health disparities and policy special report · a smoking cessation resources guide was developed...

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MICHIGAN CANCER CONSORTIUM

Health Disparities and Policy Special Report Results from the 2012 MCC Implementation Progress Report

Produced by:

Michigan Public Health Institute Cancer Control and Prevention Services December 3, 2013

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Table of Contents

Background ................................................................................................................................... 2

Health Disparities.......................................................................................................................... 3

Cancer Prevention: Smoking Cessation ...................................................................................... 4

Cancer Prevention: Healthy Lifestyle ....................................................................................... 10

Early Detection of Cancer ......................................................................................................... 12

Cancer Survivorship.................................................................................................................. 18

Equity in Health ........................................................................................................................ 22

Bio-Specimens .......................................................................................................................... 34

Policy ............................................................................................................................................ 37

Cancer Prevention: Smoking Cessation .................................................................................... 38

Cancer Prevention: Human Papilloma Virus (HPV) Vaccination ............................................ 42

Risk Assessment: Cancer Genomics ........................................................................................ 45

Early Detection of Cancer ......................................................................................................... 50

Cancer Survivorship.................................................................................................................. 63

Equity in Care ........................................................................................................................... 66

Health Disparities and Policy Special Report

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Background

In the past year, reducing health disparities in cancer outcomes and promoting policies to increase access to and utilization of cancer services have been a main focus of the Michigan Cancer Consortium (MCC). In order to evaluate the sum of action member organizations have implemented to accomplish these goals, the MCC membership were invited to report on their activities through the Implementation Progress Report (IPR) survey. The reporting period was from January 1, 2012 to December 31, 2012.

The IPR survey tool was designed to address the new direction of the MCC strategic plan, which focuses on the continuum of cancer control and prevention. The sources used to create the survey tool were the priorities identified by the MCC health disparities workgroup and the MCC policy committee, as well as the “What You Can Do to Fight Cancer in Michigan” document in the Comprehensive Cancer Control Plan in Michigan. The online survey was sent to all MCC member representatives in February 2013. Of the 109 MCC member organizations, 87 organizations completed the IPR survey resulting in a 80% response rate.

This report summarizes the activities implemented by MCC organizations to address the priorities identified by the health disparities workgroup and the policy committee. When priority areas overlap, the implementation activities are presented in both sections.

Health Disparities and Policy Special Report

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Section I. Health Disparities

Health Disparities and Policy Special Report Section I: Health Disparities Prevention: Healthy Lifestyle

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Cancer Prevention: Smoking Cessation A goal of the MCC is to reduce rates of tobacco use among adults and youth. Of organizations that completed the 2012 IPR survey, 85.7% said that their organizations’ mission was compatible with this goal.

Figure 1.1: Implemented Tobacco Cessation Activities Tailored for Minority Populations and/or Populations

Disparately Affected by Tobacco Use, 2012

n=64

Yes 60.9%

Health Disparities and Policy Special Report Section I: Health Disparities Prevention: Tobacco Control

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Table 1.1: Tobacco Cessation Activities Tailored for Minority Populations and/or Populations Disparately Affected by Tobacco Use, as described by MCC Organizations, 2012

ACCESS Community Health Center

Ongoing Tobacco Prevention Education-addressing the harms of tobacco and second hand smoking exposure. -WIC client/Mom Education- Educational sessions on the harms of smoking while pregnant and harms of second hand smoke exposure. -Resource table

Alpena Regional Medical Center - Alpena

Cancer Center

Tobacco cessation classes were provided in 2012. Targeted efforts led classes’ specific to community mental health clients.

American Cancer Society, Great Lakes

Division, Inc.

Provided awareness and educational materials on the risk of tobacco use to agencies serving disparate populations. Promoted the Michigan Tobacco Quit Line. With the Commission on Cancer (CoC) state chair, provided CoC accredited facilities referral forms to the state’s quit line.

