Colorectal Cancer Survivorship in Greene County, Pennsylvania:  Assessment and Provider Education

Mary Ann Ealy, Marlene Shaw and Carolyn Wissenbach

Background

The Greene County Cancer Coalition was formed in 1999 with support from Penn State Cooperative Extension, community agencies and citizens and guidance from the Northern Appalachian Leadership Initiative on Cancer. Currently a subcommittee of the Physical Health Committee of Greene County MAGIC (Making a Great Impact Collectively), the county’s State Health Improvement Partnership (SHIP), the group aims to improve community health through education and coordination of resources. Over the past eight years, the coalition has hosted a variety of community outreach, education and screenings events focused on the following cancers:• breast • colorectal• prostate • skin.

Between 2003 and 2006,the coalition participated in two community-based participatory research projects resulting in published journal articles: • The Impact of Cancer Coalitions on the Dissemination of Colorectal Cancer Materials to Community Organizations in Rural Appalachia. Preventing Chronic Disease . April 2006 • Development of Community Plans to Enhance Survival from Colorectal Cancer: Community-Based Participatory Research in Rural Communities. Journal of Cancer Survivorship. September 2007

County Facts

• Located in the southwest corner of Pennsylvania • Population just over 40,000 • Nearly 69% of the population live in rural areas• Predominantly white (95.4%) • Median age - 39 years • Classified as “distressed” by the Appalachian Regional Commission

Plan

Develop a strategy to improve colorectal cancer survival and improve quality of life for those diagnosed with the disease.

Methods

• Community Assessment (surveys and key informant interviews)• Assets (resources) inventory • Development of a directory of local, state and national resources• Health care provider dinner and education• Dissemination of resource guide through providers

Evaluation• Community assessment and assets inventory. • Participant surveys from the health care education program and materials dissemination.

Results

The assessment showed two primary findings:• CRC survivors were often unaware of local, state and national community resources that may aid their survival. • Local physicians were often unaware of local resources, current advances in screening, treatment and genetic testing to assist families in dealing with CRC.

Participant surveys showed of the 13 healthcare providers attending the education program, 10 (77%) completed evaluations. • All reported a high level of knowledge gained regarding hereditary factors. • 9 (90%) reported a high level of knowledge gained about screening. • All agreed the materials provided were useful.• 6 (60%) reported continuing medical education credits influenced their attendance.• All reported that they would attend again

Conclusions • A locally hosted dinner was an effective method of informing providers with CRC medical education and new materials • Collaborative partnerships were essential to the success of local provider education on CRC.

Acknowledgements

• American Cancer Society, Greene County• Appalachia Community Cancer Network*• Linda M. Farkus, MD • Lance Armstrong Foundation• Northern Appalachian Cancer Network at Penn State University**• Penn State Cooperative Extension Service – Greene County• Pennsylvania Department of Health – Greene County State Health Center• University of Pittsburgh Cancer Institute

* Funding support for the resource guide, invitation, speaker and dinner through a Community Development Grant

** Training and technical assistance

Speaker, Linda M. Farkus, MD, Director of Hereditary Colorectal Tumor Program, Division on Surgical Oncology, Assistant Professor of Surgery, University of Pittsburgh School of Medicine, is shown with coalition chair, Carolyn Wissenbach at Strykers Grill in Waynesburg, PA on April 12, 2007 .

Colon Cancer Resource

Guide

Preventable. Treatable. Beatable!

Information for people touched by Colon

Cancer

GREENE COUNTY, PA

Problem

Colorectal cancer (CRC) is a significant health problem in Greene County. With a death rate higher than the national rate and the Healthy People 2010 goal, CRC is also diagnosed at a later stage when it is less curable.

Objectives• Understand the barriers and gaps experienced by local CRC survivors• Assess resources available to survivors• Develop a resource guide to provide information about local, state and national community resources for CRC survivors and providers• Increase knowledge among local health care providers about hereditary factors, screening and resources for CRC survivors.

Colorectal Cancer Percent Staging Distribution, 2002-2004

EpiQMS

42.9

31.9

13.2

0 10 20 30 40 50

Local

Regional

Distant

Percentage

Provider Education

Improved survival and quality of life

Resource Directory

AssessmentColorectal Cancer Death Rate Comparison, All

Ages, All Races, Both Sexes, 2000-2004 Cancer Control PLANET

19.421.3 20.9

13.9

0

5

10

15

20

25

Rat

e

US

PA

Greene

HealthyPeople 2010