Center of Community Alliance for Research and Education (CCARE)
Download our introductory flyer in English, Spanish, and Mandarin Chinese
In recognition of the fact that African-Americans, Latinos and other ethnic minorities and lower socioeconomic persons 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) in 2006. Spearheaded by Dr. Ashing, CCARE is a broad initiative that facilitates the translation of scientific knowledge into community practice 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 to underrepresented and underserved patients and communities the best that City of Hope has to offer. Our mission is to increase education, screening and prevention practices, awareness of cancer resources and knowledge of therapeutic advances and clinical trials within our diverse underrepresented and underserved communities.
Promoting Community Participation; Encouraging Diversity
CCARE’s goal is to increase community participation via:
Face-to-face community education seminars
Cancer prevention and screening services for medically underserved families and persons
Identifying and documenting the health needs and resource gaps in targeted communities
Providing health education materials and awareness of health services resources to improve health and access to medical care
Documenting community quality of life and resources including availability of low-cost healthy foods and recreational facilities
Robust community-research partnerships to streamline the translation of innovative research to community-based health practices, improving health outcomes for all.
Expanding community engagement and participation in research including clinical trials, biospecimen studies, and population and behavioral studies
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 Health Disparities
National reports document that ethnic minorities experience poor life expectancy and unfavorable disease burden and mortality. Negative health and cancer outcomes in minority populations may be explained by factors such as delayed diagnosis and impeded access to to best-practice treatment. Poor outcomes in minority populations may also be explained by biological factors, e.g., increased incidence of triple negative breast cancer among African-American and Latino women, or genetic factors, e.g., familial cancers. Lifestyle risk factors such as smoking, inactivity, over-consumption of meats and under-consumption of fruits and vegetables can account for 60-80% of poor health risk and outcomes.
Diversity in Clinical Trials, Biospecimen Studies, and Health Research
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 Intensive Course in Cancer Risk Assessment for community-based clinicians, from the Division of Clinical Cancer Genetics, plays an increasingly important role in cancer prevention and control among at-risk populations.
Our Advisory Council
CCARE’s Advisory Council members represent a wide cross-section of concerned Southern Californians from government, academia, medicine, public health, and community interest groups. Advisory Council members are dedicated to carrying out CCARE’s mission of improving healthcare access, diagnosis, and treatment outcomes in underserved communities.
Annette Mercurio, George Somlo, Jeffrey Weitzel,
, Joyce Niland, Kristen Pugh,
Lucille Leong, Melanie Palomares, Robert Morgan, Smita Bhatia, & Sue Wyninegar, City of Hope
CCARE joins a multi-sectorial team representing advocacy groups, community organizations, faith-based organizations, academic institutions, health services organizations, the public and private sector, and policymakers. In collaboration with our 188 community partners, we provide educational workshops, materials and demonstrations as well as screening for early detection and disease prevention (e.g., diabetes, hypertension and breast-, cervical- and prostate cancers). CCARE also partners with community organizations including the American Cancer Society to implement health promotion, cancer prevention and early detection programs to respond to the needs of our diverse community. Since the inception of the CCARE program, thousands of people (predominantly African-American, Asian-American, and Latino-American) have participated in our community education events. Attendees reported increased knowledge about cancer risk reduction and awareness of community cancer resources
Community Health Promotion Activities
“Eat, Move, Live!”
This community collaborative program links City of Hope with cities and school districts to implement an obesity, diabetes, cancer and other chronic diseases prevention program via culturally and linguistically appropriate nutrition and exercise classes for children and their parents, in a local school setting.
Over the years, the "Eat, Move, Live!" lifestyle intervention program has demonstrated success in increasing knowledge and practice of health behaviors among both adults and children.
Children demonstrated increased knowledge of food groups and health behaviors.
Parents demonstrated significant increases in knowledge and behavior by increasing daily servings of fruit and vegetables and daily physical activity.
Justifications provided by parents for not engaging in health behaviors (e.g., healthy eating) at pre-test were areas that were address by this series.
At the end of this class series, all participants reported they planned to use the healthy lifestyle changes they learned.
For more information on the "Eat, Move, Live!" program, and additional resources, click here.
Cancer Equity Forum
In honor of Minority Cancer Awareness Week, City of Hope hosts this special event on the third week of April, every year. Read more in Professional Development.
