Center of Community Alliance for Research and Education (CCARE)
In recognition of the fact that African-Americans, Latinos and other ethnic and racial minorities are traditionally underserved by the health care industry, and often face unique challenges in dealing with cancer and other life-threatening diseases, City of Hope established the Center of Community Alliance for Research and Education (CCARE). CCARE is a broad initiative that implements specific best practice community strategies to reduce and eliminate inequalities in cancer outcomes. Our mission is to increase education and awareness of the most advanced practices in health care for all patients, bringing the best that City of Hope has to offer to underrepresented and underserved patients and communities.
CCARE is a unique opportunity for collaborative projects involving stakeholders from multiple spheres, including healthcare, academia, public health, policy, government, industry and the community. CCARE’s initiatives establish a durable network of community providers, nonprofit organizations, state and local governments (including public health departments and school districts) and City of Hope staff to share resources and information. Each initiative is rigorously and continuously evaluated using instruments, i.e., website surveys, self-reports, and process evaluations and community feed-back.
Southern California, specifically the Los Angeles area, is a natural setting for CCARE, because it is home to the largest Latino and Asian communities and third-largest African-American population in the U.S. In addition, Los Angeles is among the cities with the highest cancer rates.
CCARE’s objective is to create a model for equalizing cancer outcomes for all Americans, one that can be disseminated to institutions across the United States. The etiology and maintenance of cancer disparities are multifactorial. Accordingly, CCARE is innovative, multifaceted, and highly adaptable.
Promoting Community Participation; Encouraging Diversity
CCARE’s goal is to increase community participation via:
- Face-to-face community education seminars to inform and empower patients
- Cancer prevention and screening services for uninsured and underinsured families
- Robust community-research partnerships to streamline the translation of innovative research to community-based health practices, improving health outcomes for all
- Expanded access to clinical trials for underrepresented communities
- Identification and documentation of gaps in access to medical care through community evaluations
- Frank assessment of community quality of life and resources including availability of low-cost healthy foods and recreational facilities
By encouraging minority participation in cancer prevention, screening practices and education within the community, CCARE raises awareness of available cancer-related resources and closes health care gaps. Working in concert with community groups, City of Hope staff provides invaluable time and expertise in the areas of cancer prevention, genetics, survivorship, quality of life, treatment, pain management, psychosocial concerns and family issues.
Understanding the Disparities
CCARE aims to gain a comprehensive, detailed understanding of the multifaceted nature of disparate cancer treatment outcomes in minority populations. Negative outcomes in minority populations may be explained by factors such as delayed diagnosis and impeded access to best-practice treatment modalities as well as by genetic and/or behavioral differences. For example, it has been known that African-American patients with head and neck cancer tend to have significantly worse prognoses than white head and neck cancer patients. A clear reason for this disparity was not known. However, a recent study reported that most white patients with the disease tend to have tumors that are positive for HPV (human papilloma virus), while their African-American counterparts tend to have HPV-negative tumors, which are less responsive to treatment.
Diversity in Clinical Trials
Proper representation of ethnic minorities in clinical trials is important so that disparate responses to treatment and idiosyncratic adverse drug reactions can be noted and studied. City of Hope is at the forefront of innovation in personalized therapeutic approaches that take into account individual biomarkers to optimize patient outcomes and eventually make cancer not just treatable, but eminently curable.
Continuing Education and Professional Development Outreach
City of Hope creates continuing education outreach programs in order to advance the scientific and clinical talents of care providers working with underserved and underrepresented populations, including physicians, oncology nurses and medical social workers. The Division of Clinical Cancer Genetics' Intensive Course in Cancer Risk Assessment for community-based clinicians plays an increasingly important role in cancer prevention and control among at-risk populations.