ucan general membership meeting march 28, 2019 · 3/28/2019 · male 359 44.5 209 43.1 age at...

UCAN GENERAL MEMBERSHIP MEETING

MARCH 28, 2019

UpdateUCAN Strategic Plan

March 28, 2019

Input: 2018 Strategic Planning Process“To develop a strategy for UCAN to effectively implement the Utah State Cancer Plan.”

Output: 2018 Strategic Planning Process

Organizational Chart

Strategic Steps Presented at 2018 Q4 Mtg

✓ Release RFP for funded projects

✓ Codify by-laws

✓ Plan for State Conference

❏Develop Administrative Team

❏Develop sub-committees

Strategic Steps 2019➢ Plan for State Conference

Date: September 27, 2019Theme: “Public Health & Preventive Medicine: Translation in Action”

➢ Develop Administrative Team

➢ Develop Subcommittees

➢ Schedule Quarterly MeetingsQ1: Strategic Plan Update / UCAN Funded ProjectsQ2: Capacity BuildingQ3: State ConferenceQ4: Annual Plan / Celebration / Recognition / Awards

Cancer Survivor

Experiences Project

(CASES)

Judy Ou, PhD MPH

Evaluator/Analyst

Utah Cancer Registry

March 2019

Introduction

Utah Cancer Registry obtained funding from CDC to

partner with UDOH and UCAN to develop and

implement a survey assessing survivors' status on issues

such as access to health care and quality of life.

Short term goal:

–Develop and conduct a survey of cancer survivors

addressing issues including access to health care and

quality of life

Long term goal:

–Use survey data to support evidence-based policy changes

Partner Organizations and Data providers

Utah Cancer Action Network (UCAN)

Utah Department of Health (UDOH)• Utah Behavioral Risk Factor Surveillance System (BRFSS)

• Statewide survey administered every year to a random

sample of Utahans to monitor health status and identify

community health problems.

• Cancer Control Program


University of Utah academic researchers

Utah Cancer Plan: Survivorship and Quality of

Life Targets for Change

Utah Cancer Plan: Survivorship and Quality of Life Targets for Change

Survey Methods

Eligibility

Aged ≥18 at diagnosis; diagnosed in Utah between 2012 and

2016; SEER-reportable invasive or benign brain/CNS tumor; living in Utah in 2018

Sampling strategy

Identified 807 potential participants

– 533 in small health statistical areas with highest percent with no

health care coverage (Low SES)

– 267 in small health areas with lowest percent with no health care

coverage (Higher SES)

Recruitment and data collection

Recruitment May to November 2018; participants aged 18 to 79

years sent a $2 incentive and letter with link to an online survey; participants aged ≥80 years sent a paper questionnaire; surveys

were in English

Differences Between BRFSS and CASES

BRFSS

Random sample of

Utah population

Participants asked if

they EVER had cancer

• If yes, administered

cancer survivor

module

Telephone survey

CASES

Random sample of

known cancer

survivor population

Diagnosed from

2012 to 2016

Online and paper

survey

Table 1. CASES participant characteristics, 2018

Eligible Sample Respondents

N % N %

Total1 807 485

Insurance coverage by small area

Highest % no health care coverage (Low SES) 515 63.8 289 59.6

Lowest % no health care coverage (High SES) 292 36.2 196 40.4

Sex

Female 448 55.5 276 56.9

Male 359 44.5 209 43.1

Age at diagnosis

0 to 39 years 97 12.0 43 8.9

40 to 64 years 399 49.4 243 50.1

65 to 95 years 310 38.4 199 41.0

Cancer Site2

Breast 145 18.0 103 21.2

Melanoma 107 13.3 72 14.9

Prostate 138 17.1 86 17.7

Colorectal 70 8.7 36 7.4

Brain And Central Nervous System 62 7.7 22 4.5

1Response rate = 60%; 2Five most common cancer sites shown

TargetBaseline

%1

Utah 2020

Target %

2018

CASES %2,3

Increase statewide cancer patient

enrollment in clinical trials.5.6 8.0 7.5

Increase the proportion of cancer patients

receiving survivorship care plans.44.5 50.0 60.24

Increase the proportion of cancer patients

and survivors reporting their pain is under

control.

