Community engagement to inform multi-level analyses of the role of neighborhood factors in cancer control behaviors in African Americans.

Background: While community engagement has had a substantial presence in public health research, community input to inform geospatial and health analyses remains underutilized and novel. This manuscript reports on community engagement activities to solicit stakeholder perspectives on the role of neighborhood conditions in health and cancer. We discuss how this community input refined a priori conceptual model to be tested in the larger Families, Friends, and Neighborhoods (FFAN) Study.

Materials And Methods: We conducted semi-structured virtual interviews with 82 stakeholders (e.g., community and faith leaders, educators, healthcare workers) across four states (Maryland, Connecticut, Alabama, Missouri). Participants discussed how where a person lives can impact their health and cancer risk. We subsequently convened a virtual group discussion with 17 randomly selected interviewees. Our study team individually reviewed discussion notes, which were synthesized into a consensus document.

Results: In addition to constructs from the original conceptual model, participants identified neighborhood-level factors not in the original model, including K-12 education quality, local property investment, homelessness, public transportation infrastructure, proximity to healthcare facilities, environmental toxin exposures, access to healthy foods, and cost of living. These factors will be incorporated into the FFAN study analytic models.

Conclusions: Though geospatial analyses in health research has not traditionally employed community engagement techniques, this study illustrates the value of informing multi-level analytic models with the lived experiences of those negatively impacted by neighborhood conditions that underlie the risk, prevention, and screening behaviors driving cancer incidence and mortality.

Impact: Future social epidemiology research can be enriched through community engagement.