidence software for systematic review management. The search yielded 11,165 abstracts. Following the removal of duplicates, 6,179 articles remained for analysis and underwent title and abstract screening, leaving 215 articles for full-text review. 159 articles were excluded. To date, 56 articles meeting inclusion criteria have been identified. In the majority of studies, the caregiver was a partner/spouse (44%) or parent/guardian (44%) and caregivers were primarily Spanishspeakers (40%) from Central/South America (54%). Themes uncovered include: lack of access to information, lack of support in retrieving appropriate information, challenges interacting with interpreters and translational services, as well as the role of interpretation in communicating with the patient and healthcare provider. Findings will offer insight about the impact of limited language proficiency and newcomer status on cancer caregivers. Understanding the barriers faced by LLP cancer caregivers will provide an understanding of how to best support this population and offer guidance into specific tailoring of interventions and resources. Objectives: The participant will be able to identify barriers related to the experiences of unpaid newcomer cancer caregivers with limited language proficiency (LLP We created a brief cancer education intervention by administering a 10-question pretest to Kentucky middle and high school students in 6 counties, 5 of which are located in the Appalachian region. Access to these students was obtained by contacting school administrators and teachers, who then allowed visitation during regular science and health class periods. The pretest was then followed by a cancer education presentation given by Markey Cancer Center employees. Then, we administered a posttest with identical questions to the pretest. Students also recieved a 3-month follow-up survey. All questionnaries used were designed specifically for this study. The results show that the intervention improves cancer knowledge in students. Moreover, it demonstrates that these students are likely to share this information with others. To further improve cancer literacy, we developed a 3-part culturally tailored and academic standard responsive cancer curriculum to be incorporated into science and/or health classrooms. The first lesson teaches about the basics of cancer. The second discusses risk factors, and the third covers treatment. These lessons include a PowerPoint presentation, in-class activities, and a teacher's guide. Such curriculum could aid in lowering Kentucky cancer rates especially in the Appalachian region of the state. Improving cancer literacy, which can be achieved through proper education, can increase cancer prevention behaviors. By making cancer curricula more widely available, students and even community members' cancer literacy could increase, and Kentucky's cancer disparities could be reduced. Objectives: Identify the cancer disparity in Appalachia Kentucky and identify specific factors that increase cancer incidence and mortality rates. Define cancer literacy and explain its potential implications on the cancer rates in Appalachia Kentucky. Examine potential methods and explore developed curriculum that strives to increase cancer literacy rates in Appalachia Kentucky. Jude STEM Club is a ten-week afterschool club that aims to increase 5th-grade students' science identities and critical thinking skills. During the club, students study a patient with osteosarcoma who requires a prosthetic and engage in an engineering design challenge to build a prosthetic hand. Due to COVIDrelated school closures, the Fall 2020 clubs shifted to a virtual platform. This study compared the impacts of the virtual and in-person versions of the club. On the final day of both the virtual and in-person versions of the program, students completed a retrospective, self-change survey to assess the club's impact on STEM identity, STEM engagement, critical thinking, perseverance, adult relationships, and peer relationships. To contextualize these results, students also provided written responses to the following prompt: "Was your prosthetic successful? Why or why not?" Responses were qualitatively coded and themed. Preliminary comparison of the virtual and in-person versions of the club showed that STEM engagement, STEM identity, critical thinking and adult relationships remained relatively unchanged. Peer relationships, however, showed slight decrease in the virtual format. Hosting virtual STEM clubs appears to increase students' STEM identity, STEM engagement, critical thinking and foster relationships with adults in a way that is similar to the in-person version of the clubs; but may be deficient in fostering peer relations, perhaps due to the independent nature of the virtual space. Objectives:

The participant will be able to identify three successes and one drawback of hosting a virtual afterschool cancer education STEM club. Abstract: American Indians (AI) present with higher rates of advancedstage disease for screening detectable cancers and have a lower level of basic cancer screening knowledge, than non-AI patients. We sought to identify and elevate perspectives on colorectal cancer screening from a strengths-based approach within AI communities. A community engagement process was carried out in addition to a regional environmental scan to ensure proper grounding in the topic area. We carried out semistructured interviews across four tribal reservation communities in North Dakota, USA. We utilized purposive sampling to ensure maximum variation in age, gender, and community until data saturation was achieved. Thematic analysis was carried out to identify consistent themes rooted within the AI experience. An Indigenous methodological orientation was also engaged throughout the research process that facilitated a culturally appropriate interview process. Ethical approval was gained for this project from all the relevant IRBs. We carried out twelve semistructured interviews with AIs between the ages of 40-75 years of age located on one of the four reservations in North Dakota. Four main themes were identified as barriers for the engagement with colorectal cancer prevention including: colorectal cancer screening barriers (transportation, rurality), focused on other health problems (diabetes), lack of colorectal cancer tailored health promotion, and socio-cultural factors effecting colorectal cancer prevention (mistrust). Three main themes were identified as facilitators for the engagement with colorectal cancer prevention including: reasons for getting a colorectal cancer screen (role model), role of culture (storytelling), and getting out into the community. There is need for more community-informed, strengths-based approaches to colorectal cancer education strategies in AI communities. Due to shared structural barriers including colonization across AI communities, our findings may have relevance in other regions. More in-depth research on AI socio-cultural factors that affect uptake of colorectal cancer education are needed. Objectives: -The participant will be able to describe and understand the difference between strengths-based vs deficit-based approaches to colorectal cancer education screening approaches in American Indian communities. The participant will be able to list the considerations for incorporating American Indian culture into colorectal cancer education and screening implementation processes. Abstract: Effective communication between healthcare providers (HCPs) and patients is important for HCP well-being, patient engagement, and health outcomes. Yet, HCPs do not receive adequate communication skills training and report feeling unprepared for difficult conversations with patients. Difficult Conversations in Health Literate Care was developed to meet this need. Four years later, a workshop on inclusive language has been integrated given a sharpened, social focus on inclusion, exploring how words manifest our biases, and impact care. Designed to focus HCPs on the needs of each standardized patient presented to them in 5 live simulations, course facilitators had noticed a gap in the curriculum around language and how poor choice of language can detract from care. The course was redesigned to include an interactive unit on the power of inclusive language. Run as pilot sessions involving~75 multi-professional learners, comparative evaluation data will be presented. Evaluation of this program is currently underway. Impact will be measured by assessing participant's motivational beliefs around incorporating inclusive language and other techniques in difficult conversations with patients before and after the program, through a qualitative review of peer and facilitator feedback and satisfaction data. This program has the potential to increase HCP's competency in conducting difficult conversations with patient and families and in utilizing inclusive language to foster inclusion and build a culture of belonging within the health care organization. were from racially and/or ethnically underrepresented communities, 88% were firstgeneration college students, and 99% were from low-income families. When asked to list the biggest problems that would make it difficult for students to continue college, 84% (n = 317) of the entire sample identified financial barriers, with 90% of the 317 listing finances first. Although 61% (n = 229) of all students reported their families would help them figure out how to meet the costs, incoming freshmen were statistically significantly more likely than community college students to report anticipated financial help from their families and statistically significantly less likely to report that the financial costs of college are beyond what their parents are willing/ able to help them figure. Financial concerns were widespread, but statistically more prevalent among community college transfers. Due to their diverse backgrounds they may be an underutilized resource for addressing cancer disparities. Research needed to better support these students' transfer to 4-year universities, matriculation to graduate school, and entry into the health and science workforce. Objectives: The participant shall be able to identify the unique contributions graduates of community colleges can make to efforts to reduce cancer disparities. The participant shall be able to identify the major barriers that community college transfer students encounter when transferring to a four-year college. Abstract: Familial Cancer Clinics counsel an increasingly high volume of patients regarding hereditary cancer risk. The first appointment typically takes an hour, most of which is spent educating the patient on the foundational principles of hereditary cancer and genetic testing. In order to liberate time for genetic counsellors to focus on more personal consultation and potentially see a higher volume of patients, we developed a video series to educate patients prior to their first appointment. A salient belief assessment asking 15 patients to write down their thoughts about genetic testing and cancer was distributed to ensure their most pertinent informational needs were addressed. Subject matter experts further developed the content. The 3-video series covers hereditary cancer, genetic testing, and possible results. Videos used plain language and a high degree of understandability and actionability evidenced by the achievement of at least 80% on the Patient Education Materials Assessment Tool (PEMAT). A 12-item survey was developed to evaluate perceptions of the videos' value in reducing first-appointment times and facilitating patient understanding. The survey included questions regarding the quality of information in the videos, feasibility of implementing the videos as a standard of practice, and predicted time savings during genetic counselling appointments. A digital survey link was sent to the Canadian Cancer Genetics and Genomics (C2G2) Community of Practice in May 2021. The C2G2 is a national community comprised of 350 individuals interested cancer genetics, including genetic counsellors, geneticists, oncologists, and patient representatives. Results are expected June 2021. By providing baseline information prior to genetic counselling, these videos are expected to improve the quality of genetic counselling appointments and allow patients to make more informed healthcare decisions. Genetic counsellors may also be able to help more patients as the demand for their services continue to grow.

Objectives: The participant shall be able to identify how to reduce patient appointment times through education. The participant shall be able to consider how to implement a virtual pre-appointment education program in their institutions. The participant shall be able to list steps taken to create effective patient education animations. References Abstract: Cancer is a major public health concern globally and the incidence is rapidly rising. Focused on capacity-building on a local and global scale, education priorities include growing the cancer workforce, nurturing a culture of critical inquiry and embedding interprofessional care and patient engagement into all aspects of cancer care. Abstract: Informal caregivers take new responsibilities that alter their everyday life, reducing the time for activities that involve self-care or socialization. When caregivers need more interaction and social support, they have less time to receive it. Asynchronous education programs provide caregivers with flexibility to learn during the time and place that works best for their personal routine. However, a disadvantage of these courses is the lack of interaction between users. The Caregiver Support and Skills Program is an asynchronous program that does not involve socialization between users. However, it promotes social support by presenting content that fosters socialization between caregivers and their friends and family. The program: Actively includes the voice of caregivers as part of the curriculum through videos, animations and quotes. Teaches strategies to socialize with others in situations that are common among cancer caregivers. Informs caregivers about relevant community support services that deliver in-person support. The program is stored in a Learning Management System (LMS). The LMS can track the number of clicks made to each resource. We will measure how many clicks caregivers make to the resources that promote socialization. Additionally, a caregiver and patient committee will validate the usefulness of the content in the program. This validation will evaluate the impact of the caregiver videos, animations, community services listed and relevant eLearning modules. Cancer education initiatives can promote social support even if they do not offer interaction between users. Listening to others' experiences, connecting with specialized institutions and learning how to interact with friends and family during difficult times can encourage caregivers to look for social support. Objectives: The participant will be able to identify and utilize strategies to promote social interaction through asynchronous courses. The participant will be able to justify the value of encouraging social interaction in asynchronous courses. Participants were asked about 1) barriers and motivators to HPV vaccination, 2) acceptance of an ECA to promote HPV vaccination, and, 3) strategies to culturally tailor the ECA system for Black men. Data were analyzed using conventional qualitative content analysis and constant comparison techniques. A culturally tailored ECA intervention was acceptable to Black men and identified strategies for culturally tailoring the intervention content: 1) Race/ethnicity: preference for a Black male or female agent to role model healthy behavior and increase trust and relatability; 2) Agent persona: favored the agent to have the persona of a younger medical professional (doctor or nurse); 3) Setting: Using a hospital or clinic background to convey the seriousness of HPV; 4) Language: Deliver HPV information in simple, clear way with limited medical jargon; 5) Credibility-provide links to government sites and display professional credentials on the ECA. A culturally tailored, ECA system is an innovative, accessible and highly scalable approach to augment clinical care by provide trusted, interactive, and accurate HPV information to Black men to reduce HPV vaccination barriers and promote HPV vaccination uptake. Objectives: The participant shall be able to: 

Kathy Janes Jinkins, Sarah Christensen The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: Services at our institution changed dramatically in March 2020 with the advent of widespread COVID-19. Face-to-face services shuttered, including the patient education resource library. The equitable delivery of services to patients and resultant patient experience issues became challenges to overcome. Having no knowledge when to expect an ending to the restrictions, services were planned for immediate and long-term utilization to meet patient health and disease information needs and new virtual services and programs were implemented. Changing from a highly interactive face-to-face service presented challenges. As staff began working remotely, the interaction ceased and staff were longing for interactions with their patrons. Patients had information needs that were not realized or being met with restricted access to the facility. By implementing new virtual services, patient needs were met and staff had patron interaction, albeit virtually. Patient access and staff satisfaction were outcomes specifically realized with the implementation of new services. New virtual services and programs were analyzed for best return on meeting patient needs, ease and immediacy of implementation, ability of users and access of users to utilize technology, and long-term efficacy. All services had to meet these criteria for consideration. New services implemented included live chat and live text to chat with library staff, direct messaging to library from portal on patients' electronic health record with access via web or mobile app, use of social media for outreach, staff assignment to clinical areas for information referrals, email question and reference service, and enlisting institutional communications assistance with messaging. Patients, families and caregivers had heightened information needs while navigating the pandemic. These needs were met with new services and offered access via phone, email, virtual sessions and messaging. All virtual services implemented in pandemic circumstances will continue once onsite interactions are allowed and are an enhancement to service delivery. Objectives: The participant shall be able to evaluate new resource library services relative to meeting patient needs, ease and immediacy of implementation, ability of users to utilize and long-term efficacy. The participant shall be able to assess and evaluate resource library service ideas and challenges to equitable access for potential implementation in their institution. Abstract: Staff engagement can improve outcomes for health care organizations [1] . Since 2015, the Princess Margaret Cancer Centre's Cancer Education Awards have recognized excellence in the field of cancer education. Healthcare workers in the Cancer Program who go above and beyond in their practice are nominated by their peers, and award winners from a variety of clinical roles are celebrated at an annual awards ceremony. Each year, improvements are made to the awards process based on learnings from the previous cycle. For the 2020 awards cycle, the nomination, selection, and celebration of award winners were shifted to a virtual environment out of necessity due to the pandemic, whereas in previous years, some aspects of the awards had been conducted in person.

