CCEP Training

Overview
Core Curriculum
Research Experience
Mentors
Evaluation

Overview
Cancer prevention and control is a broad concept that stretches from the laboratory bench to the community and from prevention of disease onset to quality of life for survivors. Continued advances in cancer prevention and control depend on research that identifies, translates, and implements new knowledge from diverse areas -- from molecular discovery of prevention opportunities to community/provider interventions to increase use of prevention strategies to the adoption of policy supported by outcomes/cost-effectiveness studies.

Research effectiveness in any one area of cancer prevention and control is enhanced by understanding the overall context and by collaborating with experts in complementary areas. In the future, the best cancer prevention and control researchers will be those who can communicate across the various continua. They will be behavioral scientists working on a community intervention to increase use of a new molecular screening test for colon cancer who also understand something about: the natural history of colon cancer; the rationale for the molecular marker; the sensitivity/specificity/and positive predictive value of the screening test; and the cost/policy implications of the screening strategy. They will be laboratory prevention scientists working on a gene-nutrient interaction who also understand something about: the epidemiologic evidence for the nutrient; the prevalence of the relevant dietary behaviors; and the barriers/promoters for changing those behaviors.

It is not necessary that everyone become expert in everything. Social psychologists do not have to be able to perform PCR reactions, and laboratory scientists do not have to debate in detail the merits of social cognitive theory v. the transtheoretical model. What is necessary is that cancer prevention and control scientists be able to communicate with a shared vocabulary. Each must recognize, appreciate, and learn from the major tenets of each other's expertise.

Multidisciplinary training with exposure to a broad spectrum of ideas and mentored collaborative research is fundamental to the development of effective cancer prevention and control researchers. Through its specialized core curriculum and mentored research experience, the CCEP focuses on training that crosses and integrates different disciplines. The flexibility in both eligibility and training allows the CCEP to enhance diversity within the field and, at the same time, provide the understanding and language for unifying that diversity.

Objectives
To prepare pre- and postdoctoral fellows for careers in interdisciplinary and collaborative cancer prevention and control research, the CCEP has six training objectives. Through the Program, fellows will:

• Understand the fundamental issues in cancer prevention and control;
• Develop research expertise by mastering a content area;
• Develop collaborative capability by learning the basic tenets and vocabulary of complementary content areas;
• Become competent in research methods;
• Gain mentored research experience under the guidance of a multidisciplinary team of mentors; and
• Develop professional skills required for successful research careers (such as writing grants, presenting research findings, writing for publication, etc).

As part of their postdoctoral program, physicians, nurses, and other health professionals without masters-level training are expected to pursue an advanced degree (MPH, PhD, or DrPH), primarily at the UNC-CH School of Public Health. Other postdoctoral fellows may also elect to pursue a master’s degree or to begin coursework for a Ph.D. Fellows interested in pursuing advanced degrees from the UNC Chapel Hill School of Public Health or other UNC Chapel Hill programs must separately apply to and be accepted into those programs.

Flexibility
Because the CCEP encourages diversity in background and interests, the Program stresses flexibility in training, especially for postdoctoral fellows. Each fellow enters the Program with an identified mentoring team that includes a primary faculty mentor and additional faculty identified during the application and selection process. For predoctoral fellows, the mentor and mentoring team are principally the dissertation advisor and committee. For postdoctoral fellows, upon entry into the Program, the Training Advisory Committee (TAC) and prospective mentors review each fellow's prior training, assess the individual needs, and, in collaboration with the fellows, design an appropriate training plan.

Postdoctoral Training Plans
The training plan is key to the evaluation of postdoctoral trainee's progress. Upon fellows' acceptance into the Program, the Training Advisory Committee, the mentoring teams, and the fellows develop a training plan. Fellows then annually submit training plans for review, modification (if appropriate), and approval by the Training Advisory Committee. Plans, which are individually tailored to fit each fellow's needs, generally have three major components: Goals/Objectives, Core Curriculum, Research Experience. Postdoctoral fellows and the mentoring team meet every six months with CCEP leadership to discuss progress.