88.6 94.0 91.2

1Baseline established with the 2010 BRFSS data or age-adjusted using the 2014 BRFSS; 2Percentages

weighted to the 2000 US Standard Population and account for stratification by small health area; 3CASES and

BRFSS results are not directly comparable as CASES participants are diagnosed in 2012 to 2016; 4Only

includes cancer survivors who no longer receive treatment; 22.9% if all respondents included

Table 2. Targets for Change, 2016-2020 Utah State

Cancer Plan

TargetsBaseline

%1

Utah 2020

Target %

2018

CASES %2,3

Increase the proportion of cancer survivors

reporting “Excellent”, “Very Good”, or

“Good” physical health.

79.1 83.0 86.4

Decrease the proportion of cancer patients

and survivors who are current smokers.19.4 17.0 7.0

Decrease the proportion of cancer patients

and survivors reporting limitations in their

usual activities due to physical, mental or

emotional problems.

38.7 35.0 48.2

Decrease the proportion of cancer

survivors reporting life dissatisfaction.5.2 4.0 7.5

1Baseline established with the 2010 BRFSS data or age-adjusted using the 2014 BRFSS; 2Percentages

weighted to the 2000 US Standard Population and account for stratification by small health area; 3CASES and

BRFSS results are not directly comparable as CASES participants are diagnosed in 2012 to 2016

Table 2. Targets for Change, 2016-2020 Utah State

Cancer Plan

Next steps

2019 CASES study population will include

persons diagnosed from 2013 to 2017

2019 survey distribution will begin in April

–Spanish-language letter and survey

Evaluation of Utah State Cancer Plan using

2018 CASES data and 2010 and 2017 BRFSS

cancer survivor module

© U N I V E R S I T Y O F U T A H H E A L T H , 2 0 1 7

ACKNOWLEDGEMENTS

Utah Department of Health

Brad Belnap, MPA

Natalie Loots, MPH, CPH, CHES

University of Utah/Huntsman

Cancer Institute

Anne C. Kirchhoff, PhD


Carol Sweeney, PhD

Lori Burke

Marjorie Carter, MSPH

Sandie Edwards, MA

Mandy Giles, BS

Kate Hak, BS

Kimberly Herget, MStat

Morgan M. Millar, PhD

Valerie Yoder Otto, BS


FUNDING

Utah Cancer Registry is supported by:

– National Program of Cancer Registries (NPCR)• Grant 5 NU58DP006320-02-00

– Surveillance, Epidemiology and End Results

program (SEER)

– University of Utah

– Huntsman Cancer Institute

20


QUESTIONS

Contact info: [email protected]

State Cancer Plan Implementation Projects• Received 9 applications

• 4 PA/Nutrition, 2 Survivorship, 2 Skin, 1 Screening• 4 organizations new to UCAN

• Five applications selected for funding• Projects run June 30, 2019 – June 29, 2020• FY2020 (year 1) appropriation: $94,960

University of UtahGet Healthy Utah

Wasatch Community GardensAlliance Community Services

International Rescue Committee

Leveraging an existing mobile health clinic to

decrease structural and financial barriers to

colorectal cancer screeningCo-Principal Investigators: Jessica Cohan, MD, MAS & Sheetal Hardikar, MBBS, PhD, MPH

• Colorectal cancer is

the third most

common incident

cancer globally

• The American Cancer

Society estimates

101,420 new cases of

colorectal cancer in

the US in 2019

Colorectal cancer: global statistics

Top 10 cancer types for estimated cases and

deaths worldwide for both sexes combined

Global Cancer Statistics 2018:GLOBOCAN estimates

Colorectal cancer screening recommendations

Current USPSTF recommendations:

- Annual stool-based test (including FIT)

- CT colonography or flexible sigmoidoscopy every 5 years

- Colonoscopy every 10 years

No specific recommendations for those with a higher risk for CRC,

including family history of CRC

Shi L, et al. J Health Care Poor Underserved 2011;22:945-61.MMWR 2015. 64(17); 464-468.

