THE COMMUNITY GATEWAY STUDY

The Community Gateway Study aims to investigate the impact of a multi-level approach to target pathways that impact cancer control outcomes in the health care delivery system and community. The Gateway Study embodies the theme of our Center, which is advancing cancer control by strengthening the capacity of community health centers (CHCs) to deliver evidence-based cancer screening and tobacco treatment and by promoting social, civic, and digital connection among patients and their communities. By focusing on four key pathways influencing cancer control outcomes—social capital, civic engagement, digital skills and technology access, and access to evidence-based cancer control care — we will build community capacity and strength for improving community resources for cancer control, increase opportunity for civic engagement, improve resident access to resources, and ensure that CHCs have the support needed to provide evidence-based care. The community-level intervention is an innovative approach to build social capital and civic engagement, led by Union Capital, a non-profit designed to amplify resident voice and power through resource exchange and collaboration. This will enable residents to access resources that they need by building social ties and engaging in community opportunities. It will also support residents to come together to engage with institutional structures, such as local government, that could change laws or policies to reduce the impact of the selected pathways (e.g. tobacco product sales to minors). The health care system-level intervention includes: (1) point-of-care population management tools for breast, cervical, and colorectal cancer screening and tobacco use, and implementation support to increase their use; and (2) screening and navigation to get needed resources for digital skills and technology. We will use a cluster-randomized, stepped-wedge study design in 12 CHC sites to determine the impact of the community- and systems-level interventions. Cancer control will target breast, cervical, and colorectal cancer screening rates and tobacco use. Outcomes will be measured at community, systems, and patient levels. The proposed study, a partnership between academic and community-based researchers, aims to link CHCs and communities in ways that can improve cancer control outcomes. The interventions are designed to maximize sustainability and scalability. Our community-level intervention is conducted in partnership with an existing organization focused on social capital and community engagement, and the systems-level intervention increases use of existing population management strategies and tools that can be integrated into CHC infrastructure, but are significantly underutilized.