Let’s Dance: Programmatic and Public Partnerships to Improve Cancer Prevention and Control

Cancer Survivorship Needs Through the Lens of the National Comprehensive Cancer Control Program

Authors:

Julie Townsend (Presenter)
Centers for Disease Control and Prevention

John Rose, Battelle
Annette Gardner, Centers for Disease Control and Prevention
Adrienne Cocci, Battelle Memorial Institute

Public Health Statement: Cancer survivors face several issues after treatment including side effects, preventing recurrence, and maintaining emotional health. A priority of the National Comprehensive Cancer Control Program (NCCCP) is to address the public health needs of cancer survivors.

Purpose: This project assesses NCCCP needs in serving cancer survivors; it is part of a larger study examining National Cancer Survivorship Resource Center (NCSRC) activities and resources.

Methods/Approach: In 2016, an online survivorship survey was sent to 65 NCCCP program directors (PDs); use of NCSRC resources was also assessed. The response rate was 78% (n=51). Responses were captured using a Likert Rating Scale with measures of very important, important, not important, don’t know. Data were analyzed using SAS.

Results: PDs overwhelmingly reported that it was very important to provide survivors with healthy lifestyle and behavior information (86%). Many (>60%) said late/long term effects, palliative care, expectations for follow-up care, psychosocial resources and support, and patient navigation referrals were very important. A majority said providing clinicians with information on using survivorship care plans (86%), coordinating care (78%), promoting healthy living (75%), and using care guidelines (63%) were very important. Only 47% of PDs were at least moderately familiar with the NCSRC materials. Those who were familiar most frequently reported using or sharing the survivorship care E-learning series (n=22) and the survivorship care guidelines (n=17).

Conclusions/Implications: NCCCP PDs identified several areas of importance. Increased use of existing NCSRC materials, and development of additional tailored resources may support the NCCCP with addressing these areas.

Innovative Public-Private Partnerships to Address Lung Cancer Disparities

Authors:

Dwana “Dee” Calhoun (Presenter)
SelfMade Health Network (Centers for Disease Control and Prevention-National Disparity Network)

Jennifer Redmond Knight, University of Kentucky-College of Public Health (SelfMade Health Network-Regional Resource Lead Organization)

Public Health Statement: Cancer disparities continue to exist among vulnerable populations including those with lower levels of education as well as populations living below, at and near poverty levels. As noted in the most current Centers for Disease Control and Prevention (Centers for Disease Control and Prevention) reports, lung cancer incidence and mortality rates remain higher in specific regions including the Appalachian region as well among males.

Purpose: In 2016, University of Kentucky-College of Public Health became one of the newly designated Regional Resource Lead Organization (RRLO) with multi-year funding from SelfMade Health Network (SMHN). With a rural-oriented focus, the purpose of the Kentucky RRLO is to address lung cancer disparities (tobacco prevention, secondhand smoke, radon prevention, screening and survivorship) among primarily low-income, male adult populations residing in high disease burden counties through increased local infrastructure, capacity and coordination.

Methods/Approach: In an effort to address its goals, the Kentucky RRLO approach involves convening a series of focus groups and roundtables utilizing multi-sector engagement throughout the year, as well as establishing public-private partnerships. Multi-county focus groups and roundtable sessions consist of professionals representing from various industries, genders and geographies (including “high burden” counties).

Results: The initial findings from Kentucky RRLO’s approach resulted in the development of new strategic public-private partnerships. In addition, results from the Kentucky RRO’s approach (included focus groups) revealed several opportunities and challenges that exist among low-income male adults associated with lung cancer disparities. A total of 8 focus groups with a total of 45 participants in the 8 counties participated. These participants estimate their service reach to be 163,849 men.

Conclusions/Implications: The initial results from the Kentucky RRLO’s approach may potentially lay the groundwork for the adoption of interventions that, if systematically applied, may yield more efficient strategic planning when addressing lung cancer disparities relative to male adults (low-income) and “blue-collar” industry worksites.

Innovative Partnerships and Strategies to Promote Cancer Genomics: Best Practices in Michigan’s Comprehensive Cancer Control Plan

Authors:

Debra Duquette (Presenter)
MDHHS

Polly Hager, MDHHS

Public Health Statement:
Cancer genomics services and technologies are rapidly evolving and increasing in utilization of cancer prevention and treatment efforts. State Comprehensive Cancer Control (CCC) Plans with multilevel partnerships and strategies are important to ensuring promotion of appropriate cancer genomics best practices.

Purpose:
The 2009–2015 CCC Plan for Michigan was the first in the US to add an entire cancer genomics goal. The 2016–2020 plan also includes measurable genomics objectives with strategies. The Michigan Cancer Consortium (MCC) with state and local partners is key to successful implementation of these objectives.

Methods/Approach: The 2009–2015 CCC Plan for MI included a genomics goal with three objectives and 12 strategies that encompassed expanding provider and public knowledge and improving access to genetic services. The 2016–2020 plan includes three measurable genomics objectives with 13 strategies. Progress is measured through multiple statewide data sources.

Results: As demonstrated by the MCC Implementation Progress Report, multiple state and local MCC members were instrumental to achieving the 2009–2015 cancer genomics goal. Furthermore, based on 2017 state population-based survey results, Michigan has already surpassed one of the 2016–2020 cancer genomics objectives. The Michigan CCC genomics goals, objectives and strategies have been shared and led to similar efforts in other states.

Conclusions/Implications: State CCC Plans are instrumental to building consensus among multiple sectors on the importance of cancer genomics and implementation of appropriate strategies to promoting cancer genomics best practices. Cancer genomics integration in the Michigan CCC Plans are successful examples that may be helpful for other states.

Evolution in Motion: How Michigan Developed a Breast and Cervical Cancer Navigation Program Model in Response to the Affordable Care Act (ACA)

Authors:

Debbie Webster (Presenter)
Michigan Department of Health and Human Services

Bethany Hollender, Michigan Department of Health and Human Services

Public Health Statement: In order to remain effective, state managed breast and cervical cancer control programs have to quickly adapt programs to the changing health care landscape.

Purpose: Since 1991, the Michigan Breast and Cervical Cancer Control Navigation Program (BCCCNP) has worked with local health agencies to provide services to 512,400 low-income women. Following ACA implementation, the number of eligible women plummeted from 31,000 women seen in 2012 to 7,200 in 2016.

Review of Medicaid data showed a 40% breast cancer screening rate among women, enrolled through the ACA. Furthermore, health departments were receiving calls from former BCCCNP clients unsure of how to use insurance.

Methods/Approach: In response, Michigan implemented strategies to transition the program from providing primarily screening services to implementing evidence-based population health strategies to increase screening rates regardless of insurance status.

Results: The result is a robust program model including three components: Clinical Services, Navigation Services, and Health System Change. Under this new model, BCCCNP has partnered with 14 health departments and uses Small Area Health Insurance Estimate (SAHIE) and GIS mapping to target “very hard to reach” women. Navigation services were expanded to 25 agencies that utilize a diverse team of lay navigators and partnerships with 7 health systems change organizations were formed to implement evidence-based interventions.

Conclusions/Implications: Through use of surveillance data and effective communication with external partners, Michigan successfully evolved its program model to better reach low-income women.