Collaborating with Community Partners to Address Cancer Screening

OCTRI pilot project recipient partners with community organizations


When the day labor site in Portland, Oregon opens at 7 a.m., there are usually workers waiting outside the chain link fence that borders the former parking lot. Like the roughly 60 day labor sites across the country, Portland's site is a central location for workers and employers to connect for temporary work arrangements -- usually in construction, painting, and landscaping. The site benefits workers -- most of whom are Latino men -- by establishing a minimum hourly wage, providing bilingual staff, and empowering workers who get hurt on the job or aren't paid. 

VOZ, the local nonprofit chosen to manage the site, considers health and safety central to their mission, so it's not surprising that they've partnered with an OHSU researcher to address a public health concern. The question is: Why are VOZ and other community groups partnering with OHSU professor, Jessica Gregg, M.D., to collect information about cervical cancer screening?

The answer is in two parts. First, data that shows Latina women in the United States are less likely to be screened for cervical cancer and more likely to die from what is a preventable cancer. In order to address this disparity, Gregg is first conducting a small study to gather information about beliefs and opinions – both men's and women's – surrounding the Pap smear (the initial screening mechanism for cervical cancer). Rather than jump to a solution – doing extensive educational outreach on the importance of Pap smears, for example – Gregg is operating on the assumption that effective solutions should be informed by an accurate assessment of the perceptions and knowledge surrounding Pap smears and cancer.

Gregg received pilot project funding from the Oregon Clinical and Translational Institute (OCTRI) to collect preliminary data that would help her team understand the beliefs and perceptions surrounding Pap smears and cervical cancer in the Latino community. With that information, Gregg's team can design an intervention that aims to increase screening rates and prevention. In the world of medical research, pilot funding is critical for researchers who need to gather preliminary data to support larger grant applications. It is often difficult to garner national funding for innovative ideas in their early stages, so OCTRI provides funding and support to researchers who propose promising pilot studies. Gregg's funding has allowed her to conduct traditional study activities -- hiring staff, designing questionnaires, and collecting data.  Perhaps even more importantly, the support from OCTRI has facilitated Gregg's ongoing effort to nurture and learn from her relationships with community partners.

Gregg will apply for additional funding from the National Institutes of Health (NIH) to create and implement the intervention, but her vision doesn't end at cervical cancer.  "I think the most important thing I have learned from partnerships with VOZ and with the other generous community partners is that the issues that I consider important aren't necessarily the issues that the Latino community finds particularly worrisome.    And unless we address those community-identified concerns, community members will remain largely disenfranchised and disengaged from even the most well-meaning public health efforts," said Gregg. Her approach—working with community partners to define and analyze the health issues, rather than dictating her own public health agenda—helps to explain why VOZ and other groups agreed to work with Gregg.

Community organizations have always maintained coalitions and partnerships with each other to leverage resources and coordinate efforts, but researchers haven't always come to the table prepared to incorporate the community's input. From the beginning, Gregg sought guidance and feedback from organizations like Familias en Acción, a community-based organization that promotes the holistic well-being of Latino families. The scope of the current project is limited to cervical cancer screening, but it has allowed Gregg to establish and maintain working relationships with VOZ, Familias en Acción, and other Latino community groups. While the current study is collecting important preliminary scientific data, it has also prompted the more delicate work of nurturing the human and organizational relationships that will allow future projects to thrive. Gregg and her partners have an ambitious vision – they are looking ahead to projects that "increase the community capacity to address the social, political, and economic determinants of health that lead to disease generally."

Jessica Gregg received a Master of Clinical Research (MCR) degree through the Human Investigations Program at OHSU.