Barbara Ann Karmanos Cancer Institute/Wayne

State University

The Institute has developed a policy whereby all patients receive tobacco cessation information (smoke free campus, the benefits of quitting and available resources) on system entry. Electronic medical record and patient assessment documentation further identify tobacco history and use. When appropriate, the benefits of quitting while receiving treatment are discussed by the health care provider and a referral to the Michigan Tobacco Quitline is completed and faxed. The Institute increased calls to the Quitline in 2012. Tobacco cessation is highlighted at community education presentations and health fairs that occur throughout the year. Over 30,000 people participated in events in 2012, including minority populations in Detroit area churches and missions.

Barry Eaton District Health Department

Offered a holistic cessation program that includes auricular acupuncture, hypnosis, Emotional Freedom Techniques, psycho-physiological leaning theory and Sleep Mix Detox Tea. Uninsured are higher users of tobacco. All patients at Barry Community Free Clinic are questioned at each visit about tobacco use by intake nurse and referred to Quitline. Project involving at-risk youth (low-income, disproportionally non-white, disproportionally parenting/pregnant, learning disabilities, etc.) with tobacco cessation and prevention services. Participated in health fairs in multiple community settings where youth, homeless persons, and low-income persons were the focus. A smoking cessation resources guide was developed and distributed widely. Staff were also instrumental in promoting smoke free and tobacco free parks in our counties. Individual education with clients on the harms of smoking and how to get assistance for quitting. Free Quit Smoking Workshops provided by BEDHD, Promotion of Quit Line 1-800-QUIT-NOW. Community outreach such as press releases, Facebook posts and health fairs

Botsford Cancer Center Provided free head and neck screening for the uninsured and underinsured. This included smoking cessation literature available at the event.

Cancer Services

We provide tobacco cessation services for any adult or teen who wants assistance to stop tobacco use. However, we focus on three disparate groups: low income adults, individuals with disabilities (mental health, physical, or prior chemical dependency), and teens in non-traditional school settings. We provide either group or individual nicotine dependency treatment. Last year we provided a cessation class series to two groups: a sheltered workshop-type organization (Arnold Center) and a long term care facility for the disabled (Pinecrest Home) for both employees and workers when they established a smoke-free campus policy. We provided a class series/support group for teens at an alternative high school (Windover) and receive referrals from Probate Court and the Juvenile Care Facility to provide individual tobacco use awareness and cessation assistance for adjudicated teens.

Catherine’s Health Center

Providers and other staff question patients about tobacco use and advise cessation. Provide referral to MI quit line as well as RX support if desired and appropriate.


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Table 1.1 cont’d.: Tobacco Cessation Activities Tailored for Minority Populations and/or Populations Disparately Affected by Tobacco Use as described by MCC Organizations, 2012

Central Michigan District Health

Department

Education for pregnant women who are smoking, one to one basis Promotion with all clients of 1-800- quit line

District Health Department #2

All of our clients that came in for BCCCP were given information about smoking cessation


Tobacco cessation programs are available to all DHD#10 cliental regardless of ability to pay for services.

District Health Department #4 Smoking Cessation for pregnant women enrolled in Maternal Health Program.

Genesee County Health Department

Offered a free quit smoking class quarterly. Made referrals to the state quit line. Promoted smoke free apartments including public housing. Began a county wide survey of smoke free park policies. Conducted a butt pick up day in a community park. Participated in enforcement of local tobacco control regulation. Participated in FDA tobacco regulation inspection program.

Genesys Hurley Cancer Institute

Provide monthly Stop Smoking Support Group Distribute Stop Smoking Educational Materials Posting of Stop Smoking Materials. Accessibility to Stop Smoking aids as needed.

