Our Research Framework

The Center seeks to advance cancer health equity by utilizing the Alcaraz Framework by Gomez et al. This framework illustrates the upstream and downstream factors impacting cancer outcomes. The upstream factors generate inequities due to conditions, such as social structures and social injustice, institutional environments, and living environments. The downstream factors generate disparities due to consequences, such as risk factors, biomarkers, cancer/comorbidity, and mortality. The CARES Center seeks to improve cancer health equity by impacting both upstream and downstream factors.


CARES Center Programs

Cancer Prevention through Enhanced Environment (PREEMpT)

PREEMpT will partner with Live HealthSmart Alabama, UAB’s Grand Challenge, to provide infrastructure and expertise in facilitating improvements in the built environment (lighting, green space, traffic calming measures, etc.), community programs, and improvements in access to care via the Mobile Wellness Van. The project will determine whether improvements to these physical and social environments can reduce community-level cancer risk.

Leveraging Adaptation & Multilevel Implementation Strategies to Address Unique Health Promotion Challenges among Cancer Survivors (LEAP)

LEAP will work to adapt diet and physical activity programming into interventions that are appropriate in persistent poverty contexts. The project will conduct evaluations by implementing LEAP in persistent poverty areas where project PREEMpT modifies the built and social environments and where it does not.

Pilot Projects

The pilot project program of the CARES Center supports the expansion of cancer research in persistent poverty areas by encouraging innovative interdisciplinary studies that seek to understand the complex impact of the living environments on cancer risk, the mechanisms by which this impact occurs, and the interventions to reduce it.

To learn more about one of our funded pilot projects, choose a name below.

Role of Mortgage Discrimination and Housing Assistance in Colon Cancer Treatment and Patient Outcomes in the United States

Researcher: Hussaini Syed, MD, MS

Program Description: Persistent poverty census tracts, with ≥20% of residents in poverty for ≥30 years, bore the brunt of government-sponsored redlining in the 1930s, leading to prolonged neglect and underinvestment. These areas have lower wealth, homeownership, education, and limited access to high-paying jobs and health insurance. Residents experience increased health-harming exposures and limited
access to health-promoting resources. Infrastructure, including transportation and specialty health
services, is lacking. Creating opportunity requires sustained investment and local capital flow. Both
mortgage financing for easier access to loans for purchasing real estate, and housing assistance
contributing to social mobility play major roles here.

Project Aims:

  • Establish aggregate measure of contemporary mortgage discrimination in PP areas.
  • Investigate association between mortgage discrimination and outcomes across the cancer care continuum in PP areas.
  • Evaluate impact of federal policy intervention of providing housing assistance on cancer outcomes in PP areas.
Decomposing Persistent Poverty and Gastrointestinal Cancer Mortality

Researcher: Mackenzie Fowler, Ph.D., MPH

Program Description: This project will provide greater understanding of how our built environment and personal social and economic characteristics affect known differences in mortality from gastrointestinal (GI) cancers between persistent poverty (PP) and non-PP areas in Alabama. Ultimately, future studies will seek to implement interventions aimed at addressing these findings and eliminating the existing difference in GI cancer mortality between PP and non-PP areas.

Project Aims:

  • Examine the extent that area level-built environment factors differ between PP and non-PP areas and decompose differences in GI cancer-related mortality by PP using factors associated with the built environment in AL.
  • Develop and pilot-test message approaches and communication channels that are effective in improving knowledge of and attitudes toward LCS among residents of PP Areas.
Community-centered Lung cAncer scReening and Awareness (CLARA)

Researcher: Soumya Niranjan, PhD

Program Description: This pilot project will develop a sustainable program that improves lung cancer screening adherence rates among African Americans through increased awareness of and concordance with screening guidelines. Assessments of the perspectives of individuals screened eligible for lung cancer screening regarding screening can improve the development and delivery of a culturally and geographically tailored education. Group Concept Mapping will be used to engage communities and explore complex health issues.

Project Aims:

  • Identify barriers and facilitators of screening for lung cancer among residents of persistent poverty areas.
  • Develop and pilot-test message approaches and communication channels that are effective in improving knowledge of and attitudes toward LCS among residents of PP Areas.
Barriers to cancer care in persistent poverty urban areas of Jefferson County, AL

Researcher: Maria Pisu, PhD

Program Description: This project seeks to understand the challenges in access to medical care in persistent poverty areas. We will use the Penchansky and Thomas Access to Care Framework to understand the challenges in each domain to guide appropriate effective sustainable interventions and increase access and utilization of cancer screening and detection, diagnosis, treatment, and survivorship care.

Project Aims:

  • Identify challenges to access to care from the perspective of residents in PP vs. other urban Census tract in Jefferson County, AL.
  • Identify challenges related to access to care and participation in cancer-related research from the perspective of health care providers practicing in urban persistent poverty areas and other areas of Jefferson County, AL.

Funding Opportunities

If you’re interested in submitting a pilot project for funding consideration, please visit our funding opportunities page.

Research and Methods Core

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