Mobilizing Newcomers and Immigrants to Cancer Screening Programs
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Transcript of Mobilizing Newcomers and Immigrants to Cancer Screening Programs
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Mobilizing Newcomersand Immigrants to Cancer Screening Programs
Funded by Public Health Agency of Canada (PHAC)The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada (PHAC).
Adriana Diaz, Project Coordinator, South West Regional Cancer Program
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Newcomer/Immigrant populations Less likely to participate in cancer screening Have later-stage cancer diagnosis (sometimes
present at stage of entryAnd as a result More likely to experience unfavorable
outcomes from the disease
Why Do This Project?
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Project Goal
Develop, deliver and evaluate evidence-based cancer prevention and screening
service delivery model
Targeted to newcomer and immigrant under/never screened populations in
London, OntarioDisseminate across Canada
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Project Deliverables
Reduce barriers that limit access to cancer prevention/screening information and cancer screening programs
Increase awareness about cancer prevention and screening
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Project Deliverables
Improve cultural safety of immigrant and newcomer cancer care experience
Promote participation of immigrants and newcomers in cancer screening and early detection
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Project Structure
Advisory Committee Members
PHAC
SWRCP
CCS LIHC
SWRCP
MLHU
Focus Group Facilitators
Admin Assistant
Project Coordinator
Spanish PHE (2)
Arabic PHE (2)
IraqiPHE(2)
Evaluator Consultant
Nepalese PHE (2)
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Target populati
on
Immigrant communities
Arabic Spanish Iraqi Nepalese
Health Providers
Middlesex London
Health Unit
PCP, Nurse practitioners
and PCP office staff
OBSP LRCP
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PHEs “represent the intersection between risk and resilience, between institution and community, and between research and practice” (Landers & Stover, 2011, p.2198)
The Institute of Medicine (2002) recommended that PHEs be included on multidisciplinary health care teams to address issues in serving racial and ethnic populations that face chronic barriers in accessing the health care system
Peer Health Educator (PHE) Model
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Roles: preventative and health education interactions with other Health Human Resource (HHR) Research and health system access and navigation
PHEs have strong ties, based on trust, respect, and mutual understanding, with the communities they serve PHEs understand the needs of their communities, mainly because they have lived and experienced those needs
Peer Health Educator (PHE) Model
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Peer Health Educator TrainingTrainingOrientation to the Project
Integrated Cancer Screening/Prevention Education
Training
Focus Group Facilitation Training
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Phased Approach to Material Development
Phase 1Determine
Barriers and Knowledge
Phase 2Test
Education Model
Phase 3Deliver Final
Education Product
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Phased Approach to Material Development
Phase 1Determine
Barriers and Knowledge
Phase 2Test
Education Model
Phase 3Deliver Final
Education Product
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Language“There are many brochures but they do not answer my questions. In our Latino culture we are more personal. I would like the information in person where I could ask in my own language. We do not want to read those and then look on websites or call that number” Spanish Participant
Community Evidence-Based Barrier
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Community Evidence-Based Barrier
Knowledge“If I have an abnormal pap test or if I have cervical cancer, my husband should leave me…I would be disowned by my husband. I will not go… I have 4 kids”
Arabic participant
“Why does the doctor ask if I have relatives with cancer? Is it because it is contagious? Could I infect others?”
Nepalese participant
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Community Evidence-based Barrier
Accessibility “My mom had a medical appointment, so I had to go with her to be an interpreter. When we were in, I asked for a breast screening test – a mammogram – for my mom……the answer was you need to book another appointment to talk about it. I do not have time and get permission…it is not easy… it is another barrier.”
Spanish participant
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Phased Approach to Material Development
Phase 1Determine
Barriers and Knowledge
Phase 2Test
Education Model
Phase 3Deliver Final
Education Product
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Cultural differences among target populations necessitates
Customized presentations
Mobilizing Newcomers and Immigrants to Cancer Screening Programs
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Next Steps
Develop test
materials
Focus test materials
Review & ReviseDeliver KTE
Evaluate and Refine
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Phased Approach to Material Development
Phase 1Determine
Barriers and Knowledge
Phase 2Test
Education Model
Phase 3Deliver Final
Education Product
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Delivered by PHEs in their language
Child care offered and refreshments
Culturally-relevant/community locations
Workshops
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Reducing cancer risk (healthy living)
Breast, cervical and colorectal cancer screening programs
Workshops
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Video – sharing personal experience in cancer screening
“How to reduce your risk” form
Booking mammogram and pap test appointments and arranging – “community appointments”
Workshops
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Peer Health Educators ‐ Approach communities in a culturally
sensitive manner ‐ Build trust in communities‐ Deliver information in own language‐ Deliver information with understanding of
culture, traditions and behaviors‐ Find the right location
Learning Points
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Use healthy living examples to help overcome fear and anxiety of cancer
Immigrant communities participate in cancer screening programs when the purpose, access to programs, and procedures are understood
Learning Points
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ABCDE Model for CulturalCompetency
Acknowledgements to SickKids Hospital in Toronto
Grand Rounds LRCP (1) and Evening Workshops (2)Dr. Bhooma Bhayana, Schulich School of Medicine and
Dentistry Dr. Jan Owen, Primary Care Lead, Southwest Regional
Cancer ProgramDr. Adriana Diaz, Project Coordinator
Health Care Providers – Cultural Competency Workshops
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Thank you