In a year where healthcare workers have been stretched and tested with clinical priorities, the response to the 2020 awards was overwhelmingly positive, with a record number of nomination submissions and ceremony attendees compared to previous years. The nomination and selection processes were modified to improve and streamline the experience of the nominators and selection committee. An evaluation of past awards cycles and winners will summarize lessons learned and opportunities to improve recognition of staff. Evaluating past Cancer Education Awards cycles will help determine which practices to continue during the pandemic and beyond. Learnings will highlight where improvements may be made in streamlining the nomination process and increasing diversity of clinical staff groups that may not have been represented in past cycles.

Objectives: The participant shall be able to: Discuss the gaps and opportunities for different approaches to staff recognition in a healthcare workplace. Describe ways to optimize the application and selection process and create a morale-boosting virtual space to recognize staff excellence. The quality improvement project enhance awareness, education, screening, health promotion, prevention, and knowledge, using an Evidence-Based. Community Health Needs Assessment (CHNA) was conducted in 2019 acknowledges the gap in clinical prevention and population health management with Breast, cervical cancer, and Human papillomavirus (HPV), among women of African descent that needs to be addressed to improve the community's health due to the prevalence and mortality. The Model for Improvement: Plan-Do-Study-Act (PDSA) Cycle; Pre-postfollow-up approach and the Health Promotion Model (HPM) are used to guide the project. Conduct a pre and post-intervention survey to assess participants awareness and knowledge, perform an education and sustaining the program. Survey/questionnaire using the African Women Awareness of CANcer (AWACAN) tool for measuring awareness of breast and cervical cancer. Use the resources and toolkit to perform education and awareness on breast, cervical cancer, and HPV prevention for the community identified from the need's assessment. Follow-up phone calls, referral to resources/access, education, and reminders increase participation in the following screening & prevention activities and decrease the disparities indicated in the community health needs assessment (CHNA). a. Mammography and Breast Self-examination b. HPV test Breast, cervical cancer, and HPV as health care and population health problem are significant concerns to the community. Early detection impacts the mortality rate and helps with decreasing the death rate for those diagnosed. Regular screening tests, education, and early detection approaches that are culturally congruent can decrease deaths. Objectives: Identify at least two intervention approaches to creating a culturally congruent cancer education, awareness, screening, and prevention among women of African descent. Identify two toolkits to utilize for community/population health approach with breast, cervical cancer, and HPV prevention and education. Identify two barriers to the dissemination of cancer education during a pandemic References: American Cancer Abstract: Our goal is to provide free structured functional fitness classes following an evidence based program over 12 weeks to those post primary cancer treatment. There is significant need for those post-cancer treatment to re enter the process of physical exercise to reduce chronic fatigue along with other associated effects both physical and mental. Through coach led and online training sessions the Battle Cancer program offers a incremental program of functional training and movement assessments. Using over 65 academic resources, the Program offers alternative movements for those post-cancer treatment. The Program is designed around time domain-based exercise, and each movement is selected to echo the functions of everyday movement. The Program utilises group training and self-assessment to encourage community interaction. The Program also uses social interaction exercises to address the mental impact of cancer diagnosis. The Program is delivered inside CrossFit gyms twice a week for 12 weeks. The Program is centred on physical strength and fitness, and the WHO Quality of Life questionnaire. Participants are assessed on several physical measures including resting heart rate, mobility and strength-based exercises. Participants also complete a selfassessment of the WHO Quality of Life questionnaire three times over the 12 weeks. Impact on both physical ability and quality of life is measured by the change in these scores. The Program is creating a growing data set that identifies trends in cancer survivors' age, gender, cancer type, treatment, and symptoms post-treatment along with the impact of structured exercise on these conditions and side effects. This data, combined with participants' and coaches' feedback allows the program to continuously improve and develop. Data will inform safe movement and exercise programs for those affected by cancer across the world. By funding Programs in gyms across the U.S and by offering it to fitness professionals for free, we will drastically improve the accessibility to fitness among cancer survivors in all social groups regardless of their financial situation. Objectives: The participant shall be able to access a structured exercise program to aid in recovery post-cancer treatment. Fitness professionals shall also be able to access the latest advice on how to best support those post-cancer treatment back into physical exercise. The data collected will help to show the impact of a structed fitness program on those post-treatment to improve mobility, fatigue, strength and cardiovasular capacity. With a wide subject range, we will also be able to offer this data to the wider academic and medical community. Abstract: Clinical practice guidelines emphasize the importance of oncology clinicians improving their communication skills to provide quality spiritual and cultural care. However, few clinicians receive formal communication skills training with an emphasis in spiritual and cultural aspects of care. The purpose of this abstract is to describe the Interprofessional Communication Curriculum (ICC), a train-the-trainer course for interprofessional oncology dyads to help prepare them to provide communication skills training at their home institutions. Organized by the 8 domains of the National Consensus Project (NCP) Guidelines, ICC includes skill-building exercises (e.g. role plays and case studies), interactive small group discussions, and vignette demonstrations, to improve participants' abilities to provide effective spiritual and cultural care for cancer patients and their families. Using a goal-directed method of teaching, teams develop 3 goals for integrating communication training into their clinical settings. Evaluation included a pre-course survey and an immediate post-course evaluation. The first ICC course was held January 2021 (virtually) with 27 teams (52 participants) consisting of nurses, social workers, and chaplains. The pre-course survey revealed participants' least effective areas of communication were related to spirituality and culture and when asked how frequently they provided spiritual care, an average of 2.7 on a scale of 1 to 5 (1=never) was reported. Post-course evaluations, on a scale of 1 to 5 (1=lowest), revealed that the course met participant's expectations (4.8) and that the spiritual (4.9) and cultural (4.8) modules and small group discussion sessions provided the most value to their practices. With funding from an R25 NCI training grant, four additional ICC courses will be held in the next four years nationwide. A 6-and-12-month post-course follow-up will occur to capture participant training activity and goal progression. (1) whether sociodemographic factors (e.g., gender, age, doctor recommendation), acculturation, religious social capital (e.g., trust among church members), and mobile media-based cancer information seeking can predict CIs' endoscopy screening;

(2) How these factors affect CI's screening. The validated survey and interviews that have the same questions were used to collect data. 90 surveys and 32 individual interviews were collected from church-going Chinese Immigrants in local Chinese American churches. Logistic regression was used to model the three macro-level predictors of screening behavior. A thematic qualitative analysis was used to analyze interview data. The majority aged between 50-64, highly educated, married, employed, had a high income, had private insurance and received doctor recommendations. 54.4% did an endoscopy, while 25.6% did annual stool tests. Moreover, participants are highly acculturated (Mean=26, high acculturated: scored ≥15), high religious social capital, and high mobile media-based cancer informationseeking scores. Logistic regression showed that doctor recommendation and income were significantly positively associated with endoscopy screening (p<.05). The qualitative study confirmed that doctor recommendation is the determinative motivator for endoscopy screening. Religious social capital and mobile media can facilitate endoscopy screening by reducing screening anxiety and knowing screening benefits and Multiple interventions are needed to enhance endoscopy screening among CIs. Doctors should provide culturally and language-tailored screening recommendations. Chinese American churches should take advantage of religious social capital to share endoscopy screening information and provide mental and tangible supports. Mobile media should be used to enhance CI's screening knowledge. Objectives: Previous studies mainly focused on relationships between CRC screening behaviors and cognitive/affective factors, but few have looked at systematic level factors. In my research, participants will be able to view the relationships between CRC screening behaviors from a systematic/macro level. They will be able to identify at least one determinator (doctor recommendation) and two facilitators (religious social capital and mobile media) of CRC screening among Chinese Immigrants. Moreover, the mixed research method provides a comprehensive picture of factors affecting Chinese immigrants' CRC screening and how. This research will also provide a and prostate examination use in men within the last two years. Religiosity was assessed by self-rated religiosity (high religiosity versus low) and participation in religious groups (as volunteer or member). Logistic regression analyses were used adjusting for potential confounders such as sociodemographic characteristics, comorbidity, and functional status. Fifty-four percent of women received a Pap test, and 39% had a mammogram. Forty-seven percent of men had a prostate examination. Eightyfive percent of participants had high religiosity, and 35% participated in religious groups. Multivariate logistic regression analyses showed that participation in religious groups was associated with higher odds of having a mammogram (OR=1.10; p=0.0235) or a Pap test (OR=1.12; p=0.0069) in women and a prostate examination (OR=1.13; p=0.0158) in men. Also, high religiosity was associated with higher odds of having a mammogram in women (OR=1.21; p=0.0074). Participation in religious groups is associated with increased cancer screening use among older men and women, with potential application in religious organizations worldwide. Contacting religious leaders to provide information in health prevention campaigns or regular events and celebrations could enhance opportunities for cancer screening education and prevention. Objectives:

The participant shall be able to identify types of religious beliefs or participation as potential associated factors for cancer screening use in older adults. The participant shall be able to discuss the role of religious groups for promoting cancer screening use among older men and women. Abstract: Cancer disproportionately affects Indigenous peoples, and efforts to address cancer are much more successful when culturally relevant. Many Indigenous peoples communicate in visual ways. This research team conducted a scoping review to identify studies that have utilized arts-based research methods with Indigenous peoples to address cancer across the cancer control. Literature searches were conducted in MEDLINE, CINAHL, Embase, and Scopus databases using search terms related to arts-based research methods and Indigenous peoples. All countries of origin, date ranges, and grey literature were included in this review. Literature selection was based on pre-determined inclusion and exclusion criteria and three reviews by an analysis team in more than two iterative cycles. The initial selection was based on a review of manuscript titles, keywords, and abstracts. Literature selection was finalized after a review of the full article text and a consensus meeting to resolve any disagreements. Of the 128 publications found, 31 met the review's inclusion criteria. Art as research (55%) was the most common arts-based research method followed by art in research (35%). The most common art forms employed in arts-based research were visual (32%), such as photovoice, traditional arts, and crafting, and sound (29%), such as storytelling. Most publications (58%) did not specify a single cancer type; cervical (13%) and breast (13%) were the most identified cancer types in publications that did specify. Half of the publications selected were not specific to one stage in the cancer control continuum (52%). This review identifies the need to further investigate the ways in which arts-based methods can be used to make cancer efforts culturally appropriate. Furthermore, these publications demonstrate how arts-based research methods can be utilized to develop effective cancer education and research with Indigenous peoples across the cancer control continuum.

Objectives: The participant shall be able to identify arts-based research methods and practices that have been previously implemented with Indigenous populations to address cancer across the cancer control continuum Abstract: South Asian American (SAA) women are diagnosed with more aggressive breast cancer than non-Hispanic White (NHW) women. Partial, subcutaneous, total, or radical mastectomy, are common surgeries. Understanding the factors governing these surgeries can shed light to educate women with breast cancer from this culturally distinct population to make health decisions. We extracted data on age at diagnosis, grade, stage, estrogen and progesterone receptors, and surgery from 4591 SAA and 429,030 NHW breast cancer cases in the Surveillance, Epidemiology and End Results (SEER) program. We used logistic regression with surgery as the binary outcome (subcutaneous, total, or radical mastectomy (STRM) versus partial mastectomy, no, unknown or other (PNUM)) and included main effects of all the variables and their interactions with race/ethnicity (SAA and NHW). Type I error of 5% was used to assess statistical significance of the effects. All analyses were done using the R programming language version 4.0.5. SAA were significantly more likely than NHW cases to receive STRM relative to PNUM surgery among women diagnosed at or after age 50 years and having localized stage disease (OR = 1.27, 95% CI = 1.06 -1.52). Further, SAA were significantly less likely than NHW cases to receive STRM relative to PNUM surgery among those diagnosed before age 50 years and having regional or distant stage disease (OR = 0.75, 95% CI = 0.59 -0.95 for age at diagnosis < 40 years; OR = 0.77, 95% CI = 0.62 -0.95 for age at diagnosis 40-49 years). Disease characteristics play a key role on the type of surgery received by breast cancer patients. The findings of unadjusted analysis that SAA women are more likely than NHW women to receive STRM is driven largely by more aggressive disease occurring in SAA women at the time of diagnosis. Objectives: The audience will be able to identify specific factors associated with surgery decisions in breast cancer patients. The audience will be able to interpret odds ratios and identify that treatment decisions are based on tumor characteristics in both South Asian and non-Hispanic White breast cancer patients. Abstract: Cancer organizations and healthcare providers (HCPs) want to provide the best care possible and strive to maximize the patient experience. Published reports suggest a variety of factors that are considered important. We decided to survey patients undergoing radiotherapy to determine what they considered desirable traits and identify areas for improvement. An ethics approved 35-item patient satisfaction survey evaluating cancer patient experience was developed at our centre by an interdisciplinary team of HCPs working in the radiation medicine program. It was an anonymous, voluntary, paper-based survey for self-completion. It evaluated a variety of domains with respect to the quality-ofcare patients received (not just radiation-related) and was administered to patients undergoing radiotherapy at our academic hospital-based cancer centre. The survey was completed by 199 patients. Overall patient satisfaction was high. Most (>90%) stated they received adequate explanations about treatment, and had their questions answered. The majority (93%) felt included in the decision-making process. However, areas for improvement were identified. These included the following: receiving more information about clinical trials and other treatment options; being given contact information about community resources and psychosocial services; and being offered future appointments to discuss their diagnosis and treatment. Also, HCPs tended to focus mainly on the physical needs of patients and to a lesser degree on their emotional needs, but spiritual and cultural needs were not routinely addressed ( < 1 0%). Cancer patients undergoing radiation reported high rates of satisfaction with the care that they received. However, there remain areas for improvement including providing more information, having enough time available to address concerns, and addressing spiritual and cultural needs. Objectives: The participants will be able to understand and appreciate the various aspects of care that cancer patients undergoing radiotherapy value and this should highlight areas for improvement. Our study stresses the importance of maximizing all aspects of cancer care, emphasizing a holistic approach. The diet of Puerto Ricans in the US relies more heavily on processed foods, such as white bread, meats, and cheese, as they are more affordable and accessible than traditional Puerto Rican foods. In PR, although the diet is heavily influenced by the Western diet, aspects of the traditional PR diet still contribute to total nutrient intakes, such as legumes, plantains, fish, yautia, and other tuber vegetables. These foods are studied for their anticancer properties particularly in breast and colon cancer. Nutrition is an important part of our culture and health. The cancer disparity between the two populations presents a unique opportunity to examine the role of diet in cancer, and protective factors certain foods may have. Once better understood, specific ethnic outreach programs could be designed to address this disparity. Abstract: Targeted therapy utilizes drugs matched to dysregulated biological processes in cancer cells. This study had two tasks: 1) Literature review about the influence of socioeconomic status (SES) and race/ethnicity on access to cancer treatments; 2) Analysis of the influence of these factors on targeted therapy using a medical registry. A search of the scientific literature on the influence of SES and race/ethnicity on access to cancer treatments was conducted. PubMed, JSTOR, EBSCO, and Google Scholar were the databases utilized to inspect articles published within the last few years. The search terms used to refine the focus of the articles I examined were: cost, cancer, treatment, expensive, race, ethnicity, underserved, communities, and underprivileged. Of the 38 articles reviewed, 14 articles were deemed as applicable for the literature review. A local medical registry of 5304 patients (ARMOR) containing drug-mutation matching information was used to validate and expand the observations. A majority of the studies reviewed suggest SES is a significant factor in cancer patients receiving expensive cancer treatments, with people of low SES being 17% less likely to receive precision therapy treatment. In addition, African Americans are at the highest risk of not receiving access to effective but expensive cancer treatments. Low SES patients, as inferred from non-private medical insurance, were less likely to receive targeted therapy (TT) as observed in 210 EGFR-lung cancer patients in the ARMOR registry. In contrast, race and ethnicity were not significantly associated with the TT prescription. The studies reviewed demonstrate that financial and racial disparities in cancer treatment are prevalent across the majority of cancer types. Comprehensive research regarding the implementation of specific programs to educate and assist communities that experience disparities in access to expensive cancer treatments are needed. Objectives: The participant will be able to identify at least one racial/ethnic community that experiences barriers to access to expensive and effective cancer treatment. The participant will be able to identify 2 factors that present additional barriers to access to expensive and effective cancer treatment. The participant will be able to recognize whether or not insurance is related to access to expensive targeted therapy treatment based on analysis of the medical registry. Abstract: Hispanic children are more likely to be exposed to pesticides than children from other demographics. As Hispanic children in the United States possess the highest rates of acute lymphoblastic leukemia (ALL) diagnoses and poor treatment outcomes, this study elucidates the potential link between pesticide exposure and ALL in an epigenetic perspective. A narrative literature review combining environmental health and epigenetics was conducted. PubMed and Proquest were utilized to identify articles with principal search terms: pediatric acute lymphoblastic leukemia, children of farm workers, Hispanic farm workers, Hispanic children + ALL, epigenetics + pesticide exposure, and pesticide exposure + ALL. The references of key articles were analyzed to gain additional scientific information and background. Lastly, Google Scholar was used to further obtain peerreviewed articles in various journals. The rate of Hispanic children diagnosed with acute lymphoblastic leukemia steadily increases despite extensive research on its mechanisms and treatment innovations. Poor outcomes such as mortality and drug resistance are common in Hispanic children.