Adherence to recommended colorectal cancer

screening guidelines in US adults (National Health

Interview Survey)

0%

25%

50%

75%

2000 2008 2013

Non-Hispanic White African-American Asian Hispanic

Colorectal cancer: Prevalence of screening

Colorectal cancer screening rates in Utah

Colorectal cancer screening rates in Utah

Rates of colorectal cancer screening in

Utah by county

Source: CDC www.statecancerprofiles.cancer.gov

What are Known Barriers/Facilitators?

https://www.thecommunityguide.org/sites/default/files/assets/Cancer-Screening-Multicomponent-Colorectal.pdf

Multi-component interventions:1. Increase colorectal cancer screening (by 15%)

2. Cost effective

People Don’t Know

People Face Financial or Structural Barriers

Provider Barriers


Utah Cancer Action Network Implementation grant

“Leveraging an existing mobile health clinic to decrease structural and

financial barriers to colorectal cancer screening”

Co-PIs: Drs. Hardikar and Cohan

Partner: The Wellness Bus

Funding period: July 2019 – June 2021

• Utah Population Database

• Health Fairs

• Wellness Bus

Year 1: Needs Assessment

• Administer FIT tests on the Wellness Bus

• Patient navigation

• Identify barriers and facilitators to FIT testing

Year 2: Implement FIT Testing




• Utah Population Database (State-wide)

• Health Fairs (Surveys)

• Wellness Bus (Surveys)

Year 1: Needs Assessment

Method: Use state-wide data and surveys to understand

patterns of screening and reasons for non-screening.

Goal: Identify population-based and individual risk factors for

non-screening.

Rationale: Allow appropriate targeting and tailoring of FIT

intervention.




• Administer FIT tests on the Wellness Bus

• Patient navigation

• Identify barriers/facilitators to FIT testing

Year 2: Implement FIT Testing

Baseline survey

• Attitudes Administer FIT

Patient Navigator

• Ensure test completion

• Follow up results

• Ensure proper follow up

Exit Interview

• Barriers/facilitators

The Wellness Bus

Miller Diabetes Initiative

• Every week:

– 4 sites

– 25 people

• Currently offer:

– HTN screening

– DM screening

– Nutrition

– Health counseling

– Social services

Eligible Individual

Survey and FIT Test

FIT Not Returned

FIT Returned

Result Normal

Annual Screening

Result Abnormal

Connect 2 Health

PCP

HCI

Identified through health counselorEducation through posters

Obtain baseline attitudesInstructions for FIT

Interview N~50

Interview N=100

ColonoscopyCancer Care

ColonoscopyCancer Care

CommunityHealth Educator

What are known barriers/facilitators?


Multi-component interventions:1. Increase colorectal cancer screening (by 15%)

2. Cost effective


Expected Outcomes

• Characterize state-wide screening behavior to guide future implementation projects

• Rich understanding of individual attitudes and beliefs toward screening

• Identify barriers and facilitators to FIT at every step of screening

• Sustainable mechanism for FIT on mobile clinics

Thank You

Acknowledgements:

- Utah Cancer Action Network

- Utah Department of Health

- Dr. Robin Marcus and Nancy Ortiz, The Wellness Bus, Miller Diabetes Initiative

- Dr. John Sweetenham, Director for Clinical Affairs, HCI

- Garrett Harding, Jennyffer Morales, and Donna Branson, Community Outreach, HCI

- Huntsman Cancer Institute

- University of Utah Department of Surgery

- University of Utah Department of Population Health Sciences

Chair

Greg Bell, CEO, Utah Hospital Association

Vice Chair

M. Locke Ettinger, Former Director Health Promotion and Wellness, Intermountain Healthcare

Secretary/Treasurer

Juliana Preston, Executive Director, HealthInsight

Board Members

Heather Borski, Division Director, Utah Department of Health

Kathleen Britton, Director of Child Nutrition Programs, Utah State Board of Education

