Center for Advancing Health Equity in Rural and Underserved Communities

Utilizing implementation strategies to enhance screening and early detection of colorectal, prostate, liver, breast, and cervical cancers.

Rural Health Coalition

The Rural Health Coalition aims to:

• Achieve efficiencies through regular coalition partner meetings and the launch of a survey to understand provider and community needs

• Address the barriers to local rural healthcare delivery through the development of a strategic plan

• Strengthen rural healthcare delivery through health systems evaluation, provider education, and intervention to address local barriers

• Expand access to the quality of basic healthcare services and health outcomes by including social determinants of health

• Utilize the collective RHC vision to develop sustainable models and expand goals for future funding opportunities

Benchmarks for Partner Success

• Engage all levels to identify gaps in rural healthcare

• Understand health system needs through engagement

• Plan and implement strategies, tailored from survey findings

• Focus on sustainable models and expanded goals

Current Initiatives

Engaged Coalition Meetings

• Program meetings held with partners, to learn organizational strengths and perspectives

• Leadership team identified main barriers to rural healthcare service delivery

Environmental Scan

• Use a mixed methods approach, to focus in on areas such as:

  • Workforce Shortages

  • Sources of Clinical and Research Information

  • Community to Clinical Linkage

Mobile Health

• Partnering with Penn State specialists and the Penn State Mobile Units to bring care to FQHC locations

• Offering screenings and primary care in low resource communities

PA-wide Initiatives

• PA Office of Rural Health

• Farm Bureau

• Extension Offices

• Mobile Clinics

Penn State Partnerships

• Cancer Institute

• Endocrinology Dept.

• Ophthalmology Dept.

View a downloadable PDF of Rural Health Coalition information.

Pennsylvania Colorectal Cancer Alliance to Reduce Mortality and Enhance Screening (PA-CARES)

Centers for Disease Control & Prevention (CDC) - Public Health and Health System Partnerships to Increase Colorectal Cancer Screening in Clinical Settings

Image description: A map of Pennsylvania shows colorectal cancer screening rates (crude prevalence) among adults aged 45–75 years in 2022. Counties are color-coded into five ranges of screening rates with a state average of 66.9%. Health networks and institutions involved in networks are Penn State College of Medicine (central Pennsylvania), Broad Top Area Medical Center (south-central PA), KeyStone Rural Health Center (south-central PA) and Rural Health Corp of NEPA (northeastern PA). Five Penn State Health hospitals are numbered on the map: Milton S. Hershey Medical Center, Hampden Medical Center, St. Joseph Medical Center, Lancaster Medical Center and Holy Spirit Medical Center.

Project Aim

The overall purpose of PA-CARES is to establish a multifaceted framework to increase organized approaches to colorectal cancer (CRC) screening and prevention, in partnership with a diverse group of healthcare systems. We aim to increase CRC screening rates by implementing evidence-based interventions (EBIs) in primary clinics and health systems. PA-CARES serves a defined target population of persons 45-75 years of age within partner health systems, defined geographical area (Pennsylvania), and disparate populations.

Partners

Penn State College of Medicine, Penn State Health Clinics, Penn State Cancer Institute, Broad Top Area Medical Center, Keystone Rural Health Center, Rural Health Corporation of Northeastern Pennsylvania

Project Period

September 2025- June 2030

Implementation Goals

• Conduct clinic-level organizational readiness assessments during the pre-implementation phase to assure organizational capacity/readiness to implement EBIs and identify resources needed

• Implement multiple EBIs to target multilevel influences that hinder the recommendation and uptake of CRC screening

• Utilize supportive strategies and technology to accelerate and facilitate the adoption and impact of the selected EBIs

• Establish a referral network with each health system to facilitate timely linkage to care, including follow-up diagnostic colonoscopy and cancer treatment

PA-CARES Leadership Team

• Fornessa T. Randal, EdD, MCRP, Principal Investigator

• Karen Kim, MD, MS, Dean, Penn State College of Medicine

• Raymond J. Hohl, MD, PhD, Director, Penn State Cancer Institute

• Mack T. Ruffin, MD, Co-Investigator

PA-CARES Project Team

• Paula Lozano, PhD, Evaluator

• Chieko Maene, MS, Data Manager

• Passang Gonrong, MPH, Senior Program Manager (pgonrong@pennstatehealth.psu.edu)

• Madeline Bernard, MPH, Program Implementation Manager (mbernard2@pennstatehealth.psu.edu)

View a downloadable PDF of PA Cares information.

Screening, education, and prevention of common diseases, such as hepatitis, diabetes, cardiovascular disease, as well as vital programs to address health literacy, vaccine confidence, and language access.

INSPIRE PA

(Increasing Networks of Specialty Providers to Improve Rural Engagement in PA)

INSPIRE PA, led by the Center for Advancing Health Equity in Rural and Underserved Communities (CAHE-RUC), connects with specialty care providers across health systems in rural and underserved communities in Pennsylvania, improving access to critical services like dermatology, ophthalmology, cardiology, and endocrinology.

Why does it matter?

Rural communities face significant barriers to specialty care, contributing to poor health outcomes in areas like diabetes, cancer, and maternal-child health. INSPIRE PA bridges these gaps by coordinating care across systems and targeting regions with the greatest need—ensuring that no community is left behind.

Our Strategy

INSPIRE PA uses a data-driven, community-centered approach to expand access to specialty care in rural Pennsylvania.