Urine samples of children of farmworkers reflect higher rates of pesticide exposure while the majority of farmworkers are Hispanic. Although indepth studies of Hispanic children of farm workers & ALL have not been conducted, epigenetic research has shown that DNA methylation is a possible mediator to pesticide-exposure related pathogenesis, including ALL. Furthermore, DNA methylation serves as an epigenetic biomarker for drug resistance in pediatric ALL. ALL disparities in Hispanic children are, at least in part, a byproduct of environmental injustice. Reducing the effects of residential, ambient, and occupational pesticide exposure coupled with epigenetic research and pharmaco-epigenetic treatments can significantly diminish the burdens of pathogenesis/tumorigenesis and poor treatment outcomes. Objectives: The participant shall be able to identify environmental health conditions that potentially lead to acute lymphoblastic leukemia while acknowledging the disparities seen in Hispanic children along with the burdens that render these cancer disparities in a scientific and social perspective. (PCOS) in women. African American (AA) women and white women have the highest rates of PCOS and uterine cancer, yet AA women have the highest mortality rate for both. Twenty-eight articles were used to examine how the gut microbiome increases the risk for PCOS and uterine cancer. This literature review also addressed the racial disparity faced by AA women in having a higher mortality rate than their white counterparts. Articles, published since 2016, were found in PubMed, CINAHL, and Google Scholar using the search terms: AA women, cancer, gut microbiome, endometrium, uterine, and PCOS. Reference lists of these articles were searched for additional key articles. The American Cancer Society and National Cancer Institute were used to provide cancer statistics for uterine cancer. Dysbiosis, a gut microbiome imbalance, is increased in PCOS individuals; additionally, studies support a link between the gut microbiome and various types of cancer. PCOS patients shed their uterus lining less often, thus increasing their risk for uterine cancer. AA women have high incidence rates of PCOS and uterine cancer, as well as biological differences in their gut microbiome, including genetic variance. Research shows that the human microbiome plays a role in cancer treatment effectiveness which may explain why AA women have a higher mortality rate of PCOS and uterine cancer, compared to their white counterparts. There is a biological difference in AA women's gut microbiome compared to their white counterparts, which may be associated with increased mortality rates for both PCOS and uterine cancer. The connection between the gut microbiome and cancer has been established, but more PCOS and uterine cancer research is needed. Objectives: The participant shall be able to identify the connection between the gut microbiome and polycystic ovary syndrome and how it relates to uterine cancer. The participant shall also be able to identify the disparity that African American Women face compared to their white counterparts, in both polycystic ovary syndrome and uterine cancer. Abstract: BRCA mutations are associated with a higher overall risk of prostate cancer (PCa) and a higher risk of an aggressive phenotype. Genetic testing (GT) for BRCA is important for cancer screening and treatment. This study identified barriers that may explain why men with PCa are less likely to receive GT. This narrative literature review explored barriers to GT that men face by examining articles found using PubMed/ Medline, CINAHL, PsycINFO, and ERIC. Among the keywords used were prostate cancer, BRCA, men, genetic testing, cancer, and education. Reference lists of key articles were also reviewed to find additional relevant articles. The search focused on two groups: men at risk of BRCA mutations and men diagnosed with PCa. Articles were excluded if germline variants other than BRCA1 and BRCA2 mutations were primarily discussed in genetic testing or the focus of cancer was other than prostate. Out of 230 screened articles, 20 examined barriers to GT in men at risk for BRCA mutations, or those already diagnosed with PCa. These barriers included cost, accessibility, knowledge, and recognition of the benefits of GT for BRCA in men. These barriers impacted both men and their healthcare teams. Studies identified the growing need to inform men at risk of or diagnosed with PCa, and their healthcare teams, about BRCA considerations in screening and treatment decisions; however, little progress has been made to fill the educational and accessibility gaps regarding the incorporation of GT in PCa risk assessment and care. Results showed a lack of awareness, accessibility, and use of GT in men at risk for BRCA. Awareness of GT benefits and expanded resources for men at risk or diagnosed with PCa could decrease barriers, as previously achieved for women at risk for BRCA and associated cancers. Objectives: The participant shall be able to identify three barriers to genetic testing that men at risk for BRCA mutations or men diagnosed with prostate cancer face. articles out of 23 screened examined perceived barriers to screening and community-based interventions for AAW. Most studies were crosssectional in design, while some included focus group interviews and interventional studies. Groups studied included AAW of all religious backgrounds and nationalities. The most significant barriers to breast cancer screening for AAW included insurance coverage, cost, language proficiency, lack of provider recommendation, and perceived discrimination by healthcare providers. Studies were inconsistent regarding the impact of religious fatalism and modesty concerns on screening behaviors. Acculturation, measured by the length of US residency and English language proficiency, was associated with increased screening practices. Due to the distinct cultural values and health behaviors of AAW, physicians and researchers must disaggregate data on AAW from non-Hispanic white women. Future interventions to address screening barriers must utilize social networks and religious frameworks, in addition to training physicians in the delivery of culturally competent care for AAW. Objectives: The participant shall be able to identify at least one cultural barrier to breast cancer screening for Arab-American women. The participant shall be able to identify at least one proposed intervention for increasing cancer screening rates for Arab-American women. Abstract: Multiple Myeloma (MM) is the second most common blood cancer in the US and the first most common for African Americans (AAs). The incidence and death rates of MM for AAs are double that of the nearest demographic. The factors which account for these disparities are an ongoing topic of investigation. A narrative literature review was conducted using PubMed, Google Scholar, Embase, CINAHL, Psycinfo, and Web-of-Science in order to isolate factors contributing to an increased risk of MM among AAs. Articles concerning MM disparities published in English with full text between 2016 and 2021 were identified and their references were reviewed for maximum and updated accuracy.

The following six factors were identified: obesity, immunological challenges, family history, genetic variations, access to healthcare, and disparities in treatment. Once sorted, each factor and its corresponding effects were synthesized into a comprehensive summary detailing the causes for the disparities in MM risk. The literature search revealed that obesity played a significant role in the development of MM. However, many studies suggest that immunological challenges, family history of MM, genetic mutations and variations, decreased access to healthcare, and racial differences in treatment and therapy have also shown correlation to increased MM risk. It is theorized that AAs exhibit higher incidence of MM because larger proportions of the AA community suffer from and are affected by a combination of these factors. While family history and genetic variations are difficult to control, factors such as obesity, immunological challenges, access to healthcare, and treatment differences can be addressed with focused interventions. Future strategies should aim to address social injustice issues linked to MM. Abstract: The United States is a record-holder for high incarceration rates. Prisons' smoke-free policies mandate prisoners' immediate tobacco abstinence, thereby linking freedom from prison with freedom to smoke again. A search for evidence-based interventions that effectively reduce the high post-release smoking relapse rate prompted this review of the scientific literature. A scientific review of the literature was conducted relating to smoking cessation and substance abuse programs designed for persons during and after incarceration. Databases including PubMed, PsycINFO, CINAHL, and EBSCOhost, were searched using the following search terms: incarcerat*, smoking cessation, behavioral therapy, tobacco, prison*, and correctional facilities. Reference lists of articles were reviewed to identify additional articles related to article content and search terms. Eligible papers were written in English and published in peer review journals from 2010 to 2021. Articles were excluded if they were not accessible in full text. Although many incarcerated members report an intent to quit, incarcerated members expressed the lack of resources regarding both smoking risks and prolonged smoking cessation from incarceration into release. Few incarceration centers have endorsed smoking cessation programs despite these programs providing a key compulsory resource focused on persistent smoking abstinence during incarceration and after release. Studies indicate that programs involving intensive group-based cessation with pharmacotherapy, in-prison delivery of motivational interviewing, or cognitive behavioral therapy are effective treatments to address tobacco dependence. Furthermore, increased social support from family, peers, or environment following release alongside the smoking cessation treatment facilitated greater smoking abstinence. With incarcerated members expressing a desire to abstain from smoking, a greater emphasis on incarceration tailored cessation programs will potentially reduce smoking and increase preventative measures within incarceration facilities. Further research is needed concerning programs and policies that may encourage smoking abstinence and provide effective resources toward support following release. Objectives:

The participants will be able to understand potential factors contributing to harmful smoking behaviors within the incarcerated community and identify potential methods to retain smoking abstinence before and after incarceration. Abstract: Disparities in access to stem cell medicine are found in underrepresented minority (URM) communities and low socioeconomic communities. Reduced participation in stem cell donations among URM communities contributes to a lack of diversity that limits generalizing genomic research findings and reduced availability among minority groups to utilize stem cell treatment. This narrative literature review explores the factors contributing to the lack of participation in stem cell donation, stem cell treatment, and genomic research. The articles using PubMed, JSTOR, and CINAHL databases using these keywords: Asian/Asian American, Latinx/Latin American, African American/Black, stem cell medicine/ treatment, inequalities, socioeconomic, cord blood banking, and genomic research/data. These articles were mainly composed of a mix of crosssectional and longitudinal designs. The reference lists from key articles were reviewed. Forty articles highlighted the racial and socioeconomic disparities in cancer research and stem cell treatment. Along with Native Americans and Hispanic Americans, African Americans are significantly underrepresented in clinical studies. Studies suggested that the lack of diversity and cultural competency of recruiters may contribute to low donor participation rates among minority groups. Furthermore, studies have shown that African Americans and Hispanic Americans were less likely to utilize stem cell transplants as a cancer treatment due to financial barriers, lower health literacy, and medical mistrust. Low socioeconomic communities are at a disadvantage for affording cord blood banking. Solutions to address these disparities include, but are not limited to, providing more representation/mutual identity in registry recruiters and promoting educational programs. Changing health insurance accessibility to make treatment options affordable may aid in reducing these disparities. Bridging these disparities will improve clinical care, survival rates, and genetic research. Objectives: The participant shall be able to list two inequalities that minorities face in stem cell medicine. The participant shall be able to identify three reasons why these disparities exist. from high-risk families that could hold important clinical value to address lung cancer health disparities. Study participants were recruited from a network of 30 hospitals from Louisiana along with multiple states across the country. Study participants with at least two confirmed cases of primary lung cancer within the family were eligible. Medical and pathology reports were obtained from hospitals along with demographic and environmental data from the families. A total of 192 study participants (157 European American and 35 African American) from the years 1992 through 2021 were used in this study. Data abstracted from the pathology, clinical reports, and study questionnaire were entered into spreadsheets and analyzed. Histology of LC diagnosis and clinical reports on mutation analysis were documented. The preliminary analyses of results have found that the average age of onset for AAs is significantly lower than in EA (P value < 0.0001). Additionally, while smoking is commonly referred to as a major contributor to LC disparities, AAs were found to have significantly lower pack years of cigarette use than EAs (P value < 0.05). The average age the AA participants 'begin to smoke' was also found to be significantly lower than EAs (P value < 0.05). The majority of the study participants with LC were diagnosed with adenocarcinoma irrespective of the number of pack-years for cigarette use. Additional analysis is ongoing. Clinical and pathological characterization in association with risk factors from high-risk families with European American and African American ancestry will provide us with a better understanding behind the disproportionate distribution of incidence and survival for lung cancer in the African American population. Objectives: The participant shall be able to recognize the social, cultural, environmental, behavioral and biological factors contributing to lung cancer disparities. Abstract: Recent literature indicates that gut microbiome alterations may trigger an increase in breast cancer risk. African-American (AA) women have the second-highest breast cancer morbidity rate and the highest mortality rate. This literature review explores harmful microbiome influences and their impact on increasing AA breast cancer rates. This search of scientific literature explored the effects of microbial dysbiosis associated with the increased risk of breast cancer as well as higher mortality rates among African American women. This narrative literature review identified articles from PubMed, CINAHL, and Google Scholar databases using keywords such as African American/Black, women, microbiome, gut, breast cancer, microbial dysbiosis, and mortality. Reference lists of articles were reviewed to identify additional articles relating to keywords and content. Articles were excluded if unavailable in full text. Eligible papers were published in peer-reviewed journals from 2016 to 2021 and written in English. Studies showed that socioeconomic factors, host genetics, and environmental influences can affect microbial diversity in breast tissue. After review, growing evidence strongly suggests an association between microbial dysbiosis and breast cancer in women. Microbial diversity in breast tumor tissue of non-Hispanic Black (NHB) women was found to be significantly lower compared to non-Hispanic White (NHW) women. Although the relationship between microbiota diversity and microfauna composition within breast tissue differs among racial groups, especially between NHB women diagnosed with breast cancer and healthy NHB women, it is unclear what factors contribute directly to these microbiota compositional differences. Unhealthy diets, polluted communities, and stress-inducing factors negatively affect the microbiome and increase the significant health disparity that exists among AA women with breast cancer. Research demonstrated a variation in microbiome composition of breast cancer patients of differing racial/ethnic backgrounds, warranting further research to understand these differences. Objectives: Participants should be able to identify at least two factors that negatively impact the microbiome of African-American women with breast cancer. Participants should also be able to grasp how the cumulative exposures of the built environment affect the microbiome of different racial/ethnic demographics disproportionately. Abstract: Non-Hispanic white (NHW) men have the highest incidence rate of glioblastomas. Although this population tends to have better and easier access to medical care, their survival rate is the lowest compared to other ethnic groups. The purpose of this study was to identify factors related to this disparity. A literature review was conducted using PubMed, Academic Research Complete, CINAHL, ERIC, and Google Scholar to find articles related to ethnic/racial differences of patients diagnosed with glioblastomas since 2016. The keywords searched were white/male, genetic variations, brain tumor survival, disparities/brain cancer, and ethnic/cultural survival rates. Reference lists within articles were used to acquire additional key articles. Thirteen articles addressed ethnic/ racial differences between glioblastoma patients. The majority of the studies used retrospective analysis from SEER, WHO, and CBTRUS databases. The incidence rate in NHW was 25-50% more than other groups. Age, type of diagnosis, and type of care were found to be important prognostic factors. NHW are diagnosed later in age, are more likely to receive a primary glioblastoma diagnosis, which is harder to detect and are more likely to receive gross total resection. Non-NHW have genetic mutations at younger ages and associated better treatment response. Younger age at diagnosis is the largest contributing factor correlated with survival in NHW. However, Asian/Pacific Islander and Hispanic patients diagnosed at younger ages may have a net survival loss and lower quality of life. Research to address the disparities of older and younger patients is needed. Objectives: The participant will be able to identify three reasons the survival rate is lower in non-hispanic white males. References: Bohn, A., Braley, A., Rodriguez de la Vega, P., Abstract: Adequate health literacy and numeracy skills are key in improving preventive health behaviors such as HPV vaccination uptake in racially diverse populations. The current study assessed self-reported health literacy and numeracy and examined associations with sociodemographic characteristics among a diverse sample of adults aged 18-45 living in the United States. Racially and ethnically diverse participants (n=3,757) completed an anonymous online survey assessing health literacy and numeracy skills, sociodemographic variables, health beliefs, and engagement in HPV vaccination behaviors. Literacy was measured with 3 self-reported items, assessing difficulty obtaining medical information, understanding health information from healthcare providers, and understanding written health information. Numeracy was measured with 4 selfreported items, assessing difficulty understanding medical statistics, dependence on numerical information to make health decisions, preference of receiving information using words or numbers, and an objective numeracy question. Descriptive statistics, multivariable logistic regression for binary outcomes, and proportional odds models for ordinal outcomes were utilized. Approximately 69% of participants reported white race, and 18.5% reported Hispanic ethnicity. Approximately 38% of participants reported it was very easy to obtain and understand written health information. More than half (51.9%) preferred receiving information using numbers over words. Being Asian (OR: Overall, oncology trials may not reflect the demographics of the populations sought to be served. Objectives: The participant shall be able to identify specific disparities between ethnicity and race proportions in clinical trials of neoplastic disorders, and the representation of these same groups in the U.S. population. Reasons for disparities in trial participation are myriad, including historical issues of racial injustice in medical research, anxiety and cynicism towards clinical trials, as well as practical limitations in communication, transportation, and financial capacity of trial participants. Understanding these disparities is important to the field of cancer education, and may help to inform discussions between healthcare providers and minority patients who seek to participate in clinical trials. References: P48: Health behaviors of cervical cancer screening among refugee women in Omaha, Nebraska this population's reasons are not well known. The purpose is to assess the health behaviors using the health belief model and explore the indicators of CC screening uptake among refugee Secondary data was collected from a convenience sample of refugee women at Bridge to Care health fair and refugee women meetings between 2017 -2019. although no documentation was inquired to ascertain their refugees' status. The survey was administered to 121 refugee women assessing their baseline knowledge, healthcare access, behaviors, attitudes, and perceptions towards CC. Descriptive statistics, chi-square independence test, and binary logistic regressions were used to estimate the association between sociodemographic determinants and health belief model (e.g., perceived susceptibility, perceived benefits, and cues to actions), barriers, and uptake of CC screening, and facilitators predicting CC screening. 1) Most participants were from Asia, particularly Burma. 2) There was an association between parity and perceived susceptibility to having CC. Likewise, an association exists between health insurance and perceived benefits of screening; 3) 17% of refugee women were unaware they should go for screening, 26% did not know where to go for screening, and 40% mentioned other reasons for not going for cervical cancer screening. 4)The facilitators of cervical cancer screening uptake among refugee women are good health insurance coverage and high parity. Higher parity increased refugee women's perception of developing CC later in life and promote screening behavior due to greater exposure to health education from frequent antenatal visits. Health insurance with comprehensive coverage is likely to have pap smear screenings included. Future qualitative research is needed to understand CC screening barriers. Objectives: Identify the facilitators of uptake of cervical cancer screening among the minority population. Identify the barriers to increasing cervical cancer screening among refugee women of different cultures. Identify areas where policymakers can make national recommendations for promoting CC screening in underserved populations. References: 1) American cancer society (2020 Abstract: Certain cancer treatments have been linked to an increased risk of infertility, raising reproductive concerns, especially among young adults. Few patients are provided with information about the impact of cancer treatment on fertility. This literature review identified barriers to fertility preservation in cancer patients. A literature review was conducted to highlight disparities in family preservation among cancer patients. Relevant articles were identified using the following databases: CINAHL, Pub-Med, Google Scholar, and PsycINFO. Keywords included fertility, reproductive, fertility preservation, cancer treatment, reproductive health, cancer patients, and young adults. Barriers to fertility preservation include lack of awareness of infertility risk, lack of educational resources, and low physician referral. The risk of infertility with certain treatments is often not communicated effectively by providers, posing multiple issues for fertility preservation. The literature identified age, gender, type of cancer, financial challenges, and lack of insurance coverage as influencing sociodemographic factors for being informed about family preservation. Female patients were more likely to receive information compared to males. Females 35 years or older were less likely to receive information. Language and cultural differences between physicians and patients also served as barriers. Highlighting barriers to fertility preservation is important for increasing awareness on this topic.

Patients should be provided with information and the opportunity to make their decisions about fertility preservation before initiating cancer treatment. Further research is needed to target minority groups and provide culturally appropriate information to patients. Objectives: The participant shall be able to identify existing disparities within family preservation among patients with cancer. References: Abstract: Practicing and future healthcare professionals are responsible for addressing the disproportionate cancer experience of sexual and gender minority (SGM) patients. The Cancer Prevention Research Training Program at MD Anderson encouraged summer students to explore careers in oncology through a student-organized seminar, Cancer Care Collaborators: LGBTQIA+ Initiatives, which included a panel of cancer professionals. The intention was to promote SGM cancer research and use attendee feedback to offer advice to others organizing similar events. One college and one medical student, with support from the summer program director, recruited five SGM panelists from different institutions and professions. The students then designed a QR code pre-registration flyer which they emailed to over 100 MD Anderson summer students and to SGM volunteer/support groups. The hour-long Zoom seminar was cofacilitated by the students including introductions, a presentation, and audience questions. They administered a pre-survey and post-survey to participants to evaluate the seminar's effectiveness. Of 34 attendees, there were 10 undergraduates, 5 medical students, and 5 MD/PhD/DO. 22 attendees had no experience with SGM research. Most reported having enough time for questions (n=26) and being satisfied with the seminar's organization (n=29). Many (n=20) were very/extremely interested in seminars about research collaboration and suggested genomics and cancer prevention, legality and medicine, combined MD/PhD funding, research opportunities/initiatives, prospective researchers advice, survivorship, and pandemic-altered cancer care as future seminar topics. Other suggestions included decreasing survey reminders, changing marketing approaches, adding break-out sessions, more direct audience interaction with panelists, a summary, and more discussion about panelists' publications. Online seminars expose young professionals to the importance of SGM status in cancer care, the detrimental effects of health disparities, and new career path exploration. Improving cancer education seminars will better prepare the organizing students for leadership and the attendees to serve diverse individuals, settings, and communities. Objectives: The participant shall be better able to educate trainees on specialized topics, especially when the format is online seminar style. Abstract: Breast cancer is the most common non-cutaneous malignancy among women. Compared to other groups, Hispanic women have among the lowest breast cancer incidence rates. Yet they have higher rates of breast cancer mortality. These effects are related to delays in diagnosis and are partially attributable to lower rates of screening. The purpose of this study was to conduct a review of the literature to address factors influencing why Hispanic women have lower rates of breast cancer screening. Articles were identified using PubMed, Google Scholar, and EBSCOhost databases. Keywords searches include "Hispanic," "women," "clinical breast examination", "breast cancer disparities," "low mammography screening," "mortality and incidence rates," and "language/ educational barriers." Reference lists of identified articles were crossreferenced for additional relevant studies. Reoccurring factors contributing to low screening rates were summarized following a discussion of recommendations for future research and health interventions specifically designed to address the needs of Hispanic women. Health literacy and U.S. acculturation rates were found to be significant predictors of cancer screening outcomes. Lack of English fluency was associated with inadequate health literacy and low acculturation rates in Hispanic women, particularly among the foreign-born women. Reports of health care avoidance due to fear of deportation suggest that available data likely underestimate screening rates in undocumented Hispanic women. These unaddressed disparities diminish participation in preventative services and contribute to unfamiliarity with the healthcare system. Importantly, reduced screening rates are associated with more advanced disease stage at diagnosis and increased risk of breast cancer mortality in Hispanic women. Hispanic women lack resources such as adequate medical facilities, language interpreter services, and readily available medical information in a preferred language. Further research of breast cancer disparities and implementation of educational and other interventions to promote access to and utilization of preventive services are necessary to address disproportionate mortality rates. Objectives: The participants shall be able to identify at least 2 to 3 barriers in cancer screening among Hispanic women. The Hispanic community has the highest rates of liver cancer morbidity and mortality, and these rates have been increasing. This literature review examines how these rates compare to other groups and explore ethnic-related barriers that have been reported to contribute to these higher rates of disease and death. This literature review identified articles using PubMed, PsycINFO, CINAHL, and Google Scholar using the following keywords: liver disease cancer, Hispanic, Latinx, men/ women, socioeconomic status, immigration status, liver cancer, hepatitis, hepatocellular carcinoma, screening, insurance, and education. The reference section of key articles was reviewed to identify additional relevant studies. Articles were eligible for inclusion if they were available in fulltext, in English or Spanish, peer-reviewed, and published between 2010 and 2021. Thirty-six articles (out of 72 screened) examined liver cancer's impact on the Latinx community. Several studies suggested that diet and metabolic risk factors may play a significant role in increasing the risk of liver cancer. Hispanics experience high comorbidity from such diseases as non-alcoholic fatty liver disease, hepatitis, and diabetes compared to non-Hispanics, possibly contributing to increased rates of liver cancer morbidity and mortality rates. The few studies that evaluated whether insurance status was related to late-stage disease detection found no significant effect on diagnosis, treatment, or survival rates within the Latinx population. These differences are not attributed to insurance status and may have a racial/ethnic component related to diet and other health risk factors. Further research is needed to address this disparity. Overall, the Latinx community was at a higher risk of liver cancer compared to other ethnicities. Objectives: The participant shall be able to identify 3 reasons liver cancer mortality rates are higher in the Latinx community. The participants will be able to name two barriers to liver cancer risk factors and explore ethnic-related barriers reported etiology to this disease.