Health Department of Northwest Michigan

Promotion of Michigan's Smoke-Free Air law and tobacco cessation to public through small media and website. Assisting schools with tobacco-free campuses and teen smoking reduction by forming focus groups. Promotion of Michigan's Tobacco Quitline for eligible adults, pregnant women and fathers through all our programs. Promoting Quitline telephone number on tear-off posters Promotion of Great American Smoke-out campaign to general public Increasing access to smoke-free environments by working with municipalities to establish smoke-free parks and beaches Formation of county tobacco reduction coalitions Focusing on socio-economic disparities that came out of Community Health Assessment and targeting those areas with substance abuse workgroups which includes tobacco use Promoting education among low income,(all ethnicities), pregnant women in smoking cessation

Henry Ford Health System Smoking cessation program. Information in multiple languages.

Huron County Health Department

We utilized the Quitline by referring clients to this resource from multiple programs at the health department

Inter-Tribal Council of Michigan, Inc

Community education on the dangers of commercial tobacco use; promotion of the State Quit Line; provider training and education specific to the Native American population

Kent County Health Department

Actively referred BCCCP clients as well as general population to tobacco cessation resources, including toll free telephone assistance. Generated mass emails to community partners, providers and staff members regarding increase in awareness and education of opportunities.

Luce-Mackinac-Alger-Schoolcraft Health

Department

LMAS received a small amount of Tobacco funding during FY12, and conducted site visits at various facilities within our district, and compiled reports. We discuss smoking cessation with each of our clients as indicated. We have not received Tobacco funding for fy13.

Marquette General Cancer Center Participated in the MCC challenge

McLaren Cancer Institute

We are actively holding the America Cancer Society Smoking Cessation Classes for adults. Once one session is competed we start another. Have set up tables during the year at the hospital so that people can stop by. Also working with local high school to possibly start a class for teens.


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Table 1.1 cont’d.: Tobacco Cessation Activities Tailored for Minority Populations and/or Populations Disparately Affected by Tobacco Use as described by MCC Organizations, 2012

McLaren Cancer

Institute-Clarkston

Literature about our smoking cessation classes at McLaren Oakland Hospital and at the cancer center, on the scrolling marquee outside of the hospital and quit line literature in the cancer center

McLaren Home Care Group We are part of a hospital system that provides smoking cessation classes and materials

McLaren-Macomb

Participated in the Great American Smoke-out with an informational display regarding the risks associated with tobacco use, with an interview by one of our Pulmonary physicians in a local newspaper. Ongoing efforts include being actively engaged with a local high school to develop young adult ""champions"" to help educate adolescents on the dangerous effects of tobacco use and to encourage them not to start smoking. Smoking cessation classes are offered year -long at no charge using the Freedom From Smoking format.

Mercy Cancer Network the 7 hospitals of the Mercy Cancer Network use direct mail and other advertising to reach populations who need support in tobacco cessation. Special programs, education and tools are provided.

Michigan Department of Community Health

Partnered with InterTribal Council (ITC). ITC conducted a survey and focus groups to measure the appeal of the Michigan Tobacco Quitline to Native American Women, specifically those who were pregnant. The survey and focus groups led to new materials designed for this population in order to help them understand what the Quitline does and what kinds of benefits are available. Provided a grant to the Grand Rapids Urban League to encourage the organization to talk to their clients about tobacco use and to encourage them to use the Quitline. Worked with the Asian Center to promote a new national Asian language tobacco Quitline. The national Asian Quitline is funded by the Centers for Disease Control.

Muskegon County Health Department Worked with Community Mental Health on the issue of tobacco cessation.

Providence Cancer Institute Started to refer patients to the Michigan Quitline.

Saginaw County Department of Public

Health

As a Regional Coordinating Agency, continued to be responsible for Compliance Checks. Additionally, partnered with the Sheriff Department for Compliance Checks to all tobacco vendors in the County. Partnered with prevention providers on Tobacco awareness in schools and throughout the community

Spectrum Health Cancer Program

Free tobacco cessation classes were offered through the Healthier Communities Department, which provides education and support to the underserved in the community. These classes were marketed toward clients of the healthier communities programs as well as to others in the community. Additionally, underserved diabetes and heart failure participants in the Core Health Program were provided with cessation home visits by referral from their home visiting nurse or community health worker.