• Data-Driven Targeting: We use health indicators—such as diabetes prevalence, cancer rates, and maternal-child health outcomes—to pinpoint rural areas most in need of specialty services.

• Coordinated Specialty Provider Mobilization: By aligning health systems, we bring specialists directly to underserved regions, fostering integrated, silo-free care.

• Community Outreach & Education: Through mobile units, local events, and trusted partners, we engage residents to build trust and promote the value of specialty care.

• Continuity of Care Through Follow-Up Tracking: Initial outreach showed 30% of participants needed follow-up care. We use this insight to refine referrals and ensure ongoing support.

Impact

Launching in 2025, INSPIRE PA has reached multiple counties across central PA such as Franklin, Huntingdon, Perry, Northumberland, and Dauphin. We are continuously engaging with the community and with specialists to create a multisystem collaboration that brings specialists to the areas that need it the most.

Current Partners

• LION Mobile Unit

• Penn State Community Outreach

• Rural Health Coalition

• Penn State Health

We want to hear from you!

If you need a specialist in your area or have ideas for other health needs, please fill out our survey or email us at inspirePA@psu.edu.

View a downloadable PDF of this information.

Increasing awareness about mental health, substance use and social justice issues among communities of color and connection to culturally tailored resources.

Youth Advisory Cancer Council

Cancer remains one of the leading causes of death in the U.S., and early education is key to prevention. Yet many young people lack access to relevant, relatable health information. By putting youth at the center of this initiative, the program not only increases their knowledge of cancer prevention but also empowers them to become confident health advocates. This program is built on the belief that youth are not just future leaders — they are leaders now.

Program Overview

The Youth Advisory Cancer Council (YACC) is a program designed to engage high school students from across central Pennsylvania in cancer prevention and education. Through structured training, mentorship, and creative collaboration, youth participants will implement projects that raise awareness about cancer-related topics in their communities.

Strategies

• Recruitment: Select Central PA high school students (ages 14–18) for the YACC.

• Training & Mentorship: Deliver expertled sessions on cancer prevention, advocacy, and communication.

• Youth-Led Co-Design: Guide students in co-creating cancer education and support materials.

• Evaluation & Impact: Measure gains in knowledge, advocacy, and confidence via surveys and feedback.

Community Partners

• Kristen Olewine Milke CARE Center

• We CARE Medical Student Board

• Food as Medicine initiative at Penn State Family and Community Medicine

Email YACC@psu.edu for more information.

View a downloadable PDF of this information.

National biomedical research engagement and recruitment for Asian Americans, Native Hawaiians, and Pacific Islanders.

• All of Us Research Program & AANHPI Engagement and Recruitment Core

• MOSAAIC Research Study

• Lozano, P., Peters, A., Southworth, A., Mo, Y., Lam, H., Randal, F. T., & Kim, K. E. (2024). Smoking behavior among Asian Americans during the initial phase of the COVID-19 pandemic: The influence of pandemic stressors and depression. Tobacco Induced Diseases, 22.

• Sharp, M., Lozano, P., Southworth, A., Peters, A., Lam, H., Randal, F. T., … & Kim, K. E. (2024). Mixed methods approach to understanding COVID-19 vaccine hesitancy among immigrants in the Chicago. Vaccine.

• Lozano, P., Veitch, Z., Sharp, M., Southworth, A., Randal, F. T., & Kim, K. E. (2024). A Mixed-methods Approach to Understanding Language Interpretation Services in Health Care Settings among Asian American Immigrants from Diverse Ethnic Backgrounds. Journal of Health Care for the Poor and Underserved, 35(3), 85-101.

• Randal, F. T., Lozano, P., Qi, S., Maene, C., Shah, S., Mo, Y., … & Kim, K. E. (2023). Achieving a Representative Sample of Asian Americans in Biomedical Research Through Community-Based Approaches: Comparing Demographic Data in the All of Us Research Program with the American Community Survey. Journal of Transcultural Nursing, 34(1), 59-67.

• Lozano, P., Randal, F. T., Peters, A., Aschebrook-Kilfoy, B., Kibriya, M. G., Luo, J., … & Kim, K. E. (2023). The impact of neighborhood disadvantage on colorectal cancer screening among African Americans in Chicago. Preventive Medicine Reports, 34, 102235.

• Lozano, P., Rueger, S. Y., Lam, H., Louie, N., Southworth, A., Maene, C., … & Kim, K. (2022). Prevalence of depression symptoms before and during the COVID-19 pandemic among two Asian American ethnic groups. Journal of immigrant and minority health, 1-9.

• Randal, Fornessa T., et al. (2022). Establishing a national engagement strategy for recruiting Asian Americans and other minorities into biomedical research. Progress in Community Health Partnerships: Research, Education, and Action 16.3, 349-359.

• Randal, F. T., Lozano, P., Qi, S., Mo, Y., Lam, H., Kim, K. (2021). Do the Demographic Characteristics of the Asian American Cohort in the All of Us Research Program achieve a representative sample of Asian Americans? Journal of Racial and Ethnic Health Disparities (REHD-D-20-00715).

• Kim, K. E., et al. (2020). Implementing a Multilevel Intervention to Accelerate Colorectal Cancer Screening and Follow-up in Federally Qualified Health Centers Using a Stepped Wedge Design: A Study Protocol. Implementation Science 15: 96.

In partnership with the Asian Health Coalition, the center has many publications available to educate and expand awareness of how to address health disparities prevalent in our communities. Please contact CAHE-RUC at chandapangoda@pennstatehealth.psu.edu for more information.