Mike Clark, Hospital Administrator, McKay-Dee Hospital

Patty Cross, Health Promotion Director, Utah County Health Department

Nick Jarvis, COO, Utah League of Cities and Towns

Scott Langford, Hospital Administrator, Beaver Valley Hospital

Robin Marcus, Chief Wellness Officer, University of Utah Health Sciences

Trevor Smith, Director Health Promotion and Wellness, Intermountain Healthcare

Monica Whalen, Executive Advisor and Business Consultant

Get Healthy Utah Board Members

The mission of Get Healthy Utah is to create a culture of health

through engaging multi-sector stakeholders, building partnerships,

providing resources, and connecting efforts that support healthy

eating and active living.

We do this by:

• Engaging high level leaders

• Partnering with public and private entities

• Addressing healthy equity

• Collecting, developing, and sharing best practices

• Promoting systems level change

• Providing funds and other resources

Project: Get Healthy Utah will work to improve fruit and vegetable consumption among elementary

school students in target United Way Community Schools in the Granite School District.

Target Population:United Way Community Schools. Community schools are made up of low-income populations

and are often Title I schools. The schools serve a highly diverse population, made up of many

immigrant and refugee families.

Partners: • United Way of Salt Lake

• Salt Lake County Health Department

• University of Utah

• Granite School District Nutrition Services

Strategies:• Smarter Lunchrooms

• Recess Before Lunch

• Key Messaging to Address Myths

Improving Fruit and Vegetable Consumption in Granite School District

Year 1 (July 1, 2019 – June 30, 2020)

Objective 1: The Health Initiative Team will implement 2-3 Smarter Lunchroom strategies in 3 target Granite School District

Community Schools by June 29, 2020.

Objective 2: The Health Initiative Team will use the Utah Health Values Study results to develop 3 key culturally appropriate

messages that address barriers to participation in the school meals program directed at parents, teachers, and school

administrators in the Granite School District by January 29, 2020.

Objective 3: The Health Initiative Team will work with 3 target United Way Community Schools in the Granite School District (not

the same schools targeted for Smarter Lunchroom strategies) to get a commitment that they will implement a recess before lunch

schedule for the 2020-2021 school year.

Objective 4: The University of Utah research team will collect baseline data using plate-waste studies in 3 target schools for

recess before lunch and 3 target schools for Smarter Lunchrooms by June 29, 2020.

BUDGET

Get Healthy Utah Staff 8,895.00

University of Utah evaluation 3,500.00

Marketing 6,080.00

Materials 1,525.00

TOTAL $20,000

Year 2 (July 1, 2020 – June 30, 2021)

Objective 1: The Health Initiative Team will implement 2-3 Smarter Lunchroom strategies in 3 additional target Granite School

District Community Schools by June 29, 2021.

Objective 2: The Health Initiative Team will continue work with the previously target schools to implement an additional 1-2

Smarter Lunchroom strategies by June 29, 2021.

Objective 3: The Health Initiative Team will work with 3 previously targeted schools from year 1 to implement and evaluate recess

before lunch starting in the 2020-2021 school year.

Objective 4: Get Healthy Utah will provide the 3 newly identified target schools with brochures featuring key messages developed

in year 1 by August 1, 2020.

BUDGET



Marketing 3,705.00

Materials 1,050.00

TOTAL $16,029.50

Year 3 (July 1, 2019 – June 30, 2020)

Objective 1: The Health Initiative Team will implement 2-3 Smarter Lunchroom strategies in remaining 2-3 target Granite School

District Community Schools by June 29, 2022.

Objective 2: The Health Initiative Team will continue work with the previously targeted schools from years 1 and 2 to implement an

additional 1-2 Smarter Lunchroom strategies by June 29, 2022.