 

Core Curriculum
All fellows participate in the CCEP's core curriculum that combines five required courses, additional coursework as appropriate, and professional development/other activities.

Required Courses
Fellows take four content courses and one professional development course. Content courses provide fellows with a basic understanding and the common language of the wide range of disciplines (from basic to behavioral science) that contribute to effective cancer prevention and control. The professional development course promotes grant writing skills.

Content Courses. All fellows take a survey course in the fundamentals of cancer prevention and control (HPM/HBHE 765/EPID 772). All fellows also take three other content courses (or their equivalents), ranging from basic science to behavioral theory. Suggested courses include:

• Cancer Pathobiology (PATH 225, Kaufmann, Spring), or Diet and Cancer (EPID/NUTR 815, Satia, Spring) or Cancer Epidemiology and Pathogenesis (EPID 770, Schroeder, Spring);
• Cancer Epidemiology Methods (EPID 771/Millikan/Fall) or Advanced Cancer Epidemiology (EPID 775, Gammon, Spring);
  and
• Social and Behavioral Sciences in Public Health (Theory and Methods - HBHE 730, Fisher, DeVellis, Fall) or Social Psychological Theories of Individual Health Behavior (HBHE 800, DeVellis, Spring).

Choice in required content courses provides flexibility to match fellows' backgrounds, interests, and schedules. At the same time, the courses assure that fellows receive training in the basic tenets and vocabulary of at least three major perspectives -- basic science/carcinogenesis; epidemiology; and behavioral science.

Professional Development – Grant Writing. Fellows must take a course in grant writing. Postdoctoral fellows take NUTR 880, a grant writing seminar directed by Drs. Steven Zeisel and Barry Popkin. Predoctoral fellows may take NUTR 880 or grant and proposal writing seminars offered by their home departments, such as EPID 726. Postdoctoral fellows, with an interest in a specific department, may opt to take the equivalent grant writing seminar in that department rather than NUTR 880.

Other Courses
Fellows take, as needed, other courses to develop mastery of a content area, additional collaborative capabilities, and/or competency in research methods. For postdoctoral fellows, the Training Advisory Committee, in collaboration with the preceptor teams and the fellows, identify the need and/or desire for specific coursework.

Predoctoral fellows take coursework in research methods as part of their doctoral programs. Postdoctoral fellows take research methods coursework as individual needs dictate. Options for formal training, especially for physicians, nurses, and other health care professionals include: the UNC Robert Wood Johnson Clinical Scholars Core Curriculum (RWJ Core), the Public Health Leadership Program, the Health Care and Prevention MPH program, and the Preventive Medicine Residency.

In addition to formal University-based coursework, fellows are encouraged to take short courses either on- or off-campus to enhance content and methods expertise. Off-campus programs include such opportunities as the summer cancer prevention core curriculum sponsored by the NCI's Cancer Prevention Fellowship Program and the new investigator workshops sponsored by the American Society of Preventive Oncology. On-campus programs include an array of methods short courses through various departments and centers, such as those offered Odum Institute for Research in Social Sciences.

In addition the curriculum incorporates integrative/professional development activities, including a journal club, seminars, workshops, and other specialized activities.

Professional Development/Other Activities
Journal Club. During the spring semester, all fellows attend a weekly journal club. At a typical session, a team of two fellows present and discuss four to six articles that they had selected (in conjunction with the CCEP Co-director and other faculty). Each fellow helps organize and moderate three sessions. The weekly series ends with a series of work-in-progress presentations of current research by fellows. As needed, during the spring the schedule is altered to allow fellows to preview posters/presentations for upcoming professional meetings and dissertation defenses. The series periodically devotes sessions to special topics, such as IRB review and grant peer-review.

Special Seminars and Meetings. The CCEP and the Cancer Center also sponsor or co-sponsor special seminars or small group meetings featuring cancer prevention and control researchers. These Visiting Scholars are nationally recognized leaders in cancer prevention and control research. In addition to presenting a seminar and visiting with faculty mentors, these Visiting Scholars meet with the CCEP fellows as a group (usually at lunch). Fellows also attend seminars of interest organized by other campus groups or at nearby universities. Fellows are also encouraged to attend several of the weekly multidisciplinary clinical conferences at the NC Clinical Cancer Center. Current weekly conferences include breast, lung, and GI cancer, as well as melanoma and hematologic diseases.