smokers were more likely to quit due to personal motivation and familial support rather than through cessation programs or support services. They expressed more positive attitudes towards quitting. Lower socioeconomic status in Hispanic communities plays a role since their decreased access to quality care lowers the availability of practitioner-run smoking cessation programs. Hispanics received more medical care, but past research indicated that immigration/insurance status and socioeconomic/cultural factors presented barriers to establishing rapport between physicians and Hispanic smokers. Culturally appropriate care may help build rapport between physicians and Hispanic communities to address potential disparities. Further research, increased access to healthcare, and educational resources regarding cessation services may help address these disparities, increase awareness, and may decrease lung cancer rates within this community. Objectives: The partcipant will be able to identify the factors behind Hispanic disparaties regarding cessation programs. References: Abstract: Clinical administration and support staff are a critical team in patient-centred care. Few studies address education and training initiatives for these staff in the oncology setting, or implementation of strategies to improve their support. A recent learning needs survey confirmed this gap, leading to development of the Clinical Administration and Support Education (CASE) program -a two-part project to work with staff to develop a targeted education program to meet their education and learning needs. A working group comprised of relevant administration leads promoted the program to staff to assist with engaging their interest in the first co-design stage of the project. A convenience sampling approach identified staff volunteers across different roles to participate in semi-structured interview or focus group discussions to explore education gaps impacting on their preparedness for their work. At the completion of the discussions, participants were invited to contribute to a follow-up codesign consultation workshop. Qualitative data from the Phase 1 interviews/focus groups (audio recordings) were transcribed and analysed using a content analysis approach (NVivo (2020) Qualitative Data Analysis software). This allowed identification of education themes, while also considering differences in experiences between participants. These insights informed the framework for discussion of key themes in the co-design consultation workshop, building a profile of the education content and resources required to address the learning needs emerging from the interviews. This project represents development of an approach for implementation of education initiatives, with potential application across different staff groups, to support evidence-based learning and patient-centred care. Synthesis of the interview data supported development of the co-design workshop discussion framework, to assist in identifying meaningful endpoints for reviewing the impact of the implementation of the education on the target staff cohort, such as levels of satisfaction or stress, perceived changes in confidence in work skills and knowledge. Objectives: Participants will be able to describe how to use a co-design approach to review learning needs and develop a targeted staff education program to support patient-centred care in the oncology setting. Abstract: Allostatic load (AL) is defined as the physiological dysregulation of the body's systems resulting from chronic exposure to psychosocial stressors or possible traumatic events. Childhood cancer patients are known to undergo physical and psychological forms of chronic stress, with possible correlation to further adverse physical and mental health outcomes. This review presents the findings of AL as a key predictor of adverse health outcomes in childhood cancer survivors (CCS). A total of 50 articles were found by searching key databases, including PubMed/ Medline, PsycINFO, CINAHL, and Embase, to acquire peer-reviewed original articles published between 2012 and 2021. 22 articles that concerned pediatric or childhood cancer survivors, chronic stress, and health outcomes were included in this review. Keywords include: allostatic load, allostasis, chronic stress, cancer survivor, pediatric cancer survivor, and health outcomes. AL indices varied between studies, though AL is greater in cancer survivors than in healthy controls. CCS describe cancer as a traumatic experience, possibly affecting social, emotional, language, and learning development milestones. Post-traumatic stress symptoms (PTSS) and disorders (PTSD) are found among CCS with PTSS and PTSD prevalence ranging from 12% to 44% and 3.0% to 29%, respectively. Cardiovascular diseases are a leading cause of death in CCS, with obesity, type-1, and type-2 diabetes also prevalent physical outcomes. AL is linked with cancer-specific mortality and can be a predictor of all-cause mortality in CCS. The literature presented prevalent, adverse psychiatric outcomes associated with AL, primarily PTS symptoms, and varied findings regarding physical outcomes among CCS. Future intervention studies to reduce AL composite scores to improve the long-term health outcomes of CCS, and cancer survivors in general, are warranted. Eligibility criteria included discussing vaccination uptake among cancer survivors who had completed treatment, examining factors affecting vaccination adherence (e.g., barriers and facilitators), being published in English, and being published between 1990-2021. Articles were imported into Covidence, and screened by two independent reviewers with a third reviewer serving as arbiter as needed. The search returned 4,215 total articles, and 271 duplicates were removed. During abstract/title screening, 212 articles were identified. Following full-text screening, 64 articles were found to meet inclusion criteria. The ages of participants reported in the full-text articles ranged from 9-85+. Types of vaccination behaviors examined included: Influenza (n=31), Human Papillomavirus (n=24), Pneumococcal (n=12), SARS-coV-2 (n=1), Shingles (n=1), Hepatitis A and/or B (n=2), and multiple vaccines (n=3). Vaccine uptake ranged from 2%-82%. Factors affecting vaccination uptake included, but were not limited to, sociodemographic variables (e.g., age, gender), access variables (e.g., insurance status), health beliefs, vaccine attitudes, and provider recommendation. Vaccine uptake ranged broadly based upon type of vaccine and numerous factors. Multiple barriers and facilitators to vaccination uptake were identified. Findings of this scoping review inform potential targets for multi-level interventions to improve vaccination rates among cancer survivors. Future interventions may inform healthcare practice and policy. Objectives: The participant will be able to: 1) identify why vaccine adherence rates tend to be low among cancer survivors, 2) identify at least 3 facilitators and barriers to vaccine uptake, and 3) describe disparities in vaccine uptake Abstract: Colorectal cancer incidence is increasing among several minority groups in the US. In this ongoing work, we study the characteristics of colorectal cancer and survival and examine the determinants of effective follow-up after colorectal cancer diagnosis among various race/ethnicities. Data from Surveillance, Epidemiology and End Results (SEER) 18 Registries between 2000 and 2016 were used to study disease characteristics for colorectal cancer in multiple race/ethnicities. We calculated median survival and median follow-up times across race/ethnicities. We developed an approach to classify patients that were lost to follow-up according to stage and conducted a logistic regression analysis to identify the determinants of poor follow-up. We conducted bivariable analyses to compare mean age at diagnosis and frequencies of stage and grade categories between cases that are lost and not lost to follow-up. In our ongoing analysis, there were 136400 alive cases with complete data. Cases were considered lost to follow-up if the follow-up duration was < 5, < 3, < 2 years for localized, regional, and distant stages respectively. Cases lost to follow up were likely to be older (62 vs 60 years), of Asian race/ethnicity (5% vs 2% to 3% for White and Black race/ethnicity), and have a distant stage (6% vs 2% to 3% regional, localized). In logistic regression, younger age, female sex, single marital status, Black and Asian race/ethnicity, and distant stage were significantly associated with increased loss to follow-up. Follow-up time is important in correctly identifying the survival probability and progression of disease among cases. Our results show that Black and Asian Americans are more likely to be lost to follow-up. Further research is needed to understand the reasons and develop strategies to increase follow-up rates in these populations. Objectives: The participant shall be able to identify the determinants of loss to follow up among colorectal cancer cases. References: reported a longer period of absence from school (25% >1 year) than those who received extracranial radiation (8.7% >1 year). 34.69% of respondents noted some cognitive deficit after cancer treatment and 26.53% reported that their treatment continues to affect their learning ability today. Only 6.1% of respondents indicated that their school was equipped to handle the educational needs of cancer survivors. This study reveals that the South Florida pediatric cancer population experiences significant gaps in education during treatment and long-term deficits in learning abilities. Further research is necessary to analyze the deficits experienced by these patients in order to improve quality of survivorship among pediatric oncology patients in the future. Objectives: The participant will be able to identify at least two effects of pediatric cancer treatment on education and learning ability. The participant will be able to establish at least one potential area in both the hospital and school setting that could be improved to lessen the educational burden on pediatric cancer patients. References cited at the end of closely aligned articles were also explored in the search for relevant articles. Articles published between 2011 and 2020 were included if they focused on adults, were available in full text, and were in English. Of the 80 articles screened, seven studies identified higher fatality rates in cancer patients with SMI compared to those without. Factors associated with this disparity included medical contraindications, restrictive research treatment eligibility, institutionalized stigma, lack of SMI integration in health care services, and low socioeconomic status. Although studies recognized other factors contributing to poorer outcomes (e.g., missing or advanced stage at diagnosis and lower screening quality/rates), few studies proposed solutions. A single pilot study proposed The Bridge Model as a proactive approach to providing person-centered care for persons with SMI and cancer. Results clearly showed a higher fatality rate in persons with SMI and cancer, versus cancer alone. Although one intervention based on the Bridge Model has been proposed, the intervention has only been pilot tested in a single group trial and must be further studied. Future research is needed. Objectives: The audience will be able to determine whether or not serious mental illness predicts higher cancer fatality rates, and will learn about current research endeavors to curb this disparity. The audience will be able to iterate at least 3 factors contributing to persons with serious mental illness (SMI) and a comorbid cancer diagnosis having higher fatality rates. References: Mahar, A. L., Kurdyak, P., Hanna, T. P., Coburn, N. G., & Groome, P. A. (2020). Cancer staging in individuals with a severe psychiatric illness: a cross-sectional study using population-based cancer registry data. BMC cancer, 20 (1) and PyscINFO databases using keywords Muslim, Islamic, women, breast cancer, screening, mammography, and immigrant, and refugees. The reference lists of key articles were reviewed to identify additional published articles. Groups studied included Afghan, Somali, Iranian, South-Asian, and Middle-Eastern women. The inclusion criteria consisted of publications from 2010 to 2020, studies administered in the United States, and participants in research studies who self-identified as Muslim women Religious beliefs, cultural practices, and language barriers contribute to low screening rates among this population. The Islamic religion may increase patient tendency toward privacy and modesty with male physicians, which may decrease the likelihood of screening. Additionally, dependency on male counterparts for transportation and interpretation needs can reduce screening participation. There is also a lack of knowledge from the patients' home countries regarding mammographic practices, contributing to the belief that preventive care is unnecessary. Further, understanding different terminology for screening and treatment is difficult when health education is not accessible or not in patients' native language. This review revealed that socio-cultural barriers, religious beliefs, and a lack of breast cancer-related education can contribute to lower screening rates for Muslim immigrant women in the US. An increase in translation resources and an environment that encourages open cross-cultural discussions may improve patient-physician communication and reduce this disparity. Objectives: The participants will be able to name two barriers that immigrant Muslim women face regarding breast cancer screening access. The participants will be able to name one potential action to reduce disparities in this population. Patient must have a known incurable cancer diagnosis where their prognosis was determined to be less than 2 years, 3) Spanish is the preferred language of patient and caregiver. Patients and their caregivers completed a semi-structured interview and quantitative interview questionnaire. Their interviews were professionally transcribed then coded in Dedoose to identify key themes and relevant quotes. Ten Latinx advanced cancer patients and ten caregivers enrolled in the study and successfully completed the interviews. The interviews revealed how religious and spiritual affiliation play an important role in their dying process. The questionnaire demonstrated that the majority of patients and caregivers claimed their spirituality/religion was "very helpful" during their own/loved one's illness. The semi-structured interviews unveiled two themes: 1) Patients and caregivers trusted that the fate of their health was in God's hands, 2) Religion and spirituality guided their relationship with God in seeking/ asking for God's help/strength and expressing gratitude, resulting in improved physical health. Reasons for choosing a review cycle varied, with "Other" being the most common (n=17) and "Evidence" the least common (n=6). Review workflows varied widely. Two main challenges respondents identified were getting timely feedback from subject matter experts and managing the volume of PE materials awaiting review. Notably, respondents who chose their review cycle based on evidence (n=6) or best practice (n=14) reported varying review cycle lengths. This may be the topic of a future survey. Identifying a best practice for reviewing and revising internally developed PE resources will help organizations maintain the quality of their PE resources while avoiding unnecessary resource expenditure. Best practices for PE material review may also give patient education departments evidence to support the need for additional resources. Objectives:

The participant shall be able to identify at least 2 common challenges in patient education material review practices. The participant shall be able to identify at least 1 key area to assess opportunity for improvement in their organization's patient education material review practices. The participant shall be able to identify networking opportunities with other cancer patient education professionals whose programs are similar to their own. References: Liang L., Brach C. (2017 Using survival analysis, we found that the median OS was 32 months. If the patients had disease present in their bone marrow after the first round of chemotherapy, then the median OS dropped to 20 months. Our data show that genetic mutations present in patients can significantly help predict treatment success. We observed that removing disease from bone marrow after the first round of chemotherapy predicts OS. Furthermore, patients who received a bone marrow transplant had a much better prognosis than those who did not. Objectives: The participant shall be able to identify which genetic mutations are best at predicting patient response to chemotherapy and OS. They will also be able to differentiate between LASSO and step-wise regression. Participants will recognize the value of using cross-validation to compare different models. Lastly, audience members will be able to see the medical applications of this project, how knowing a patient's genetic mutations can help explain outcomes and identifying which mutations a patient has can help predict treatment success. They will also learn why patients who receive bone marrow transplants had a better prognosis and better survival. Children's Research Hospital moved quickly to protect the health and safety of its patients, families, and employees. Nearly every area of the institution was transformed, requiring specific, accurate, and timely communication. It was important to provide clear, easy-to-understand messages to our patients and family caregivers to promote understanding of the virus, encourage adherence to infection prevention behaviors, and share changes in hospital policies and procedures. Content covered a range of topics such as COVID-19 and Children with Cancer, How to Talk to Your Child About Coronavirus and COVID-19, Social Distancing, and Fever and COVID-19. Information was made available through the hospital website, patient app, and Together website (together.stjude.org). Additionally, a COVID-19 coloring book and an activity book were developed to provide age-appropriate information regarding the virus, how to protect yourself and others, and what changes to expect at the hospital. St. Jude-specific COVID-19 information for patient families is available by direct link on the hospital website or through the patient app, allowing time-sensitive updates. Additional COVID-19 information on a range of topics is available on the Together website. Since the pandemic began, COVID-19 content accounts for about 60% of traffic to Together. The COVID-19 coloring book has been translated into 16 languages and available in both digital and print format. Resources continue to be developed with a current focus on vaccine education, including community outreach activities and a planned coloring book. The pandemic required the dissemination of rapidly changing, complex information. Using varied communication formats and channels allowed us to provide timely, tailored messages to serve our patient families as well as global audiences. These processes and learnings will be carried forward during the next phase of pandemic communication and beyond. Objectives: After attending this session, the participant shall be able to: Identify two content strategy ideas to use in patient education in their own institution. List three challenges in developing COVID-19 education for pediatric settings. Discuss three considerations in adapting communication for internal and external audiences. Abstract: Atlantic Canada (AC) has six radiation therapy (RT) centres equipped with modern technologies capable of precision RT technique which remains under-utilized. A grant-funded, region-wide collaborative program -Advancing Radiation Oncology Practice in Atlantic Canada (AROPAC) -was designed to accelerate implementation of precision RT techniques through inter-professional learning. Funding was used to support meeting organization and coordination, multidisciplinary participation, and communication platforms. The objective is to present early impact of the initiative in the region. A multidisciplinary team from AC and Toronto conducted needs assessments of AC RT centres (2019, 2020) that guided program development. A virtual program was delivered in four phases over 4 months. Phase I and II consisted of two half-day meetings. Phase IIIa was a half-day "working meeting" for centre project leaders. Phase IIIb included half-day mentor-facilitated break out group discussions. Phase IV was a one-day meeting of both centre-and technique specific break out groups. At the conclusion of Phase IV, a summative evaluation was conducted using anonymous live polling. Of 22 respondents, 100% agreed there is value in AROPAC; that there will be positive carryover of what was learned; and that there is value in continuing the program. 96% agreed that involvement will enable implementation; and 83% felt more prepared for development and implementation. When identifying ongoing barriers, 26% said "none", while 30% indicated human resource issues as their key barrier. 91% rated their experience with AROPAC as good or excellent. All centres that completed a "progress meter" indicated positive progress across phases. Data show that a regional, collaborative approach to build capacity for stereo-tactic, hypofractionated RT techniques can be effective despite variations in centre size and mandates. Key enabling factors are access to expert mentors, facilitation of collaboration and sharing of resources. Future evaluation will track progress of individual centres. Objectives: The participant will be able to: -identify the components of a high quality virtual learning program; -describe methods of measuring impact of educational activities; -list the characteristics that enhance regional quality improvement initiatives. Abstract: About 30-40% of the Asian population carry an enzyme mutation of Aldehyde Dehydrogenase-2 (ALDH2) where the body has a hard time properly breaking down alcohol when ingested. This study explores how the enzyme mutation contributes to liver cancer (hepatocellular carcinoma [HCC] ) in the Asian population. A search of scientific literature related to ALDH2 in the Asian population and its correlation to liver cancer was conducted. The following databases were searched for articles published since 2016: Pubmed/Medline, ProQuest, cBioPortal, and Protein Data Bank. Major search terms included: Asian, East Asian, ALDH2, enzyme, liver cancer, hepatocellular carcinoma, alcohol metabolism, polymorphism, genetics, screening, alcohol. References cited in key publications were reviewed to identify additional articles. Out of 58 articles screened, nine articles were identified that examined ALDH2 and HCC risk among the Asian population through cross-sectional surveys, animal studies, and assay analysis. Studies addressed the relationship of the ALDH2 mutated genotype to HCC. Research suggested that Asians who carry the ALDH2 mutation and have the Hepatitis B virus (HBV) infection are at even greater risk of HCC compared to those who do not have HBV. HBV is a liver infection that can be prevented with a vaccine, but studies show that many Asians are not aware of treatment options and how HBV relates to ALDH2. ALDH2 polymorphism in the Asian population appears to be related to liver cancer rates, but the role of the enzyme is only partially understood among the population. Bringing awareness about HBV screening and physiological effects of alcohol consumption among Asians may help to address cancer disparities in this ethnic group. Objectives: The participant will be able to identify the role of the enzyme deficiency in the Asian community. The participant will be able to identify the importance of HBV screening and educational barriers the Asian community may encounter. References: Huang, P. Abstract: Thirdhand-smoke (THS) is as dangerous as secondhandsmoke (SHS) and some children are heavily exposed to it without control over their environment. This study compares how children's oral microbiome is altered (such as the amount of bacteria present) when exposed to THS, versus the oral microbiome of a smoking adult. Various scientific literature related to THS was identified in this review. Fifteen articles since 2016 were found using the databases PubMed and GoogleScholar using keywords such as oral microbiome, thirdhandsmoke, oral cancer, children, and adult. Relevant articles were also identified from the Thirdhand Smoke Research Center database. Citations from key articles were reviewed. This literature review will compare the risk of oral cancer in non-smoking children exposed to THS and adult smoker. This comparison focuses on certain bacteria found in the oral microbiome of these two age groups. Thirdhand smoke (THS) is the pollution that is left behind in any cigarette smoking environment. Children in THS environments have an increased risk of altering their oral microbiome because they have a high hand-to-mouth behavior.

