Abstract 

Newswise — Over the last two decades, strides in cancer prevention, earlier detection, and novel treatments have reduced overall cancer  mortality; however, cancer health disparities (CHD) persist among demographically diverse and intersecting populations.  The development of a culturally responsive workforce trained in interdisciplinary, team-based science is a key strategy for  addressing these cancer disparities. The Cancer Research – Scholarship and Training Experience in Population Sciences  (C-STEPS) program at the University of New Mexico Comprehensive Cancer Center is designed to increase and diversify  the biomedical and behavioral research workforce by providing specialized and experiential curricula that highlight team oriented cancer control and population science. Undergraduate students interested in CHD and in pursuing STEM-H (science,  technology, engineering, mathematics, and health) graduate or professional degrees are eligible for the program. C-STEPS  students are paired with a UNM faculty mentor, who guides the student’s 10-week summer research experience. They receive  mentorship and support from three layers—faculty, near-peers (graduate students), and peers (undergraduates who have  completed the C-STEPS program previously). Students generate fve products, including a capstone presentation, grounded  in the research they conduct with their faculty mentors. Since its founding in 2021, C-STEPS has trained three cohorts with  a total of 32 students. The C-STEPS program provides a unique team-science approach with multilayer mentoring to create  a sustainable pipeline for the development of students interested in STEM-H felds and CHD research. The capstone project  led to 47% of students presenting their work at conferences, and two publishing their manuscripts in peer-reviewed journals.  Overall, 89% of students were either “satisfed” or “very satisfed” with the program and the same percentage recommended  the program to other undergraduates.

Introduction
For more than two decades, public health eforts in the United States (US) have focused on reducing overall cancer mortality [1, 2]. Strides in cancer prevention, earlier detection, and treatments have contributed to a reduction in cancer deaths [1]. However, cancer health disparities (CHD) persist among communities with diverse and intersecting demographic characteristics, including race/ethnicity, sexual orientation and gender identity, age, socioeconomic status, geography, and health literacy [2–6]. National organizations, including the National Institutes of Health (NIH), call for the development of a culturally responsive workforce trained in interdisciplinary, team based science to address CHD [7, 8]. In response to the President’s Council of Advisors on Science and Technology (PCAST) report [9], the “Cancer Research Scholarship and Training Experience in Population Sciences” (C-STEPS) program was created to address the national need for more and better prepared STEM-H (science, technology, engineering, mathematics, and health) professionals [10, 11]. C-STEPS, conducted at the University of New Mexico Comprehensive Cancer Center (UNMCCC), is responsive to PCAST recommendations including (1) the use of active learning that is learner-centered rather than instructor-centered [12]; (2) employment of experiential learning in which students engage in mentored discovery-based research; and (3) facilitation of early career and skill-building opportunities via a summer research experience [11]. Mentoring design includes faculty, near-peer, and peer mentors to provide the most support for students [12]. Evidence supports that active learning increases stu- dent engagement, academic achievement, and recollection of information [13]. Likewise, experiential learning enhances student enthusiasm and confdence for a particular feld, making it less likely for them to leave [14, 15]. Importantly, summer research experiences better prepare students for and retain them in STEM-H felds, improve communication skills, encourage collaboration, and increase admissions to graduate programs [11, 16–18]. Summer research programs designed to be inclusive of students from underrepresented backgrounds support national goals to diversify the workforce [19]. In addition to the PCAST guidelines, C-STEPS focuses on cancer control and population science (CCPS). New Mexico is an ideal location for a summer undergraduate research program focused on CHD and CCPS because it is one of the nation’s fve “minority-majority” states based on the 2020 census data [20] and exhibits stark diferences in cancer incidence, mortality, survival, and screening patterns among its multiethnic, multicultural population. The UNMCCC’s CCPS Research Program and faculty provide expertise in cancer risk and risk prediction, cancer screening, and cancer care delivery and survivorship research.

