Program Co-Leaders Lawrence W. Green, DrPH Rena Pasick, DrPH

With the involvement of some 30 faculty and other scientists, this program seeks to facilitate and initiate transdisciplinary collaborations within and across research programs of the Cancer Center on important social and behavioral studies related to cancer, and to translate findings into practice, programs, and policy. Research projects are organized under several strategic themes:

Communication
Studies are underway of provider-patient communication, patient information and support, decision-making, expert system support, knowledge management systems, patient recruitment and retention in clinical trials, and primary prevention and secondary (screening) communications to enhance public participation in cancer control programs.

Specific areas of communications research that overlap with related themes are:

• Stress and coping, quality of life, symptom management
  For each of the issues in cancer patient care and self-management, communication opportunities and challenges arise for which studies of the styles and content of communications and their effects on different types of patients can inform better practices, programs, and policies.
• Culture and disparities
  For diverse strategies of communication and each of the expressions of inequalities in cancer and health, work is ongoing with specific ethnic and cultural groups in the Bay Area to develop culturally appropriate communications.

Social Determinants and Disparities in Cancer and Health
Research topics under this theme include:

• Socioeconomic status or ethnic variations (descriptive studies). Identifying unique vs. common attributes of social disadvantage responsible for social gradients of health and cancer. Ethnic populations in which investigators have ongoing, participatory research relationships, to be nurtured and strengthened, include Vietnamese, Russian-speaking, Filipino, Latino/Latina, Thai, Laotian, Cambodian, African-Americans, and Chinese.
• Clinical trial accrual and retention. The under-representation of ethnic groups in cancer prevention and treatment trials and ways to remedy these inequities.
• Patient-provider communication disparities and ways to improve communications across cultures, languages, and disadvantaged and low-literacy patient groups.
• Culturally appropriate resources for cancer prevention and control, including written, audio, and video materials; decision-support tools; web-based resources; and broadcast media.
• Cancer care and ways to ensure more equitable referrals for care, follow-up, and palliation.
• Lay health workers, including promotoras and indigenous practitioners as partners in reaching and communicating with cancer patients and diverse community members.
• Theories and conceptual models requiring adaptation to specific ethnic populations.

Dissemination and Implementation Research
The communication and social determinants themes play out at another level of investigation as research findings accumulate and need to be transmitted and applied by policymakers, program planners, and practitioners. As research results are disseminated and implemented into different practice settings, populations, and circumstances, the processes have proved a source of frustration to many of the sponsors of research who want to see the results applied. Investigation in this area is undertaken to improve the effectiveness of moving science into policy, programs and practice.

Participatory Research
As both a means of enriching and strengthening each of these thematic research areas, and as an approach to population science that itself needs strengthening with methodological and prospective study, participatory research has become a feature demanded by many research funding agencies. This is driven partly by the need to engage populations more actively in the research enterprise to regain their confidence in and support for recruitment to clinical and community trials. It is driven also by a recognition that program planners, policymakers, and practitioners will be more likely to adopt the practices and strategies recommended by research if they have had a hand in its formulation and execution.

Current research by program members is supported by grants from the NCI, the National Library of Medicine, the CDC, the California Breast Cancer Research Program, the American Cancer Society, and other agencies.

In concert with core facilities of the Cancer Center, the Social and Behavioral Science Program has a number of short-term goals:

• Convening periodic meetings, colloquia, seminars, and planning or study groups to share information and perspectives among UCSF investigators and affiliated members on research issues and experience
• Building capacity for quick response to research funding opportunities that address current research interests and facilitate the optimal linkages of disciplines, experience, and expertise
• Developing a network of postdoctoral research talent through training grants and mentoring arrangements
• Developing methodologies and measurement instruments appropriate to the diverse populations of California in which cancer research is done
• Enhancing visibility and understanding of social and behavioral science contributions to cancer prevention and control
• Developing and testing dissemination and translation strategies for adoption and implementation of research, emphasizing participatory, practice-based research where possible