Research shows that bacteria that indicate healthy oral microbiome such as Capnocytophaga, Peptostreptococcus and Leptotrichia are depleted in smokers' oral microbiome. A similar bacteria, Veillonella, was found to be depleted in children living in THS-polluted homes. There are similar patterns found in the oral microbiome of children exposed to THS and adult smokers. A THS environment affects the oral microbiome of children and increases their risk for oral cancer. Further research should be conducted to investigate the specific bacteria that is altered by THS because the health of children is highly dependent on their environment. Objectives: The participant shall be able to identify the bacteria that are found in an unhealthy oral microbiome of smoking adults and compare them to a healthy oral microbiome of a child to assess the negative effects of thirdhand smoke exposure. The participant should also be able to relate altered oral microbiome from thirdhand smoke exposure to the development of oral cancer. Additionally, it has not been evaluated in the literature, representing a critical research gap. We created 10 test HWLs depicting 4 categories of UV effects: skin damage, eye damage, premature aging, and death. The text in these test HWLs was informed by plain language guidelines and communication theory. In focus groups, women aged 18-34 who had tanned indoors in the past year discussed the test HWLs and the current federal HWL. Key discussion questions included participants' recognition of the federal HWL; perceived effectiveness; likes and dislikes about the images and text; comprehensibility; and suggested modifications. We recorded and transcribed the group discussions and conducted a thematic analysis to summarize participants' perceptions of the HWLs. Many participants found the federal HWL informative. However, most either did not recognize it, or mentioned they would not read it due to the small text, wordiness, and lack of an image. Graphic images depicting the face or eyes were seen as effective. Common criticisms of the images were lack of believability, relatability, and comprehensibility. Although concise text encouraged reading, many participants wanted more information in the test HWLs. Premature aging was often identified as a concern, but the aging-related images were not perceived as effective. Although the deathrelated HWL text was seen as effective, most participants dismissed the images. Our findings suggest that stronger HWLs are needed to inform tanners and discourage IT. Graphic images may increase HWL effectiveness, especially by attracting attention. Future research could develop text that increases the believability, relatability, and comprehensibility of images. With these modifications, HWLs could become informative and engaging cancer prevention messages. Objectives: The participant shall be able to: Describe at least three qualities of effective images for indoor tanning prevention. Identify at least two effective text features for indoor tanning prevention. Compare text-only and pictorial health warning labels in their ability to communicate the risks of indoor tanning. Identify at least two challenges in the use of HWLs as a cancer communication tool for indoor tanning. Abstract: United States' Vietnamese immigrants experience higher cancer incidence rates than Vietnamese living in Vietnam. While cancer is the third leading cause of death in Vietnam, it's the number one cause of death in the US Vietnamese population. This study examines what factors contribute to higher cancer rates among Vietnamese immigrants. This narrative literature review identified articles using PubMed, CINAHL, Embase, and Ethnic Newswatch databases, using such keywords as: Vietnamese, Vietnamese American, immigrant, cancer, rates, morbidity, mortality, and cancer incidence. References found in key articles were reviewed and included when appropriate. Articles published between 2000 and 2021 and written in English or Vietnamese were eligible for inclusion in this review. Six of the forty articles identified during the literature search were eligible for inclusion in this review. Vietnamese Americans carry a higher risk of liver and stomach cancers due to such infections as Hepatitis B and Helicobacter Pylori, infections that are endemic in Vietnam. They also develop a higher risk of colorectal and breast cancers, believed to be attributed to the process of westernization. This includes a higher red meat consumption and a sedentary lifestyle. The language barrier combined with lower health literacy levels also contributes to lower cancer screening rates among Vietnamese immigrants, lower awareness of early warning signs of cancer, and lower use of medical interventions, such as the Hepatitis B vaccination. Adapting to a new lifestyle following immigration appears to correlate with increased cancer risk in Vietnamese immigrants. This suggests that cancer disparities among Vietnamese in the US may be addressed by working directly with the immigrant population to increase cancer awareness, education, and testing. Objectives: The participant will be able to identify three reasons for the higher cancer rates in Vietnamese Immigrants in the United States compared to the Vietnamese population in Vietnam. The participant will be able to name two barriers that the Vietnamese Immigrants face to access cancer screening in the United States. Abstract: Studies have shown that women who have been victims of sexual abuse are at a higher risk of developing cervical cancer, and yet, they are also less likely to participate in screening for cervical cancer. This study aims to identify the factors that contribute to these statistics. This narrative literature review identifies English language articles between 2011 and 2021, using the following databases: PubMed, CINAHL, and PsycINFO, as well as additional articles derived from reference lists. The following key search words were used: cervical cancer, sexual abuse, childhood sexual abuse, cervical dysplasia, sexual assault, and gynecological care. Eighteen articles were identified that confirmed that women who are victims of sexual abuse are at higher risk for cervical cancer. These women are more likely to become sexually active at a younger age, have STIs, engage in smoking and unsafe sex, and have a history of abuse, all factors that can lead to an increased risk of cervical cancer. In some cases the risk is amplified when factors are combined. Additionally, these women are often less likely to have screenings due to psychological factors (e.g., retraumatization), and rarely receive the adequate support needed to overcome these psychological barriers. Sexual abuse questions should be included in patient intake forms. Care providers need training in how to respond effectively to the needs of victims of sexual abuse. It is essential to include the perspectives of the victims in the development of those questions and the training programs for providers. Objectives: Participants should be able to identify one risk factor among victims of sexual abuse that correlates with cervical cancer. Participants should be able to identify one barrier for victims of sexual abuse that correlates with relationship between obesity and BC in Asian American women. Research articles published in the past decade (2011 to 2021) were identified using the databases PubMed, CINAHL, PsycInfo, ERIC, and Google Scholar. Keywords used for the search were breast cancer, obesity, Asian American, race/ethnicity, cancer risk, and cancer survival. Reference lists of key articles were examined for additional sources. Findings on the effects of obesity on BC in Asian American women were mixed. Of the 21 articles reviewed, ten were found to directly examine this disparity. Most were cross-sectional in design, except for the Multiethnic Cohort (MEC) study (White et al., 2012) . Some studies, including MEC, found that obesity in Asian American women was associated with increased BC risk compared to other racial/ethnic groups. This disparity may be explained by higher visceral than subcutaneous adipose tissue, higher levels of estrogen and androgen, and higher body fat composition among Asian American women. However, other studies found no disparity. The links between obesity and BC among Asian American women remain poorly understood. Disaggregation of data into Asian ethnic subgroups and larger sample sizes may be a more accurate approach to conducting studies investigating this disparity, similar to the MEC. Objectives: The participant will be able to describe how obesity may be related to worse outcomes in breast cancer in Asian American women. Abstract: Gynecologic cancer patients are at a higher risk of distress and suicidality compared to the general public and women with other malignancies, reasons for which are poorly understood. This literature review will identify quality of life factors impacting distress and suicidality in gynecologic cancer patients. A search was conducted to identify literature on factors that may negatively impact psychological distress and suicidality of gynecologic cancer patients. Searches included all cancer stages and treatment phases. Articles were identified using PubMed, PsycInfo, CINAHL, Google Scholar, and GenderWatch databases. Major search terms included: gynecologic cancer, suicidality/suicidal ideation, depression, distress, anxiety, sexual dysfunction, fertility, and body image. Other sources were identified using reference lists from core articles. In this literature search, 34 possible articles were identified and 24 were selected for review. The review identified unique quality of life (QoL) concerns contributing to psychological distress and suicidality in women with gynecologic cancers. Studies indicated that women with gynecologic malignancies experienced higher suicidality risk due to sexual dysfunction, fertility concerns, and low social support. These QoL issues correlated with greater psychological distress and demoralization, increasing the risk of major depressive disorder and subsequent suicidal ideation. Ovarian cancer patients were identified to have the highest suicide risk of the gynecologic cancer population due to concern regarding high mortality rates and invasive treatment procedures. Unfortunately, clinicians may feel uncomfortable discussing these issues with patients. Sexual dysfunction, fertility concerns, and a lack of social support are related to increased distress and suicidality in patients. Health care professionals should assess these concerns and identify patients at greater risk of distress and suicidality. Better patient-provider communication is needed to support at-risk gynecologic cancer patients. Objectives: The participant shall be able to identify 3 unique quality of life issues correlating with psychological distress and suicidality in gynecologic cancer patients. colorectal cancer patients with prior liver metastasis who underwent resection for CRLM. 256 texture features were generated from preoperative computed tomography (CT) scans. Highly correlated variables were removed based on Pearson correlation (rho > .85). Lasso, elastic net and ridge regression models were fitted on training and test sets to predict if a recurrence or death occurred within the first 12 months since resection. We used area under the curve (AUC) as a measure of accuracy for the models. 64 of 256 variables were included after correlation filtering. Of those 11 were chosen in the final Lasso model, indicating that many of the radiomics features may be noisy predictors. The Lasso training set had an AUC of 0.715 and the test set had an AUC of 0.50 indicating low predictive value of radiomics features alone. The results for Elastic net and ridge regression models are very similar. Models appear to be overfitting in the testing set. Radiomics features alone were not predictive of early CRLM recurrence in this data set but a larger data set is needed to confirm findings. Future work may include time to event modeling to predict recurrence time and incorporate radiomics variables into clinical datasets to enhance the prediction of recurrence. Objectives: The participant shall be able to identify if radiomics features can be used to predict the recurrence of liver metastasis in colorectal patients. Abstract: The COVID-19 pandemic prevented in-person cancer education sessions with the Asian Pacific Islander (API) communities. Social media platforms offered an alternative dissemination strategy to disseminate clinical trials information. Instagram was tested as a dissemination strategy. This presentation describes the analytics generated to evaluate the success of an Instagram campaign. Post posters that relate to the public health information on Instagram. There are a total of six topics, published weekly for two months. The data of posters were collected, including followers, likes, comments, saves, reach, etc. were recorded over two months. Then, the data was obtained for sorting and analysis to explain whether Instagram is an appropriate platform to disseminate public health information. To be more specific, whether Instagram can be used as an important component to eliminate disparities between public health information and underrepresented populations. Starting from 127 followers at the beginning of the project, 11 unfollows and 34 follows were recorded, giving a net increase of 23 followers. During the two months, 89 total likes on posts, 1 comment, 1 save, and 328 people reached were recorded. Our results suggest that Instagram could be a potential social media platform to disseminate public health information. Although Instagram posts were not able to actively engage our audience to comment or save, data indicate that Instagram was successful in reaching out to the younger audience. While Instagram may not be the optimal platform for disseminating public health information to underrepresented groups, it is a suitable platform. However, Instagram should be considered a place to disseminate public health information due to the large number of users and the choice of paid promotion to promote posters. Objectives: Based on our study, the participants shall be able to understand the significance of clinical trials information and the reasons why people should disseminate clinical trials information to their family members and friends around in order to disparity the clinical trials gap between everyone. Moreover, participants should realize that social media platforms are also a proper way to disseminate clinical trials information to the community and better to help people understand the necessity of clinical trials. Abstract: Instagram, a free photo and video sharing social media platform, was pilot-tested as a strategy for disseminating clinical trials information to older Asian Americans. Two-thirds of the roughly one billion active Instagram monthly users are under the age of 34 and represent trusted sources of information for their elders. Six Instagram posts culturally aligned with the Asian young adult community were developed and posted weekly. Each new post included backgrounds and colors culturally aligned with Asian Americans. Instagram's story highlight option helped promote each clinical trial post. Promotion of clinical trials posts was done directly by sharing with friends of the team members, posting on UC San Diego Facebook groups, and emailing the UC San Diego student list. Promotion was done indirectly, by "following" formal and informal Asian student opinion leaders who then "followed" back to regularly see our messages. Instagram's analytics were explored to assess outcome measures. This pilot study evaluated the feasibility of using four outcome measures to assess success in delivering clinical trials information to older Asians through younger Asians. 1. Did we create culturally aligned content that attracts the Asian community? 2. Is our clinical trials content easily understood and a call to action? 3. Is usage data accessible? 4. Did we reach our once removed audience? Through review and feedback from our peers and Instagram analytics, questions 1 through 3 would be viable outcome measures. The fourth measurable could not be determined because the Instagram analytics do not track posts shared with others Creating information attracting younger Asians and encouraging them to share their information with older family members used three viable outcome measures. Our project illustrates success in creating aligned and informative content. The next step is to create a viable measure for our fourth outcome, measuring transmission of information to elders. Objectives: Specific: The participant shall be able to identify how to utilize social media platforms to disseminate important health information to underrepresented communities. Measurable: The participant shall be able to collect and analyze data through Instagram analytics. Attainable: The participant shall be able to construct their own social media platform to disseminate health information to the public. Relevant: The participant shall be able to utilize social media platforms to engage the younger generation during these times of the COVID pandemic. Abstract: Wearables are electronic devices designed to be worn throughout the day for the purpose of monitoring one's vital signs, body movement, and environment. Wearables use for continuous monitoring is well reported. This narrative literature review examines whether wearables are an appropriate medical intervention for prevention and care in oncology. The exploration of the scientific literature used variations of such terms as wearables, monitoring, cancer, care, prevention, clinical trials, survivors, and biosensors. The databases used were PubMed, Google Scholar, and CINAHL. The inclusion criteria consisted of peer-reviewed, full text, English, or Spanish articles published between 2017 to the present. Reference articles citations were also examined to identify additional articles related to the content. New terms identified in the review were added to the searches. Out of the 80 articles identified, 60 articles were found to be directly relevant to this review. Integrating wearable technology to improve cancer care and reduce incidence rates of cancers has been proven feasible by providing clinicians with relevant, reliable, and continuous data to better understand patients' health behaviors and tolerance to treatment. For cancer prevention, wearables like PACT 2.0 and SHADE have been studied to help limit certain lifestyle behaviors like smoking and over-exposure to ultraviolet radiation, respectively. Data that monitored one's physical activity level, like step count, was most helpful for cancer monitoring and early intervention. Studies reveal great promise for wearables capacity for assisting clinicians and scientists, patient care, but more research is needed. Incorporating wearables into clinical care and research can give clinicians and scientists critical, realtime information to guide and assess patients' and research participants'

