PROJECT SUMMARY/ABSTRACT Appalachian Kentucky has significant challenges associated with health, socioeconomic, and education disparities. This predominantly rural region not only has the highest cancer incidence and mortality rates in the United States, it is also one of the most economically disadvantaged, medically underserved, and poorly educated regions of the country in which less than 1% of residents earn doctoral degrees. These disparities form the basis for the need to create targeted educational and scientific workforce preparedness and health literacy intervention strategies for this population. As such, the research, educational, and outreach strengths of the University of Kentucky's Markey Cancer Center will be leveraged to develop the Appalachian Career Training In ONcology (ACTION) Program as a Youth Enjoy Science education intervention. The ACTION Program will immerse underrepresented and underserved high school and undergraduate students from Appalachian Kentucky in cross-disciplinary mentored research projects, cancer care observational experiences, and cancer education and career development activities, as well as provide hands-on community and school outreach opportunities. The overarching goal of the program is to enhance cancer-focused biomedical workforce diversity in a high-risk, rural population and to increase the community's cancer-related literacy. Expected impacts of the program include: 1) increasing our students' matriculation into post-secondary, professional, and/or graduate science degree programs; 2) instilling in our students lifelong commitments to research, education/outreach, or health care careers focused on the cancer burden and unique challenges in Appalachian Kentucky and beyond; and, 3) enhancing the Appalachian Kentucky community's understanding of cancer research and clinical care, linking these facets to the benefits of science education. The overarching goal and the program impacts will be accomplished through four Specific Aims including: 1) developing participants' cancer research knowledge and skills through cross-disciplinary faculty-mentored research training experiences; 2) enhancing students' cancer- focused career preparation by providing didactic cancer education and career development mentoring through faculty-led courses, workshops, seminars, and career coaching and mentoring; 3) conducting outreach activities in participant communities to increase the understanding of the research and clinical aspects of cancer and the importance of science education among universities; primary and secondary school groups; civic organizations; health care providers; and the families and communities of our student participants; and, 4) evaluating program progress and impacts, focusing on longitudinal participant data (including tracking progression of participants through their academic and professional careers) and outreach activity efficacy. Ultimately, the program will establish a new paradigm for enhancing cancer-focused educational preparation among rural, low- socioeconomic students and increasing citizens' understanding of cancer and the importance of science education in rural, low-socioeconomic and low-education-attainment areas.

PROJECT NARRATIVE Kentucky has the highest all-site cancer incidence and mortality rates in the United States with the highest burden of cancer localized to the Appalachian region of the state. Residents of Appalachian Kentucky also experience high rates of poverty and below-average education attainment. To address these issues, we will create the Appalachian Career Training In ONcology (ACTION) Program, which proposes a new paradigm to foster cancer- focused education and training for students from rural, low-socioeconomic, and low-education-attainment communities and to develop a better understanding of cancer and the benefits of cancer education within such underserved communities.