cancer prevention and control needs of the Hispanic community. NCI has established two cooperative agreements for NHLIC, one with the Baylor College of Medicine and another with the National Coalition of Hispanic Health and Human Services Organizations (COSSMHO). COSSMHO has established nine local project sites across the United States and in Puerto Rico to address cancer research questions with community-based organizations. NHLIC's: En Acción, an NCI cooperative agreement with the Baylor College of Medicine, is a theory-based, research-oriented program combining national and regional health expertise with grassroots community leadership to reach the major Hispanic populations in six cities across the country. The project initiated the first comprehensive epidemiologic assessment of cancer risk factors among these Hispanic and Latino population groups and has developed state-of-the-art cancer prevention and control strategies tailored to those diverse Hispanic populations. NCI allocated approximately $1.2 million for these activities in FY 1997.

ALIC serves to facilitate the development of a strong cancer network in Appalachia. As a research program, ALIC is testing the effectiveness of community coalitions and partnerships as an intervention strategy for social and organizational change in achieving cancer control objectives. The program involves four individual projects, with four research universities as the lead agencies, working with a variety of partners in 10 different states in the Appalachian region. All four projects have initially focused their coalition development activities on the following specific outcomes: an increase in early-stage diagnosis of breast and cervical cancer with a concomitant decrease in late-stage diagnosis of these diseases, an increase in cancer survivorship, and a decrease in breast and cervix cancer mortality over time. A great deal of information about the society and about the health—and cancer problems—in Appalachia, and about the individual ALIC projects, can be found in a publication, Sowing Seeds in the Mountains, an ALIC monograph published by NCI in 1994. Preliminary results suggest that the ALIC intervention has enhanced capacity (defined as a greater degree of interconnectedness among partnering organizations involved in planted action) in the Appalachian cancer control system and that this additional capacity will increase screening activities for breast and cervical cancer in the region. NCI allocated approximately $1.5 million for these activities in FY 1997.

Cancer Research Networks

NCI supports two networks to coordinate meetings and enhance the efforts of researchers working to address the needs of ethnic minority and underserved populations. The Network for Cancer Control Research Among American Indian and Alaska Native Populations (NCCR-AIANP)



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