Hepatocellular Carcinoma in Hispanic Patients: Trends and Outcomes in a Large United States Cohort

Socioeconomic status and hepatocellular carcinoma in the United States

Racial Disparities in Palliative Care Utilization among Metastatic Gynecological Cancer Patients Living at Last Follow-Up. Data Brief 10.1016/ j.dib.2020.106705

Leaf-blowers emit quantities of hydrocarbons from unburned fuel, which react to form ozone. Benzene is an aromatic hydrocarbon, known as a carcinogen, that is emitted from gas powered leafblowers. Leaf-blower PM exposure (median, tons per day) from curbs/ gutters, shoulders, and paved roadways were 61.2, 60.1, and 2.90, respectively. A systematic review and meta-analysis article linked outdoor PM disparities. References: Costa-Gómez, I

P86: Association Between Fish Oil Supplements and Per-and Polyfluoroalkyl Substances

Abstract: Per-and polyfluoroalkyl substances (PFAS) are widespread pollutants and classified as potentially carcinogenic to humans. Although fish consumption has been associated with increased PFAS levels

To determine the association between fish oil use and log-transformed PFAS levels, survey-weighted linear regression was used to evaluate the multivariate-adjusted ratios between supplement-users' and non-users' geometric mean PFAS concentrations. association, residual confounding, or chance. Objectives: The participant shall be able to describe the inverse association between PFOS levels and self-reported fish oil supplement use. References: Brantsaeter AL

Perfluoroalkyl substances and fish consumption

P91: Characterization of treatment-associated genomic changes in rectal cancer patients treated with neoadjuvant therapy

Abstract: Patients with locally advanced rectal cancer (LARC) are treated with neoadjuvant therapy (NAT), a combination of radiation and chemotherapy, followed by surgical resection. The degree of response to NAT varies widely across patients, and there is currently no effective way to predict response prior to treatment initiation. To investigate biological mechanisms of response and resistance to NAT, we analyzed DNA sequencing data from 67 LARC patients. For 47 patients with an incomplete response who underwent surgical resection, we compared somatic mutations in matched tumors sequenced before and after NAT. Whole-exome sequencing (WES) for tumor and matched normals was performed at Memorial Sloan Kettering and WES data was processed inhouse using internal computational pipelines. The OncoKB precision oncology knowledgebase was used to identify variants of functional relevance (putative driver mutations), and the FACETS tool was used to infer the cancer cell fraction associated with individual mutations. Excluding hypermutated samples

Understanding these mechanisms is important in order to design future therapies that overcome treatment resistance and maximize the likelihood of complete response, therefore improving survival rates and quality of life. Objectives: The participant shall be able to identify specific genes and mutations of interest for further study of mechanisms underlying response and resistance to neoadjuvant therapies in locally advanced rectal cancer

Concise Guide for Action: Patient Education Practice Guidelines for Health Care Professionals Abstract: The Patient Education Practice Guidelines for Health Care Professionals was developed to provide a concise, evidence-based resource for frontline health care professionals. A group of 27 multidisciplinary volunteers committed to the project. A grant was secured to provide funding for a librarian-mediated literature search resulting in over 10,000 articles and resources for review. The final Guidelines are an open source tool based on the most relevant evidence-based practices for patient education. The Guidelines are based on four patient education components: assessment, planning, implementation and evaluation (APIE). , test preparation, results, treatments, accessing care, appointments or resources. The Guidelines utilize a broad definition of consumer to include patients, family, friends, neighbors, guardians, sigeducational processes References

P93: Indoor Air Pollution as a Cancer Risk Factor Among Lower Socioeconomic Populations

Pediatric brain cancer results in long-term cognitive and behavioral functioning deficits for survivors. This literature review identifies disparities in quality of life (QOL) among pediatric brain cancer survivors. Identifying these disparities is key to reducing barriers to resources that improve the quality of life for pediatric brain cancer survivors. A narrative literature review was conducted of PubMed/Medline, EBSCOhost, PsycINFO, CINAHL, ProQuest, and Google Scholar. Key terms for the search included: Pediatric/Child/Children/Adolescent, Brain Cancer/Tumor, QOL, Socioeconomic (SES)/Low-Income/Poverty, Ethnicity/Race/Minority, Religion/Religiosity/Religious beliefs, and Parental Influence/Expectations/Decision-making. Criteria consisted of a focus on pediatric brain cancer/tumors, and quality of life outcomes in relation to SES/ethnicity/religion/parental influence. Articles written in English or Spanish were eligible for inclusion. Articles were excluded if they did not meet the main criteria of containing at least a focus upon pediatric brain cancer/tumors, QOL outcomes/rehabilitation, and at least one of the SES/ethnicity/religions/parental influence requirements. SES (including insurance coverage) was a significant predictor of QOL outcomes among pediatric brain cancer survivors. Other factors identified for their influence upon QOL were ethnicity, parental education, and type of treatment received. In studies controlling for SES, ethnicity was not a significant predictor of QOL outcomes. Lower levels of parental education predicted poorer QOL. Children that received chemotherapy/ radiation therapy reported lower QOL. There is a lack of literature surrounding how specific religious doctrines may affect parental expectations of their disabled children following brain cancer/tumor. Some studies support younger age at diagnosis and being female predictive of poorer QOL. Educating low SES parents about the benefits of cognitive/behavioral intervention options and educating health care providers on billing/coding methods to improve insurance approval rates may alleviate some barriers to access for pediatric brain cancer survivors. Further research should include investigating how culture and differing religious ideologies influence QOL outcomes. Objectives: The participant shall be able to identify at least two barriers to health equity among pediatric brain cancer survivors. The participant shall be able to identify at least two risks associated with long-term quality of life outcomes in underserved populations. The participant shall be able to distinguish at least two factors that would benefit from further research. The participant shall be able to discern at least two recommendations to increasing health equity among pediatric brain cancer survivors

Abstract: Most research examining the effects of obesity on breast cancer

Ultimately, studies indicated that Sub Saharan Africans and those residing in other developing countries experienced the worst outcomes. While this is likely to be due to the resource-constrained circumstances common in developing countries, the research conducted of those in developing, low-income countries remains limited. In contrast, numerous studies have identified disparities in patient outcomes pertaining to WT patients in the United States, Europe, and other first world countries. Overall, statistics showed that WT is most commonly found in African American children and those of lower SES. This narrative review underscores the disparities along the lines of SES and race for patients with WT. With the access to sufficient resources, a decrease in the disparity of morbidity and mortality rates may be possible for those most affected by WT. Objectives: The participant will be able to recognize at least two factors contributing to Wilms Tumor morbidity and mortality rates and why they are increased in the Black population

Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy. CA A

Numeracy is fundamental in the role of a healthcare provider (HCP) and forms the basis of practicing evidence-based medicine. Despite attaining a high level of education, many HCPs struggle with numeracy. Numeracy is often integrated into healthcare training curricula, but the teaching approach, competencies covered, learner satisfaction, and effectiveness varies. A scoping review was conducted to explore and summarize what is known about numeracy education for HCPs. A comprehensive literature search was conducted from

Physician numeracy: Essential skills for practicing evidence-based medicine

A Definition and Operational Framework for Health Numeracy

The exchange of health information between provider and patient, along with patient participation in their care (self management), under the following topics: About Cancer/Disease, Medical Tests & Imaging, Treatments, Symptom Management, Rehabilitation/Survivorship, General Wellbeing, Medical Device Care, Practical and Other. Totals for each topic were summed and analysis was conducted to determine opportunities for education development. Four hundred forty-three resources were included in the audit. Results varied based on clinic and cancer type. Majority of the materials were found in the following clinics: hematology (75), genitourinary (74) and gastrointestinal (55). The most common topics of

The complexity of shaping self-management in daily practice. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy

P108: Moving with the times, alternative cancer approach for children

Using Facebook as an Informative Platform for Analytics and Educating Public about Clinical Trial

Benefits & Risks of clinical trials participation. Importance of diverse samples. Where to find clinical trials? Tracking page activities, page views/likes, and post reach/engagement every day, weekly and monthly, then collecting data from Facebook's Insights. By gender, men landed on the Facebook page more often than women. By age range, 18-24 year-olds landed on the Facebook page most

Is TikTok the next social MEDIA frontier for medicine?

All articles were reviewed to gain an understanding of TikTok's applications in scientific-educational literature. A comparison search was also conducted, using only the term TikTok and only Facebook to gain a comparison of the uses of the new social media platform with the more established Facebook platform. The search for "TikTok" on PubMed returned 61 results, with only four results remaining when the filter "cancer" was applied

The COVID-19 pandemic posed challenges to cancer educators. Facebook, one of the most popular social-media platforms worldwide, was pilot-tested as an alternative venue to disseminate cancer conas Facebook, social-media, public health, cancer, clinical trials, and underrepresentation. Articles were reviewed to gain an underlist. The search for "Facebook" and "Public Health" yielded 2,731 results mainly of articles relating to COVID-19 rather than cancer, but still offer applicable examples on quantifying Facebook engagement. When "cancer" was additionally applied to the filter, only 221 results were returned. The addition of "underrepresented" produced 15 results while "Asian and Pacific Islander" yielded one result. This demonstrates the limited research on using Facebook to spread cancer awareness to underrepresented communities. Common topics of the 15 results found from searching "Facebook

Conducting a Formative Evaluation of an Intervention Promoting Mammography Screening in an American Indian Community: The Native Women's Health Project

P117: Wearable technology in cancer prevention and care

Including wearables can assist in bridging communication gaps, leading to better communication, treatment, and awareness to promote healthier lifestyles. Objectives: The participant will be able to identify at least one wearable device used in prevention or treatment. References: Low, Carissa A

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Arts-based methods in education around the world. River Publishers. This review examined cultural and institutional factors related to this disparity. This narrative literature review identified clinical studies and research articles that have gathered data on Hispanic smokers using PubMed, Google Scholar, and CINAHL databases. Keywords included Hispanics, smokers, cessation, quitting smoking, and healthcare intervention among Hispanics. Additional information was identified through the research articles and clinical studies' reference lists. Articles were excluded if not written in English or published between 2003 and 2021. Hispanic smokers that received less frequent advice to quit were more inclined to visit their physician compared to white smokers. Hispanic Abstract: The abrupt physical changes accompanying breast cancer treatment, along with societal and cultural expectations of femininity, can create a sense of powerlessness among patients and negatively impact their quality of life. Mastectomy tattoos may serve as a form of emotional healing for women who feel disconnected from their post-mastectomized bodies. This narrative literature review identified articles using PubMed, Google Scholar, EBSCOhost, and PsycINFO databases using keywords: mastectomy, tattoos, body image, healing. Twenty-nine articles concerning mastectomy tattoos were included in this review. Articles that were in English and published between 2010-2021 were included. Additionally, articles were excluded if the full text was not available. Reference lists of key articles were reviewed for additional relevant articles. The literature reported that women who had a mastectomy often felt less feminine and beautiful and struggled with heteronormative body ideals within society. While women acquired tattoos for a variety of reasons, common motivations for getting a tattoo were self-expression, healing, and transformation. Studies explored the positive effects of tattooing through identity development, empowerment, and increased confidence, and suggested that women viewed themselves more positively after acquiring a tattoo. Quantitative studies on mastectomy tattoos were lacking, but there was a growing body of qualitative studies regarding the motivating factors and potential benefits of tattoos following breast cancer treatment. Postmastectomy tattoos may improve women's self-view and quality of life by promoting agency, empowerment, and emotional healing. However,