Responsible Conduct of Research. During their first year of support, fellows take a week-long, summer short-course in "The Responsible Conduct of Research." Organized by Dr. David Weber and sponsored by several UNC-CH departments and centers, the course covers: Misconduct in Scientific Research; Conflicts of Interest; Ethical Use of Humans in Research; Ethical Use of Animals in Research; Responsible Authorship; Managing Scientific Data; and Patenting Biologic Material. Fellows must also complete their certification of training in the use of human subjects.

 

Research Experience
Purpose
The heart of CCEP is the fellow's "hands-on" mentored research experience. Under the direction of a primary mentor and a mentoring team, each fellow develops and conducts cancer prevention and control research. For predoctoral fellows, the major research project is the dissertation. These fellows also participate in other research projects as well. For postdoctoral fellows, projects may be independently developed parts of a mentor's ongoing research program and/or a new projects developed by the fellow. The research reinforces and applies training from the core curriculum and demonstrates fellows' mastery of a content area, collaborative capabilities, and competency in research methods. The research experience also provides opportunity to develop and demonstrate important research skills: grant writing, abstract and presentation preparation, and scientific writing.

Outcomes and Expectations
The primary outcome is for fellows to leave the Program and develop careers in multidisciplinary and collaborative cancer prevention and control research. Postdoctoral fellows should “graduate” to research/teaching/service positions. Predoctoral fellows should complete dissertations in cancer prevention and control and “graduate” to appropriate postdoctoral positions or research/teaching/service positions. In support of these primary outcomes, by the end of their training all fellows are expected to have:

• Completed the core curriculum, including additional coursework requirements established by the Training Advisory Committee and the mentor team. Physician and nurse postdoctoral fellows entering without masters-level training should have obtained or be well-advanced in obtaining an advanced degree (MPH, PhD, or DrPH).
• Completed or be well-advanced in the mentored research experience, including meeting the grant writing requirement. Fellows should have: presented research at a scientific meeting; begun publishing research; and submitted proposals for funding. Depending on their point of entry into the Program, predoctoral fellows should have completed or be nearing completion of a doctoral dissertation. Predoctoral fellows should have begun the process of publishing research and begun developing funding proposals for funding.

Specific Postdoctoral Research Expectations
For postdoctoral fellows, the mentored research experience begins at entry and lasts throughout the fellowship. Fellows participate in each of three major required activities:

Research Projects. Under the guidance of the mentoring team, fellows design and conduct one or more independent projects. In these projects, fellows address aspects of research from the research question and design to the protocol, methods, instruments, data collection, data management, analysis, and report. Involvement of collaborating experts is expected.
Grant Writing. By the end of their second year, postdoctoral fellows write an extramural grant proposal (R21, R01, K07/8/22 equivalent). An internal review committee reviews and critiques the proposal. The review committee is formed from members of the mentoring team, the Training Advisory Committee, and other relevant faculty. Following the review, fellows are encouraged to revise and submit the proposals for funding.
Although fellows have access to program funds to support their research, the CCEP encourages submission of proposals to obtain intramural and/or extramural funding.
Professional Activities. Fellows present findings at local, regional, and national scientific meetings, as well as submit results for publication in peer-reviewed journals. Mentors are encouraged to offer fellows appropriate participation in review activities (e.g., joint review of manuscripts for peer-reviewed journals).

 

Mentors
Primary and Team
Each fellow has a primary mentor who will lead, as appropriate a mentoring team. Upon the fellow's admittance to the Program, the Training Advisory Committee, in consultation with the fellow and the primary mentor, will identify faculty with appropriate expertise to participate in the mentoring team. For many predoctoral fellows, the mentoring team will be the dissertation committee. Throughout the fellowship, these mentoring teams will: develop a training plan; assure appropriate coursework and other training; identify research opportunities, support research activities; assist with the grant writing requirement; and assist in placement following the fellowships.