Cancer Screenings and Health Fairs
To address disparities, CCARE partners with community leaders in the greater Los Angeles and the Inland Empire areas to produce a series of health fairs and cancer screening events tailored to specific demographic groups. For all screening events, in addition to the diagnostic screenings, CCARE collaborates with community partners to present educational and demonstration workshops on health promotion and disease prevention. Lifesaving health screenings, e.g. diabetes and blood pressure tests, and cancer screenings, e.g., Pap smears, mammograms, and PSA tests are provided to attendees who have limited access to them elsewhere. Educational presentations, demonstrations, and healthy food samples augment the screenings in a fun “health fair” environment:
“Mejor Salud, Mejor Vida” Villa-Parke Community Center, Pasadena, California. This event featured information and lectures in Spanish on cancer, diabetes and nutrition.
A.K.A. Sorority Health Summit Health and educational services for the African American community.
Celebration of Life, Chinese Cancer Survivor Conference The focus of this conference, conducted in Mandarin, was to address health-related quality of life issues among Chinese cancer survivors.
LULAC: Latinos Living Healthy Feria de Salud Tens of thousands gathered on Olvera Street, in Los Angeles, for the free health screenings, entertainment, and games at the LULAC Feria de Salud. Read more here. Watch footage here.
To invite a speaker, please Contact Us to learn more about how we can come share with your local community!
The Eat, Move, Live! program (EML) is a community-based nutrition and physical activity program for obesity and cancer risk reduction. CCARE engages with the community in a symbiotic relationship to co-educate and exchange knowledge and wisdom. CCARE and the community infuse the best scientific practice with socioecologic and cultural relevance to improve health outcomes and reduce health disparities among diverse and medically underserved communities. CCARE collaborates with 106 community partners to engage the community covering 315 zip codes, and implemented 214 health education programs, extending City of Hope’s reach to over 20,000 households. The healthy lifestyle and chronic disease risk reduction intervention was conducted with 228 adults and 125 children with a documented positive effect on eating and physical activity knowledge, awareness and behaviors.
EML is implemented in collaboration with the City of Duarte and the Duarte School District as well as local markets.
The program consists of weekly class sessions designed to promote healthy lifestyle changes including nutrition and physical activity.
The goal of the program is cancer and chronic disease prevention through lifestyle, nutrition and physical activity
The approach is a solution focused, culturally and socioecologically informed education and demonstration community participatory intervention.
Target population: City of Duarte residents, School age children and parents, Latino community
Goals of Program
To educate the community about the connection between nutrition, physical activity (PA) and chronic disease.
Expand healthy food preparation skills to reduce calorie intake.
Increase the consumption of vegetables and fruits.
Reduce fat intake.
To increase daily physical activity.
Participants Learn About
Nutrition/Reading food labels
Recommended portion sizes
Recipes that are healthy but culturally relevant
Shopping at the supermarket
How to eat healthy on a budget
• 5 week program
• 2 hours each session, once a week (am or pm)
• Different activities and subjects are assigned to each session.
• First lesson
• - nutritional guidelines
• - food pyramid
• - nutrition labels
• Food demonstration
• Physical Activity (salsa, yoga, resistance
• In March of 2014, we're offering another nutrition program!
New to exercising? Get started with some inspiration from The Fat Chick--fun workouts for every-body and body type!
CCARE presents their research on community programs all around the globe. Take a look at the Eat, Move, Live! poster
Special thanks to our partners: Sodexho, Fresh & Easy Market, Mike's Foods, Sprouts, Ralph's, Tanaka Farms, Food4Less, Chef Louis Rice, Network for a Healthy California, City of Duarte Parks and Recreation, Duarte Unified School District's Early Childhood Development Program and our videographer, Mr. V, for their support and in-kind donations!
The Center of Community Alliance for Research is developing its role as City of Hope's leading resource on cultural and socioecological contexts and the inclusion of linguistic and ethnic minority groups. CCARE has participated in several successfully funded projects with other departments and divisions including Clinical Cancer Genetics, Developmental Therapeutics and Cancer Biology.