 

C-STEPS seeks to increase and diversify the biomedical and behavioral research workforce by providing specialized, experiential, and team-oriented CCPS curricula. In this paper, we describe the innovative characteristics of C-STEPS and summarize the outcome measures we use to evaluate the program. The program as outlined here may serve as a resource for others interested in establishing or refning a CCPS-focused summer research experience for undergraduate students. C‐STEPS Program Description C-STEPS aims to (1) develop content knowledge of cancer through inquiry-based research seminars; (2) provide a skill-based, student-oriented, mentored research experience; and (3) provide specifc opportunities to implement STEM-H career development and planning. Since its inception in 2021, C-STEPS (https://unmhealth.org/cancer/career/training-education/csteps.html) has led three cohorts of students through the program (Table 1). Of the three cohorts thus far,
C-STEPS students come from 19 institutions in 14 states across the US. Each year, 10–12 undergraduate students are selected to participate in a 10-week cancer research immersion experience at the University of New Mexico (UNM)

Health Sciences Center (HSC) and its Comprehensive Cancer Center (CCC) in Albuquerque, NM. The students dedicate 40 hours per week to the program and receive a stipend and tuition for a one-credit biomedical seminar. C-STEPS provides student housing, and the program reimburses students for research-related expenses.

C-STEPS partners with UNM HSC’s established Undergraduate Pipeline Network (UPN; https://hsc.unm.edu/ medicine/education/reo/undergraduate/upn/; Jennifer Gillette, Director) summer research program to ofer a focused summer research experience based on the health sciences. C-STEPS students engage in diverse learning experiences tailored to their mentor’s research project (Table 2). Students interact with the general UPN cohort through weekly seminars and team-building activities (Table 2). Students from both programs participate in the UPN Research Symposium at the end of the summer. In addition to UPN requirements, C-STEPS students participate in weekly inquiry-based can- cer-focused research seminars facilitated by UNM CCC faculty. Before their arrival, students are required to complete standard research, ethics, compliance, and safety training through the CITI program and conficts of interest training through UNM HSC [21].

Recruitment and Admission

C-STEPS recruits undergraduate students from across the country interested in CHD-related felds and pursuing STEM-H graduate or professional degrees. To support the diversifcation of a cancer-focused workforce representative of the individuals seeking cancer prevention, treatment, or survivorship care, C-STEPS supports applicants from underrepresented groups within the biomedical, clinical, behavioral, and social sciences. The minimum requirements to apply include current enrollment at a university, 3.0+GPA, 30–100 credit hours completed, and graduation no sooner than one semester after the program concludes. Additional considerations include an educational background that is consistent with C-STEPS goals and a demonstrated interest in translational cancer research. Students apply through the online UPN application portal from October to February. UPN flters applications that meet minimum qualifcations and indicate interest in cancer and/or health disparities research and forwards them to the C-STEPS selection committee, composed of the program’s faculty and staf. UPN forwards applicants to C-STEPS for review each year. Each committee member independently completes a structured assessment of each student’s coursework, previous employment and/or research/volunteer experience, research interests, personal statements, and recommendation letter(s) using a developed rubric and standardized criteria. Once completed, the combined scores are ranked. The committee organizes the applicants into “admit,” “waitlist,” and “not accepted” categories. To be accepted or on the waitlist, the student must meet all of the minimum requirements, then those with higher scores are frst to be ofered acceptance letters. As students accept or decline their ofers, acceptance letters to the waitlisted students go out based on scores.

Program Evaluation

Pre-/post-seminar surveys measure changes in knowledge among C-STEPS students in current and emerging CCPS topics, self-efcacy in research skills, confdence to suc-
ceed in the STEM-H field, comfort with research, and career aspiration. The Capstone Event poster and virtual presentations provide an opportunity for formal feedback
on students’ science communication skills. The long-term tracking of C-STEPS students’ academic trajectory will be conducted through the National Student Clearinghouse, which provides access to enrollment and degree completion information. Bi-annual “alumni surveys” in REDCap track the long-term achievements of students—asking if students chose to pursue graduate or professional schools and about other information related to the utilization of the research they conducted during the program (e.g., awards, research dissemination). At the end of each summer, the C-STEPS program team conducts interviews with the faculty mentors and focus groups with the students to evaluate areas for improvement and highlight successes. Throughout the program, we discuss both short-term and long-term outcomes with students. Short-term outcomes include presenting their research at regional and national conferences and publishing in national journals. Currently, 47% of C-STEPS students have presented their research at conferences, and four have submitted manuscripts to peer-reviewed journals, with two accepted.

