Mobilizing Newcomers and 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).
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Newcomer/Immigrant populations Less likely to participate in cancer screening Have later-stage cancer diagnosis (sometimes
present at stage of entry
And as a result More likely to experience unfavorable
outcomes from the disease
Why Do This Project?
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Project Solicitation Priority Removing barriers Raising awareness Promoting participation in cancer screening
and early detection among underserved populations
PHAC Cancer Program Community-Based Programming
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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, Ontario
Disseminate across Canada
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Project Partners
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Project Structure
Advisory Committee Members
PHAC
SWRCP
CCS CCLC LIHC SWRCP MLHU
Focus Group Facilitators
Admin Assistant Project
Coordinator
Spanish PHE (2)
Arabic PHE (2)
Iraqi PHE(2)
Evaluator Consultant
Nepalese PHE (2)
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Project Objectives
Increase awareness about cancer risk and prevention among newcomers and immigrants
Increase participation in cancer screening among these target populations
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Target population
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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Network with partners and organizations
Knowledge exchange
1. Awareness 2. Service Capacity 3. Service Use
Sustainable Partnerships
Train Peer Health Educators Develop cultural competency training for health care
workers
Promote screening facility usage
Develop education modules (Phase 1 & 2 focus groups)
Deliver cultural competency training for health care
workers Deliver education modules
Identification of promising practices
Community project initiatives
Organizational project initiatives
Long
-Ter
m
Out
com
es
Increased awareness
about cancer prevention
among target groups
Positive appraisal of ICS programs by the newcomer and immigrant communities
Increased knowledge of
challenges and barriers faced
by target groups
Develop increased cultural competency among service providers:
Reduced barriers, increased advocacy to accessing cancer screening services
Increased collaborations between the partnership and service
providers
Increased knowledge
about cancer screening
eligibility and accessibility
Activ
ities
Pr
ojec
t Co
mpo
nent
s Sh
ort-
Term
O
utco
mes
In
term
edia
te
Out
com
es
4. Partnership
Stronger commitment to ongoing funding, community and partner support
Inter-Agency project outcomes
Create sustainability
plan
Bridging project initiatives
Increased participation in and access to ICS
programs among newcomers and
immigrants
Develop evidence based cancer prevention and screening awareness model (MNICSP-PHAC) Output
Improve access to information, education,
screening and early detection
Increase health care providers’ understanding of
unique cultural needs
Increased collaborations between the partnership and target
groups
Intersection of Health Care/Primary Health, Community Development and Public Health
Similar goals and mandates
Varying experience with target populations
Shared capacity
Collaborative agreement
Partnership and Collaborative Action
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Respected member of target populations
English language
Target languages
Public speaking and presentation skills
Conflict resolution skills
Interest in promotion of healthy behaviours
Work flexible hours, evenings and weekends
The Peer Health Educator Team
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Phased Approach to Material Development
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Iceberg Concept of Culture and Cancer in Relation to non-Visible Barriers
Festivals Clothing Music Food Literature Language Rituals
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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
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Delivered by PHEs in their language
Child care offered and refreshments
Culturally-relevant/community locations
Reducing cancer risk (healthy living)
Breast, cervical and colorectal cancer screening programs
Video – sharing personal experience in cancer screening
“What increases your cancer risk” form
Booking mammogram and pap test appointments and arranging – “community appointments”
Workshops
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ABCDE Model for Cultural Competency Acknowledgements to Toronto
Hospital for Sick Children
Grand Rounds (1) and Evening Workshops (2) Dr. Bhooma Bhayana, Schulich School of Medicine and Dentistry Dr. Jan Owen, Primary Care Lead, Southwest Regional Cancer
Program Dr. Adriana Diaz, Project Coordinator
Health Care Providers – Cultural Competency Training
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Development of a Sustainability Plan “Model” Toolkit – development/dissemination Workshop Strategy for Targeted Communities Cultural Competency – build on what has been started…
Project Close-Out
Documentation of Project Evaluation Report and Final Report to PHAC
Next Steps
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Questions? Linda Stobo, Program Manager
Chronic Disease Prevention and Tobacco Control Middlesex-London Health Unit
Acknowledgements
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