Dr. Ashing is recognized as a stellar and exemplary investigator with seminal research in the area of psychooncology, particularly in the area of ethnic, cultural, linguistic and health disparities. She is a psychooncology champion whose work has documented the cancer experience of diverse survivors. Moreover, she is a community health advocate working to build infrastructure and capacity within community-based, grass-roots cancer-related organizations. Dr. Ashing is the notable leader in examining health disparities in order to improve quality of life and quality of care for ethnic and linguistic minority and underserved persons and communities. Her work in this area is significant and innovative, and is shaping future research efforts in health psychology, oncology and quality of life research. This originality is best illustrated through her scientific productivity and ensuing publication record.
Learn about CCARE's role in ACS' new Cancer Prevention Study, and how to join! Dr. Ashing, along with Dr. Jeffrey Weitzel, chief of the Division of Clinical Cancer Genetics, received a grant from the ACS to support their work on CPS-3 in Los Angeles County. Dr. Ashing focuses on addressing the disparities in treatment and outcomes between patients with different access and cultural approaches to medicine. Together, Drs. Ashing and Weitzel are working not only to increase understanding of the causes of cancer, but how best to educate the diverse, multi-ethnic public about how they can prevent cancer. To learn more about City of Hope's role in this study, click here.
Dr. Ashing along with seven other community partners recently received funding from the California Breast Cancer Research Program to train African American breast cancer survivors as peer navigators to guide African American breast cancer patients through survivorship with an emphasis improving access to surveillance and follow-up care.
Thanks to Susan G. Komen LA County, CCARE has newly launched a similar study focusing on the Latina breast cancer survivors of Antelope Valley. Instead of peer navigators, however, this study involves board-certified nurses.
CCARE is also working on a similar project that reaches both African American and Latina breast cancer survivors, targets low-income women in SPA 4, which covers Metro LA. Professional health educators serve as the navigators for this study.
Additionally, an Excellence award from City of Hope allows us to reach out to young African American breast cancer survivors. A licensed Marriage and Family Therapist provides the navigation.
Since 2010, City of Hope has received funding via the National Cancer Institute's Community Outreach Capacity Through Community Health Educators (CHE) of the National Outreach Network administrative supplement. CHE is housed within CCARE to integrate the CHE program within the community and develop a long-term education and outreach plan in Los Angeles County. This project provides, among other things, community assessment of cancer control needs and resources, community cancer education, diagnostic and therapeutic care presentations, and screening and early detection services. It also expands the access to and enrollment of underrepresented populations in biospecimen bankings as well as clinical research.
In response to the mandated Survivorship Care Plan (SCP) going into effect in 2015, Dr. Ashing and CCARE investigated the cultural competence of the SCP for minority communities.
Using a community-based participatory research (CBPR) framework, they involved members of the community in every aspect of the research process (J Cancer Surviv 2013).
To read the full article, click here. (To read more about the Survivorship Care Plan and the official program standards, click here.)
Dr. Ashing and CCARE implemented evidenced-based interventions investigating the benefit of a clinically responsive psycho-educational telephonic versus materials only intervention with African-American and Latina-American breast cancer survivors (BCS).
These findings suggested that long-term and late effects persist among BCS, but symptoms are responsive to intervention. The results are encouraging and provide evidence that culturally and clinically responsive psycho-educational interventions are effective for improving quality of life outcomes and reducing life burden among low-income and minority populations.
On the other hand, survivors receiving the materials only demonstrated either little change or declines in domains of health related quality of life issues over time. The current findings are informing community translational interventions (J Cancer Surviv 2008).
KCAL9: Program Educates African-American Women on Cancer
A campaign is underway at City of Hope hospital in Duarte to educate African-American women about the risks of breast cancer. KCAL9’s Melanie Woodrow reports the Patient Navigator program offers support for survivors and raises awareness for those at risk. "Behavioral scientist Dr. Kimlin Tam Ashing, the driving force behind the program, said black women often get lost in the follow-up phase of treatment..." Watch interview here.
School Children Help Raise Funds for Breast Cancer
St. Margaret Mary School in Chino celebrated their annual "Pink Day" on Friday, October 25. The children donated a dollar for the City of Hope and wore pink shirts to school. They honored all those they know who have battled breast cancer by writing their names on a large poster and took a picture of the entire school body in the shape of a giant pink ribbon (picture above). Mayra Serrano, Community Interventionist from City of Hope's Center of Community Alliance for Research and Education (CCARE), spoke with the students in the afternoon to educate them on breast cancer and about how their donations will be used. They ended the day with a fundraiser of pink snow cones. All donations and proceeds totaled $408 and were sent to the City of Hope to help end the battle of breast cancer.