Objective 3: The Health Initiative Team will work with the 3 target schools who implemented recess before lunch to help provide

solutions to at least 1 identified barriers for sustainability by January 31, 2022.

Objective 4: Get Healthy Utah will provide the 3 newly identified target schools with brochures featuring key messages developed

in year 1 by August 1, 2021.

Objective 5: The University of Utah research team will comparison using plate-waste studies in 3 target schools for Smarter

Lunchrooms by June 29, 2022.

BUDGET



Marketing 2,955.00

Materials 1,100.00

TOTAL $18,479.50

• Beginning in Year 1, the University of Utah research

team will collect baseline data using plate-waste

studies in 3 target schools for recess before lunch

and 3 target schools for Smarter Lunchrooms.

• The University of Utah researchers will conduct a

focus group with one of the schools that implemented

recess before lunch. Information from the focus group

will be used to provide support for sustainability.

Evaluation

SABORES DE MI PATRIA

FLAVORS OF MY HOMELAND

Examples of the recipe books that were created from the parent recipes last year. Each parent that participated received one.

Three Sisters at a Title I school.

Parent gathering vegetables from a school garden.

Hispanic Breast Cancer

Support Group2002-2017

Sara Carbajal-Salisbury, BS, Program Director

Jeannette Villalta, CHW, Karla Arroyo, LCSW, Gabriela Portugal, MD

March 28, 2019

Utah Cancer Action Network

Mental Health Facts among cancer

survivors

• Co‐occurring depression in women with cancer can complicate cancer

treatment, lead to poor treatment adherence for both conditions, and

decrease survival if left untreated.

• Several risk factors for depression have been identified and research has

highlighted the need for intervention programs to help women normalize

emotions and thoughts related to cancer and its treatments, and to improve

their cognitive abilities to overcome, accept, and positively reframe cancer

and other difficult situations women face throughout the cancer continuum.

• Cancer survivors have been identified to be at a higher risk of psychological

problems including suicidal ideation.

Mental Health Facts among Latina

cancer survivors• More attention is warranted in assessing and assisting survivors with their quality of life,

physical, and emotional needs. Mental health counseling and primary care providers trained

in post–cancer treatment care and survivorship concerns are critical needs for Hispanic

breast cancer survivors as well as other groups of minority women.

• Compared to interventions that focus on cancer prevention and control among Hispanics,

fewer interventions have targeted Hispanics diagnosed with cancer and those who have

completed cancer treatment and transitioned to survivorship.

• Evidence-based psychosocial interventions such as cognitive behavioral therapies that focus

on stress management, relaxation skills, coping skills, communication skills and social

support have been associated with improved emotional well-being, reduced depressive

symptoms, and reduced symptom burden among Hispanic patients diagnosed with cancer.

Project Overview

From Treatment to “Survivorship with Mental

Health”

An innovative format of group educational sessions focused in

mental health for Latina Cancer Survivors and caregivers.

Main Goals:

Identify mental health issues that affect the health of Latina

cancer survivors and what are

the needs to reduce them.

Increase awareness and education

regarding mental health and facilitate

resources.

“Survivorship with Mental Health Among

Latina Cancer Survivors from “Triunfadoras”

Target Population:

Latina cancer survivors and their

caregivers 21 years and older,

underserved and uninsured that

reside in the Wasatch Front.

“Triunfadoras”

Hispanic Cancer Support Group

Breast cancer support group founded in 2002 by Alliance

Community Services a non-profit 501-c-3 organization

that addresses service gaps directly and indirectly

related to the Hispanic community.

Created by bringing together a group of dedicated

experienced professionals with a wide array of skills and

experiences.

The program began with 10 patients in 2002 serving

Hispanic women in the Wasatch Front. Currently we

have served close to 600 patients with an increase of an

average of three + new members every month that

reside in different counties in Utah.