P72: A literature review of cultural disparities in palliative care among African American women with breast cancer Yilin Xu UC San Diego Moores Cancer Center, San Diego, CA, USA Abstract: African American women (AAW) continue to have the highest mortality rate and are less likely to access palliative care despite the national focus to create better breast cancer-related outcomes. This literature review was conducted to interpret scientific evidence related to identifying correlations between cultural disparities and palliative care access for AAW. This literature search focused on palliative care and cultural disparities in AAW diagnosed with breast cancer. PubMed, ScienceDirect, and Google Scholar databases were used to search for related terms such as Black women, African American women, health disparities, cultural disparities, Breast Cancer, and palliative care access. All full-text articles meeting search criteria in English published between 2003 and 2021 were examined. Fifteen articles (out of forty-seven screened) were identified that examined breast cancer outcomes and access to palliative care in AAW. Most studies were observational or conducted a narrative literature review. Overall, AAW are less likely to receive palliative care due to mistrust of the health care system, inadequate health insurance, and lack of access to healthcare providers. Lack of access to quality healthcare and miscommunication between providers and patients contributed to low enrollment rates for palliative care among AAW patients. Access to quality palliative care can provide physical and emotional comfort for AWW patients during their final stage of life. Educational programs are essential for AAW to improve the relationship and trust with their medical providers and increase their use of palliative care services. Objectives: The participant shall be able to identify the factors contributing to the low enrollment rate of palliative care in African American breast cancer patients Eligible participants were recruited from clinics at Alexandria University Hospitals and had to be >18 years and able to give informed consent. A multivariable logistic regression model with stepwise selection was employed to examine the associations between covariates and HPV awareness. The 99 participants were aged between 18 and 55 years (median age: 32); most were married, had education below high school, and had a monthly income between $100 to $300. Awareness about HPV was generally low (10.1%). Women who reported low HPV awareness tended to be unmarried(87.5%), educated beyond high school(70.0%), and a have higher income. In the stepwise logistic regression model, education level and religiosity score remained in the model and were significantly associated with HPV awareness. The odds of having heard of HPV were higher for respondents with higher education (OR=6.84; CI=1.42, 33.03) and lower for those with higher religiosity (OR=0.74, CI=0.57, 0.96). The areas of education and faith may be important factors to consider when increasing awareness of HPV. Programs focusing on lower education and highly religious populations would help raise awareness in groups of patients that appear to be less knowledgeable about the disease. Objectives: The participants shall be able to learn about the HPV infection and preventions method even they are related to the conservative community which has no sex out of the marriage frame. Also the benefit of the HPV vaccine. The key objectives are to identify at least three barriers to get in-depth details about HPV hesitancy among the Muslim community (Religion, Education, and Income) References: Shaltout Abstract: Currently, cancer is the second leading cause of death in Puerto Rico. Thus, community engagement in educational activities is essential to reduce risk factors. However, little is known about the effectiveness of these activities. This study explores the increase of cancer-related awareness and behavioral changes following an outreach event. To assess the educational event's impact, the study team conducted a telephone survey. Based on the literature review, the investigators designed a culturally adapted questionnaire by a Community Advisory Panel. From November 2017 to February 2018, 190 individuals were randomly selected from the Hablemos de Cáncer participants' registry list. At the awareness level, 72% of the participants agreed that lifestyles could improve or worsen life quality. At the behavioral changes, 77% reported improved lifestyle, modifying aspects such as nutrition and physical activities in their lives. The results suggest that the educational event promote favorable changes in awareness and behavior related to cancer prevention. This study recommends that continued efforts in this area improve strategies that measure educational events' outcomes. Objectives: Objective: Identify ways to evaluate the impact of a cancer outreach educational event. References: Cancer Screening Guidelines: Detecting Abstract: The U.S. Hispanic community is the ethnic group with the highest rates of blood cancer diagnosis, especially acute lymphoblastic and myeloid leukemia. Hispanics living along the border that are considered low socioeconomic status are more inclined to undergo these disparities. This narrative literature review identified articles using PubMed/ Medline and Google Scholar databases applying the keywords Hispanic(s), blood cancers, diagnosis, and border cities. Reference list of key articles concerning blood cancers and the Hispanic community.The literature concerns the disparities that Hispanics face concerning cancer. This presentation will discuss the findings from the literature review and provide suggestions for future research. Research has shown that Hispanic communities closer to the border have higher rates of diagnosis than communities farther away. Hispanic individuals also typically fall within low socioeconomic status, a key factor impacting adequate care, resources, and information available in their communities. 72% of the Hispanic population lacks medical coverage, leading to a barrier in accessing preventative healthcare. This may be further exacerbated by lack of adequate healthcare facilities and resources within their communities that can help mitigate these blood cancer diagnoses. Other related factors included lack of education, environmental factors, and genetic mutations. Multiple factors develop the disparity in the Hispanic population in border cities. Proper cancer treatment facilities in border cities should be funded to help with the diagnosis rates. Further studies concerning blood cancers need to be done in order the better the diagnosis and survival rates within the Hispanic community. Objectives: The participant shall be able to list at least two factors leading to the disparity between the Hispanic community faces living in border towns versus non-border. Abstract: Pollution indoors may be more harmful than outdoors because of degradation and the smaller size of suspended particles, which increases the risk of lung and skin cancer. Lower socioeconomic status (SES) individuals may be at risk because of increased household pollution. This literature review examined the link between indoor pollution and low SES. Eight highly related articles were found by utilizing the databases PubMed and EBSCOhost using the keywords indoor air pollution, household pollution, low socioeconomic status, low income, and cancer. The reference sections of key articles were reviewed to identify additional studies. Included articles were in English, peer-reviewed and published between the years 2000 to 2021. Overall, studies found that lower SES populations were disproportionately affected by indoor air quality. Lower SES households often have multifamily units which could increase the number of people who smoke and the amount of chloroform exposure from tap water. Particulate matter smaller than 2.5 micrometers (PM2.5), which has been proven to be harmful for the lungs, was found to be caused by smoking and cooking. Low SES populations that smoke may also use air fresheners to cover the smell, which produces volatile organic compounds (VOC). All these factors pose a risk factor for lung cancer to people living in these buildings. Crowded living spaces and smoking were the two main risk factors for low SES communities. Because the majority of individuals' time is spent indoors, it is important to assess these inequalities. Programs to address smoking, better ventilation systems, and cleaning these buildings are some ways to address this disparity. Objectives: The participant shall be able to identify two main risk factors for cancer in low SES communities related to indoor pollution. The participant shall be able to understand two main reasons why indoor pollution is more harmful than outdoor pollution. References: Abstract: Many patients will receive radiation therapy as part of their cancer treatment. Patient education (PE) materials are provided to help patients understand what to expect from treatment and support selfmanagement of symptoms. In order to mitigate decreasing levels of health literacy, there is a need to evaluate patient education materials. An evaluation of radiation therapy PE materials was undertaken at fourteen cancer centres in Ontario, Canada. PE leaders independently conducted a quality and comprehensiveness assessment on radiation therapy PE materials at their respective centres. The quality assessment was an evaluation of readability using two validated measures: Flesch Reading Ease and Simple Measure of Gobbledygook (SMOG) Readability Formula. The Patient Education Materials Assessment Tool for Print and Audiovisual Materials (PEMAT-P and PEMAT-A/V) was used to evaluate understandability and actionability of materials. The comprehensiveness assessment was an evaluation of the format of PE materials and the scope of symptoms covered. PE leaders submitted a total of 555 PE materials. Seventy materials were purposively selected for the assessment. Under half of the materials (n=34, 49%) scored at or above the 80% target for understandability (x̄= 74%, 33-100%) and just over half of the materials (n=36, 51%) scored at or above the 80% target for actionability (x̄= 71%, 33-100%). Most materials had a reading grade level above the recommended Grade 6 (x̄= 9, range = 4-12). Of the 555 materials, the vast majority were pamphlets (89%). Only two centres (N=2/14, 14%) had PE materials covering all listed side effects/ symptoms pertaining to radiation therapy treatment. Findings indicate that radiation therapy PE materials do not meet health literacy best practices. This evaluation highlights a need to improve the quality, availability and access to PE materials used in cancer centres. Objectives: The participant will be able to assess the quality of cancer patient education materials for radiation therapy using various validated instruments. The participant will be able to evaluate the comprehensiveness of radiation therapy materials by analyzing the format and content coverage. The participant will be able to identify content gaps in current patient education collections at various cancer centres. References Abstract: It is known that socioeconomic factors impact clinical trial participation. We aim to determine the impact of these factors on retention; retention means participants receive planned therapy and outcome assessments. We hypothesized that participants facing more severe socioeconomic deprivation would be less likely to be retained in a breast cancer trial. A retrospective analysis was conducted of 287 women age≥40 years with early stage breast cancer treated on a trial of breast conserving surgery and radiation. Exclusion criteria were: treated outside Texas (n=14) or did not have a linkable home address (n=16) for a sample of n=257. Patients were defined as "retained" on the trial if they attended the trial follow-up and received 3-year outcome assessment. Patients' neighborhood-based socioeconomic deprivation was measured using the Area Deprivation Index (ADI) linked to their address; higher ADI indicated greater deprivation. Patients' reasons for not being retained and social work support needs were abstracted. Median age was 61; 74% of patients were White Non-Hispanic; 22% were not retained. Reasons for not being retained were: lost contact (25.76%), insurance/provider loss/change (16.67%), transportation barrier (16.67%), active decision not to continue enrollment (13.64%), finances (10.60%), health (6.06%), other logistical (1.51%), and unknown (9.09%). Median ADI score for patients retained vs. not retained was 36.5 (IQR, 22-57) vs. 46 (IQR, 29-60) (P=0.03). Among those who requested social work support, resource needs for patients retained vs. not retained was significantly different (P=0.03). Retained patients needed psychological distress support while those not retained needed more practical help. To optimize generalizability and minimize bias in clinical trials, diverse participants need to be retained. Structural socioeconomic barriers were associated with decreased retention. Participants with baseline risks of socioeconomic deprivation may benefit from interventions which educate both patients and providers, and identify barriers to participation and retention. Objectives: The participant will be able to identify at least one potential socioeconomic barrier to clinical trial retention amongst breast cancer patients. The participant will be able to explain how socioeconomic barriers correlate with retention. References: Alcaraz, K.I., Wiedt, T.L., Abstract: Cancer treatment can be an invasive and traumatizing experience that takes its toll in children. Supportive care methods have been explored into the form of video games and how it's unique approach to entertainment may be the perfect tool to aid children who struggle with this disease. An overview of various scientific studies that accumulated into a literature review was used to observe children with cancer and the use of video games in their treatment program. Articles from APA PsycINFO, Pubmed, The Journal of Medical Internet Research and The Journal of Education and Health Promotion and more were used with the keywords Video Games, Cancer, Pain, Alternative Treatments, Children, Adolescents, Comfort, Disparities, Digital, Management, Challenges, and Medium. Citations from these articles were reviewed. A link between alternative cancer treatment options involving video games will be gathered in this literature review. Children were instructed to play video games during active cancer treatment in which pain would accompany treatment prompting use of Morphine use during treatment. Children who were allowed to play video games during this treatment period required a lower dosage use of morphine indicated that children experienced less pain during these treatments when playing video games. Along with educational software such as Re-Mission that allowed children to have a visual interpretation of what's going on inside their body which improved their willingness to keep up treatment options. In this literature review we found that Video games use during treatment options showed significant results in children experiencing less pain which further encouraged continuous treatment options as the rewards of playing a video game incentivized the child to continue prompt treatment options. Objectives: The participant shall be able to identify alternative digital mediums that help children cope with cancer treatment and be educated in cancer treatment. Abstract: Recurrence after resection of colorectal liver metastases (CRLMs) occurs in up to 75% of patients. Surgery is the only potentially curative option but is associated with high morbidity. This project aims to determine if radiomics features can be useful in predicting recurrence within one year of a CRLM resection. The cohort consisted of 199Abstract: Improving accessibility to public health information in underrepresented communities is important to reducing cancer disparities. The COVID-19 pandemic disrupted time-tested in-person outreach strategies.To adapt, the TikTok social media platform was used to disseminate relevant clinical trials information to the Asian Pacific Islander (API) community. This project describes the analytics. To create appealing 15-second TikTok videos, 36 UC San Diego college students were recruited to provide feedback. Students were recruited through emails, Facebook student groups, Discords, and friends. Fifteen videos were then created, aligned with the API college students' preferences. Throughout two month evaluation period, attention to the TikTok videos was generated using the same student recruitment strategies. "Like" views, "profile" views, visits to our clinical trials website, and other data were collected. Progression to the clinical trials website from TikTok was facilitated through QR codes and having the clinical trials website on the TikTok profile page. During two months, over 3,000 views, 119 profile views, 3 followers, and 14 visits to our linked clinical trials website were recorded. Other data collected from the TikTok videos is the average watch time which we found to be 4.9 seconds. Data indicates that our short TikTok videos were successful in reaching out to a large young audience. However, using TikTok was not very successful in reaching older Asians. The breakdown of data collected from the surveys done by the 36 UC San Diego college students recruited to provide feedback would be explored further in the presentation. Tiktok is not the best social media platform to disseminate information to older Asians. However, the platform's popularity among younger Asians suggests it may be a viable platform for disseminating information on topics more relevant to that demographic, e.g., HPV, AIDS, sunscreen use, tobacco cessation, Hepatitis B vaccinations. Objectives: Specific: The participant shall be able to identify how to use TikTok as a social media platform to disseminate important public health messages like cancer knowledge to underrepresented communities. Measurable: The participant shall be able to interpret and evaluate data collected from TikTok insights and other analytical software. Attainable: The participant shall be able to develop their own way of using TikTok to disseminate public health information. Relevant: The participant shall be able to incorporate social media platforms in their dissemination strategies of cancer education during the COVID-19 pandemic. Time-Limited: The participant shall be able to reproduce results found in our project within a timeline of three months.