American Psychological Association: Life-Changing Interventions
Psychologists’ research is preventing and reducing the burden of cancer; Dr. Kimlin Tam Ashing weighs in. Download the article
San Gabriel Valley Tribune: Senator Ed Hernandez Recognizes Women of Achievement
"Assemblyman Dr. Ed Hernandez [...] honored ten women who live and/or work within the district in commemoration of Women's History Month. Honorees were selected based on nominations submitted by people from their communities." Download the rest of the article
USC Annenberg School for Communication and Journalism: Leveling the Playing Field in Cancer Care
"Those who survive cancer run a life-changing gauntlet [...]. Many of the aftereffects can be avoided through long-term care, but those programs are often inaccessible to the poor, particularly ethnic minorities..." Download the rest of the article
Latino USA: The Psychology of Breast Cancer in Latinas
Half of Latina breast cancer survivors suffer from depression. These rates are much higher than the average among other survivors. Dr. Ashing at City of Hope in Los Angeles shares her research on the psychological aspects of recovery with our host Maria Hinojosa. She discusses the role of spirituality, family and beliefs about women’s responsibilities in helping or hindering detection, treatment and recovery. Click here for the article or
for only the audio.
Los Angeles Times: Why Breast Cancer is More Likely to Kill Black Women
This article explores why black women on Medicare fare worse after breast cancer diagnoses than similar white women, a study finds. Researchers blame preexisting health issues such as diabetes. Dr. Ashing weighs in on this relevant topic. Click here to read the full article.
The ASCO Post: Young Women and Breast Cancer
Investigators at City of Hope take a closer look at the rise in young minority women with breast cancer. Dr. Ashing and Monica Rosales share about exciting new studies. Click here to read the full article.
CCARE Encourages Cervical Exams Among At-Risk Women in Inland Empire
Studies show minority women in southern California remain at a high risk for cervical cancer. And although routine screenings make this cancer easily preventable, far too few women avail themselves of these medical services. CCARE embarked on a clinical trial to address this issue. Click here to read more.
Minority Nurse: Addressing Disparities in Cancer Treatment
Dr. Ashing discusses the role of minority nurses in working to reduce cancer disparities in their community, and discusses optimal prevention strategies for women everywhere. Click here to read the full article.
¡Recursos y enlaces electrónicos para la comunidad hispana/latina! Nuestro sitio electrónico en español se está actualizando, ¡gracias por su paciencia! Mientras tanto, tenemos varios recursos aquí mismo para usted.
¡Coma, Muévase, Viva!
Como parte de nuestro programa ¡Coma, Muévase, Viva! ofrecemos Clases de Nutrición para adultos (Marzo 2014), y un Campamento de Verano para niños (Agosto 2014)!
Para más información, ¡mándenos un correo electrónico! Los espacios se llenan rápidamente, ¡no demore!
CCARE engages with the community in a symbiotic relationship to co-educate and exchange knowledge and wisdom. CCARE and the community infuse the best scientific practice with socioecologic and cultural relevance to improve health outcomes and reduce health disparities among diverse and medically underserved communities.
Keep track of our upcoming events by subscribing to our calendar, or adding it to your iCal using the links below!
CCARE’s professional training initiatives aim to disseminate best practices in cancer care to providers in underserved communities by ensuring existing faculty members are kept up to date on best practices, while training a new generation of clinicians and researchers in these innovative methods.
is currently training three postdoctoral fellows. Two Fellows received funding under the City of Hope/California State University, L.A P20 mechanism awarded to principal investigator
Susan Kane, Ph.D.
In recognition of Minority Cancer Awareness Week, CCARE brings together scientists, physicians, health advocates and policymakers at a forum to grapple with inequity issues. The inaugural forum, titled “Can Communities Win the War on Cancer by Partnering with Science?”, focused on medical and scientific developments in cancer prevention and control, clinical trials, personalized medicine and biospecimen banking, with particular focus on underrepresented and underserved populations. About 70 participants came together to improve awareness and build relationships that will help reduce health inequity.