Looking ahead, the program aims for long-term outcomes such as students pursuing graduate or professional schools related to STEM-H felds and building careers in cancer biology or population science. The January 2024 alumni survey showed that out of 27 respondents, 18 are enrolled in undergraduate programs, eight have graduated, and one is in medical school. When asked about their primary long-term career goals, there were 26 responses from all three cohorts. Forty-six percent wish to practice medicine, 19% to work in allied health professions, 15% in industry research, 12% in university research, 4% in public health with underprivileged communities, and 4% to pursue a master’s in public health. While many C-STEPS students are still pursuing their undergraduate degrees, they have shared feedback on the program’s impact. One student noted, “C-STEPS has made it much more efcient to integrate yourself into the research world. After leaving, it was simple to reach out to researchers.” Another student mentioned, “C-STEPS helped me tremendously to confidently seek out mentors to teach and guide my professionaland academic development. It has also solidifed my passion for a healthcare career, specifcally treating patients of marginalized backgrounds.” Through three cohorts, students clearly and consistently indicate they feel more prepared for graduate school after completing their C-STEPS summer research experience. This is consistent with our fndings from the January 2024 alumni survey in which 89% of respondents reported being “satisfed” or “very satisfed” with the C-STEPS program. One student stated: “C-STEPS has helped me continue working in research and helped with my application/ drive to pursue a medical career. C-STEPS has [created] opportunities for academic/research growth.” Another student noted: “My experience studying toxicology [with C-STEPS] has convinced me to integrate my passion for research into my long-term career plans, where before this summer I was not sure if I would want a career in the basic sciences following graduation.” Overall, student satisfaction with the C-STEPS program is high and 89% of individuals have suggested that other undergraduates should apply.

Innovation

C-STEPS augments the NIH’s cancer-focused summer research experience program framework with several distinctive and innovative design features [18, 23, 24]. First, C-STEPS provides multilayered mentoring from faculty, near-peers, and peer mentors to facilitate learning from multiple mentors in various stages of their research careers. Second, the program models the importance of team education and team science to create a sustainable pipeline for cancer research. Such an environment replicates the real-world collaborative science to which future scholars will contribute. Third, C-STEPS prioritizes career exploration and planning by exposing students to a variety of undergraduate, graduate, and professional pathways and perspectives from the multiple layers of mentorship. In addition to NIH’s framework, the C-STEPS program has implemented many innovations to achieve our aims better and make the research experience more accessible to the students (Table 3). These innovations are based on feedback from students, mentors, peer mentors, and the C-STEPS team members throughout the past three summers.

 

Limitations 

C-STEPS has at times encountered challenges communicating with students and mentors, resulting in an occasional lack of clarity regarding program expectations. To
address this challenge, C-STEPS developed and distributed comprehensive handbooks for mentors, peer mentors, and students. To date, nearly all of the mentor-mentee
pairs have been productive, collaborative, and yielded positive experiences for both parties. The mentor-mentee match is fundamental to student success. For matches that did not pair well, C-STEPS promptly and discreetly discussed the concerns with the mentor and the student. In the rare event of an irresolvable situation, C-STEPS reassigned the student to a diferent mentor who was available and identifed as a better ft. Based on these experiences, we continue to fne-tune the process to match students and faculty mentors. For current R25 PIs, or those looking to start an R25, we recommend the following:
1) Create a system for involving and coordinating peer mentors to support the participant-peer mentor connection efectively.
2) Collaborate with mentors who can commit to weekly meetings with their mentees.
3) Partner with mentors who are actively engaged in their projects to provide more efective guidance to their mentees.

Conclusions 

C-STEPS is generating a pipeline of well-rounded translational researchers. The C-STEPS program is distinctive in its multilayered mentorship structure and its location in New Mexico. As the only summer research experience focusing on CCPS in the state of New Mexico, our program exposes students to geographically and demographically diverse environments and health disparities not experienced in other parts of the country. Furthermore, C-STEPS students have been consistently showcasing their research at national conferences, in which there have been 11 presentations thus far. Overall, the experiences of the C-STEPS program may serve as a model to establish or refne a CCPS-focused summer research experience for undergraduate students.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1007/s13187-024-02458-1
.
Acknowledgements

The authors also gratefully acknowledge the project’s External Advisory Committee members (Drs. Shine Chang, Jani Ingram, and Robin Harris) for their thoughtful insights and comments on the manuscript and the contributions of Monica Asencio Pimentel, who participated in the early stages of this manuscript’s development.

 

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