OVERALL ABSTRACT
Cancer mortality is higher in areas of the US affected by Persistent Poverty (PP) compared to areas in which
poverty has not persisted for decades, especially for obesity-related cancers like breast, prostate, and colorectal
cancer. While reasons may be multifaceted, the role of social determinants of health (SDH) cannot be
overlooked, including aspects of the Living Environments (e.g., physical and social) and their “downstream”
effects on behaviors that impact health promotion and increase cancer risk and mortality. In 2021, Alabama
ranked 8th in the US for poverty. The state includes some of the most impoverished inner-city and rural
communities in the nation, and thus a considerable number of both urban and rural Census Tracts (CTs)
identified as PP areas by the National Cancer Institute (NCI). The overall goal of the University of Alabama at
Birmingham (UAB) Center for Cancer Control in Persistent Poverty Areas (C3P2) is to reduce the burden of
cancer and cancer disparities in PP areas by expanding research and research capacity through
implementation and evaluation of multilevel interventions to improve cancer outcomes across the cancer control
continuum from prevention to survivorship. The C3P2 goal will be achieved through: 1) Establishment and
support of two transdisciplinary, multi-level, multi-domain research projects to adapt, implement, and evaluate
multilevel interventions across the cancer control continuum from prevention to survivorship, as well as pilot
projects through a Developmental Core; 2) Establishment of a coordinated C3P2 infrastructure to support and
strengthen the C3P2 research agenda by: a) providing overall integrated management and comprehensive
evaluation, b) providing common research resources and measures to promote project integration and
collaboration (Administrative and Research and Methods Cores); 3) Development of a pipeline of investigators
for cancer control research in PP areas by providing training, support, and research experience opportunity to
early career investigators (Career Enhancement Core); 4) Academic-community partnership building with
establishment of a Community Advisory Board and engagement of Community COaCHes to support innovative
and salient research in the community, and monitoring and evaluation to ensure achievement of proposed
goals. (Administrative Core). Our multi-disciplinary team of established and early career investigators, working
in a supportive environment with the resources and commitment to address and challenges in PP areas to
cancer prevention and control, are well positioned to make an impact in PP communities of Alabama and
improve cancer outcomes. The C3P2 will serve as a model to improve cancer prevention and control for other
PP areas in Alabama and other states.