City of Hope speakers included
Lucille Leong, M.D.,
clinical professor of medical oncology,
Jeffrey Weitzel, M.D.,
director of the Division of Clinical Cancer Genetics, and Julio Garcia-Aguilar, M.D., Ph.D., former chair of the Department of Surgery. Presentations from experts in oncology, genetics and personalized medicine and a community partners’ panel rounded out the evening’s forum. The community partners panel included Rita Singhal, M.D., M.P.H., of the Los Angeles County Department of Public Health’s Office of Women’s Health, Jasmin Ramirez of the American Cancer Society, Lucy Young and Carol Wang of the Herald Cancer Association, Eudora Mitchell of the Witness Project and Esperanza y Vida, Zul Surani of the USC Norris Patient Education and Outreach Center, and cancer survivor Kommah McDowell of the Kommah Seray Inflammatory Breast Cancer Foundation. CCARE and our community partners will continue to collaborate closely on scientific studies and community based cancer education and screening programs to increase minority participation in research, improve cancer prevention efforts and early detection. CCARE is committed to educating and empowering communities, through combining scientific knowledge with community wisdom and action, for a greater voice in cancer prevention and research and to equalize health outcomes for all.Watch footage from last year's lectures here.
For breast cancer survivors, a common worry is a recurrence of their cancer. Currently, these patients are screened with regular mammograms, but there’s no way to tell who is more likely to have a recurrence and who is fully cleared of her cancer. A new blood test – reported in Cancer Research, a journal of the...
Metastasis — the spreading of cancer cells from a primary tumor site to other parts of the body — generally leads to poorer outcomes for patients, so oncologists and researchers are constantly seeking new ways to detect and thwart this malicious process. Now City of Hope researchers may have identified a substa...
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Cancer risk varies by ethnicity, as does the risk of cancer-related death. But the size of those differences can be surprising, highlighting the health disparities that exist among various ethnic groups in the United States. Both cancer incidence and death rates for men are highest among African-Americans, acco...
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Using a card game to make decisions about health care, especially as those decisions relate to the end of life, would seem to be a poor idea. It isn’t. The GoWish Game makes those overwhelming, but all-important decisions not just easy, but natural. On each card of the 36-card deck is listed what seriously ill,...
Young adults and adolescents with cancer face unique challenges both during their treatment and afterward. Not only are therapies for children and older adults not always appropriate for them, they also must come to terms with the disease and treatment’s impact on their relationships, finances, school or ...
Breast cancer is the most common cancer, other than skin cancer, among women in the United States. It’s also the second-leading cause of cancer death, behind lung cancer. In the past several years, various task force recommendations and studies have questioned the benefits of broad screening guidelines fo...
Paternal age and the health effects it has on potential offspring have been the focus of many studies, but few have examined the effect parental age has on the risk of adult-onset hormone-related cancers (breast cancer, ovarian cancer and endometrial cancer). A team of City of Hope researchers, lead by Yani Lu,...
Hormone therapy, which is prescribed to women for relief of menopausal symptoms such hot flashes, night sweats and vaginal dryness, has recently seen a decline in popularity (and use) due to its link to an increased risk of breast and endometrial cancer. But City of Hope researchers have found that menopausal h...
Myeloproliferative neoplasms can’t be narrowed down to a single cancer, but they can be described by a defining characteristic: too many blood cells. The diseases bring with them a host of frustrating, potentially life-altering symptoms, and management of the diseases and their symptoms is crucial. An upcoming ...
More than 18,000 researchers, clinicians, advocates and other professionals will convene at the 105th American Association for Cancer Research (AACR) annual meeting taking place in San Diego from April 5 to 9. With more than 6,000 findings being presented over this five-day period, the amount of information can...
Cancer of the prostate is the No. 2 cancer killer of men, behind lung cancer, accounting for more than 29,000 deaths annually in this country. But because prostate cancer advances slowly, good prostate health and early detection can make all the difference. Many prostate cancer tumors don’t require immedi...
Despite advances made in detecting and treating nonsmall cell lung cancer, its prognosis remains grim. Even patients whose cancers are caught at their earliest stage have only a 50 percent chance of five-year survival. This poor prognosis is due in part to the cancer’s ability to resist treatment, renderi...