Tobacco Free Michigan Presentations during quarterly membership meetings on issues impacting populations disparately affected by tobacco use.

U of M Comprehensive Cancer Center

Free smoking cessation sessions were offered to registrant At annual free throat cancer screening for those without insurance.

United Health Care Community Plan

Offered provider education involving smoking cessation with products available for this activity. Provided assistance with smoking cessation for members regarding a hot line during the activity.


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Table 1.1 cont.: Tobacco Cessation Activities Tailored for Minority Populations and/or Populations Disparately Affected by Tobacco Use as described by MCC Organizations, 2012

University of Detroit Mercy School of

Dentistry

Planned awareness Events for patient population and community: June 7, 8, 2012 Michigan Oral Health Conference/Michigan Primary Care Association Exhibit on Providing Tobacco Dependency Treatment for Our Dental Patients June 16, 2012 Oral, Head and Neck Cancer Walk Exhibit/Service as a Resource on Oral Cancer Awareness and Prevention, Tobacco Dependency Treatment September 21, 2012 Ending Your Dental Patient's Dependence on Tobacco Targeted dental professionals, Muskegon County Health Department November 15, 2012 Great American Smoke out Exhibit/Service as a Resource on Tobacco Dependency Treatment Webinar on April 9, 2013: Tobacco Education for Oral Health Providers Targeted providers of the National Association of Community Health Centers Presentation on May 3, 2013: Tobacco Education for Oral Health Providers Targeted Tobacco Champions of the Mississippi Primary Healthcare Association

West Michigan Cancer Center

Made available Healthy Life Style-""Get Your Test"" in English and Spanish, Bill boards--lung screening and smoking cessation (see the e-mail that was sent) Quit Smoking Kalamazoo via health department; Michigan Tobacco Quitline CME event with information about lung cancer risk Web site Health fairs

Western Upper Peninsula District Health

Department

Worked closely with the Keweenaw Bay Indian Community to provide cessation promotion, resources and support.

ZIAD Healthcare for the Underserved, INC Offered Acupuncture for smoking cessation


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Figure 1.2: Encouraged Health Professionals to Screen Youth about Tobacco Use During Health Care Visits with Referral to Treatment When Appropriate, 2012

n=38

Yes 81.6%

Figure 1.3: Participated in Promotion or Distribution of the Michigan Multicultural Networks’ Education

Materials or Partnered with Other Organizations to Reduce Tobacco Use, 2012

n=61

Yes 67.2%


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Cancer Prevention: Healthy Lifestyle A goal of the MCC is to increase the number of Michigan residents who adopt a healthy lifestyle by improving their knowledge, motivation and opportunity to adopt a healthy nutritional regimen and obtain adequate physical activity levels to maintain good health. Of organizations that completed the 2012 IPR survey, 86.6% said that their organizations’ mission was compatible with this goal.

Figure 1.4: Organization Partnered with Michigan Healthier Communities, 2012

n=61

Yes 34.4%

Figure 1.5: Organization Partnered with Michigan Healthier Communities by Organization Type, 2012

Community-based health systems (n=17)

Organizations representing hard-to-reach or special populations (n=4)

Health care insurance plans (n=5)

Health education/research & evaluation (n=1)

Public health organizations (n=18)

Trade/professional/advocacy (n=12)

University-based health systems (n=4)


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Table 1.2: Description of Partnerships with Michigan Healthier Communities as described by MCC Organizations, 2012

American Cancer

Society Cancer Action Network

Participated in the steering committee.


Division, Inc. Served on the Steering Committee and the Community Organizations Subcommittee.

