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

linda.stobo@mlhu.on.ca

Acknowledgements