Project Overview Action Plan

From Treatment to “Survivorship with

Mental Health”

Year 1:

• Run a needs asessment

• Run mental health screening (specifically, suicide, depression and anxiety)

• Analyze results for the development of a curriculum based on

pshycoeducational model

Behavioral Screening: Anxiety, Depression, & Suicide

(GAD7, PHQ9, CSSR)

Needs Assessment: Self-esteem, Resources, Awareness,

Barriers, Behavior, & Knowledge

Analysis of Results

Develop Psycho-educational Curriculum

Survivorship With Mental Health

Among Latina Cancer Survivors From “Triunfadoras”

Year 1

Project Overview Action Plan

Year 2:

• Training ACS team for the implementation of the

curriculum.

• Implementation of the curriculum by providing pshyco-

educational clases regarding mental health and healthy

coping mechanisms in a closed group setting (identify

triggers).

• Incorporate social and emotional support group

sessions.

Evaluation:

- Number of participants impacted by this program

- Run a pre and post evaluation regarding the curriculum.

Project Partners

• Main Collaborators in this program are:

• Multicultural Counseling Center

• Intermountain Medical Center

Findings from this project will give us the basis to further develop an

evidence based intervention to better meet the mental health needs of

Latina cancer survivors that reside in Utah.

Research CollaborationsAlliance Community Services has partnered with the University of Utah

and Huntsman Cancer Institute in research projects to determine best

practices for eliminating health disparities and improvement of our

programs:

• A Community-Based Approach to Assessing the Physical, Emotional, and

Health Status of Hispanic Breast Cancer Survivors

First Published November 8, 2017 Research Article

• Addressing Disparities: The Alliance Breast Cancer Community-Based

Program for Hispanic Women. Clinical Journal of Oncology Nursing

20(5):481-486 · October 2016

• A Workplace-Based Intervention to Improve Awareness, Knowledge, and

Utilization of Breast, Cervical, and Colorectal Cancer Screenings Among

Latino Service and Manual Labor Employees in Utah.

Article Oct 2018 Journal of Community Health

• Latino Parents’ Perceptions of the HPV Vaccine for Sons and Daughters.

Journal of Community Health 40(3) · October 2014

“Triunfadoras” – Our Vision

• “Nadie debe de enfrentar el cáncer solo”

• “No one should face cancer alone”

Questions & Answers

From Harm to Home | Rescue.org

IRC New Roots

Utah State Cancer Plan Implementation

Grant - 2019UCAN General Meeting - 3/28/2019

James Hunter – New Roots Program Manager

2


Who we are…

The International Rescue

Committee responds to the

world’s worst humanitarian

crises and helps people

whose lives and livelihoods

are shattered by conflict and

disaster to survive, recover,

and gain control of their

future.

3


The IRC has New Roots programs in 12 cities in the US.

New Roots in SLC is a broad-based agricultural program founded in 2010:

• Community Gardens

• Farmer Incubator Program

• Farmers Market

New Roots - SLC

4


UCAN

State Cancer Plan Implementation Grant

3 Year Program:

• Healthy Eating &

Nutrition Education

• Community Garden

Expansion

• Neighborhood Farm

Stand Development

5


Healthy Eating and Nutrition Education

• Developing curriculum

for a series of healthy

eating and nutrition

education workshops

• Delivering curriculum to

New Roots community

garden participants

each year

• 474 individuals reached

6


Community Gardens

Expansion

• Expansion of 2 gardens

in South Salt Lake in

Year 1

• 10 additional beds

• Maintaining access to

garden spaces in Yrs. 2/3

• 67 refugee families

reached

7


• Operating in South Salt Lake

• Development and Planning in

Year 1

• Implementation in Year 2

• Operation and Expansion in

Year 3

• 1,050 individuals reached

• Increase availability of fresh,

culturally appropriate

produce

• Accept SNAP and DUFB

Neighborhood Farm Stand

8


Thank you!

ucan general membership meeting march 28, 2019 · 3/28/2019 · male 359 44.5 209 43.1 age at...

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