Faculty Mentors:
CCEP faculty mentors represent departments in the UNC Chapel Hill Schools of Public Health, Medicine, and Nursing, and the College of Arts. Mentors are predominantly senior faculty. Four are practicing clinicians, and one is a nurse. To learn more about a mentor, click on the name and follow the link.

CCEP Faculty Mentors and Areas of Expertise
Name/Title	Department	Expertise
Alice Ammerman, Dr.PH. Professor/Director	Nutrition, HPDP	Behavior change, community-based participatory research
Donald Baucom, PhD, Professor	Psychology	Behavioral intervention, coping/quality of life, survivorship
Noel Brewer, PhD, Assistant Professor	Health Behavior & Health Education	Health communication, behavioral theory medical decision making by lay people, patients and providers
Marci Campbell, PhD, RD, Professor	Nutrition	Behavior change; community intervention; survivorship; dissemination
Jo Anne Earp, Sc.D., Professor	Health Behavior & Health Education	Behavior change (screening); disparities reduction; lay health advisors
Eugenia Eng, Dr.PH., Professor	Health Behavior & Health Education	Community-based intervention, participatory action; lay health advisors
Susan Ennett, PhD, Professor	Health Behavior & Health Education	Youth/adolescent health; tobacco, other risk behaviors
Marilie Gammon, PhD, Professor	Epidemiology	Cancer epidemiology (breast, esophageal), survivorship
Paul Godley, MD, PhD, Professor	Medicine, Epidemiology	Prostate cancer screening, patterns of care; clinical trials; disparities reduction
Laura Linnan. Sc.D., Associate Professor	Health Behavior & Health Education	Behavior change; worksite interventions; survivorship
Robert Millikan, D.V.M., PhD, Professor	Epidemiology	Cancer epidemiology; molecular epidemiology; DNA damage/repair
Merle Mishel, PhD, RN Kenan Professor	Nursing	Psychosocial support; survivorship; breast cancer, prostate cancer
Andrew Olshan, PhD, Professor, Chair	Epidemiology	Cancer epidemiology (head and neck, pediatric), risk and prevention
Michael Pignone, MD, MPH Professor	Medicine	Decision-making, physician-patient communication, clinical epidemiology, screening
Barry Popkin, PhD Professor	Nutrition	Diet, physical activity, social determinants, global health
David Ransohoff, MD, M.P.H., Professor	Medicine, Epidemiology	GI cancers, screening, epidemiology
Kurt Ribisl, PhD, Associate Professor	Health Behavior & Health Education	Tobacco and youth, tobacco policy, internet
Barbara Rimer, Dr.P.H. Dean, Alumni Distinguished Professor	Health Behavior & Health Education	Health communication, screening, survivorship, behavior change, dissemination
Robert Sandler, MD, M.P.H., Professor	Medicine, Epidemiology	GI cancer epidemiology, prevention, and early detection
Deborah Tate, PhD, Associate Professor	Nutrition, Health Behavior & Health Education	Diet, physical activity, community intervention, health communication
Melissa Troester, PhD, Assistant Professor	Epidemiology	Molecular epidemiology, breast cancer
Bryan Weiner, PhD, Professor	Health Policy & Administration	Adoption/dissemination of innovation; organizational theory and behavior
Morris Weinberger, PhD, Professor	Health Policy & Administration	Health literacy, quality of care / outcomes, patient -centered care, and primary care
Steven Zeisel, MD, PhD, Kennan Professor	Nutrition	Chemoprevention, diet and carcinogenesis

Evaluation
To assess fellows' progress, the Training Advisory Committee annually reviews and evaluates fellows. As part of the annual selection process, returning predoctoral fellows annually apply for fellowship positions along with new applicants. The application includes a statement of progress and plans for the additional year of funding. Postdoctoral fellows annually submit progress reports and training plans to the Training Advisory Committee. The Committee, in collaboration with the mentoring teams, reviews, modifies (as appropriate), and approves the reports and training plans. In addition, the Program's leadership meets every six months with fellows and mentor teams to assess progress and problems. CCEP leadership also conduct exit interviews with fellows completing the CCEP.