Barry Eaton District Health Department

Served as a contracted entity with the Capital Area Health Alliance to promote and conduct the ACHIEVE program in Eaton County, which includes a short assessment, identification of a policy or environmental change, and reimbursement of the cost to implement it; Worked with Capital Area Health Alliance to promote 4x4 through ACHIEVE in Eaton County.


Department

Added a link on website, and utilizing the 4X4 plan in Health Improvement Planning committees as a basis for goal setting in one of served counties (Roscommon). Utilizing flyers and awaiting the final power point from them to do community presentations. Partnering with Federally Qualified Health Center to do this.

Dickinson Iron District Health Department Website link; news release

District Health Department #2 We referred to the Wellness Plan to apply for grants that promoted healthy lifestyles


DHD#10 was one of the six organization funded to work on the 4x4 project in Michigan. Promotion of this plan through existing and new partnerships has been ongoing within the health jurisdiction since 10/1/12.

Genesee County Health Department

Being a member of the Greater Flint Health Coalition - the local funded agency, the local program advocate presented the program to our primary clinic providers.

Ingham County Health Department Partnered with the Capital Area Health Alliance (CAHA)

Inter-Tribal Council of MI, Inc.

Promoted the 4 x 4 among 12 tribal communities - clinic, worksite and community based activities

McLaren Home Care Group Provided flu and Pneumonia vaccine to staff

Michigan Department of Community Health Responsible for implementing the 4 x 4 Plan and MI Healthier Tomorrow campaign.

Michigan Health & Hospital Association We have supported the adoption in our member hospitals

Michigan Primary Care Association

MPCA serves on the steering committee. MPCA has shared information on the plan and related activities with FQHCs

Providence Cancer Institute We provided colorectal cancer screening and physicals for the wellness plan

Saginaw County Health Department Public Health Week there was a community fair

Tuscola County Health Department

Used the MI Healthy Communities materials and also referred people to the MI Healthier Tomorrow website where they have tools and resources at their fingertips.


Department Disseminated information.

Health Disparities and Policy Special Report Section I: Health Disparities Early Detection

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Early Detection of Cancer A goal of the MCC is to decrease the cancer death rate in Michigan by increasing the proportion of the population receiving appropriate cancer screening and follow-up of abnormal screening results for breast, cervical, and colorectal cancers. Of organizations that completed the 2012 IPR survey, 86.4% said that their organizations’ mission was compatible with this goal.

Figure 1.7: Implemented Educational Activities for Populations Who Never or Rarely Receive Appropriately Timed Breast, Cervical, or Colorectal Cancer

Screening by Organization Type, 2012



Health insurance plans (n=4)





Figure 1.6: Implemented Educational Activities for Populations Who Never or Rarely Receive

Appropriately Timed Breast, Cervical, or Colorectal Cancer Screening, 2012

n=63

Yes 82.5%


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Table 1.3: Educational Activities for Populations Who Never or Rarely Receive Timely Breast, Cervical, or Colorectal Cancer Screening as described by MCC Organizations, 2012


The Arab American Breast and Colon Cancer Project was designed as a local collaboration between the Arab Community Center for Economic and Social Services (ACCESS) and other clinical cancer screening entities. The goal of this collaboration is to provide in-home community-based, bilingual and culturally sensitive breast cancer education and screening services. Our stated project goal was to provide breast cancer education and screening by conducting 2,000 home visits and recruiting 1,500 women for mammogram screening in the Arab community of Wayne County/Greater Detroit area. At the end of December (final report), our program outcomes reflect our projected goals, for breast and cervical program. In addition to maintaining an active seminar outreach schedule our project team has completed 25,624 educational contacts and 2,297 mammograms through our BCCCP clinic and referred 400 women for follow-ups. Our collaboration with Karmanos Cancer Institute decreased the time between screening and diagnosis and/or diagnosis and treatment. The BCCCP six months report indicated that 98.5% ACCESS cases closed within 60 days. We have had continued success with our in-home model of health education and have adopted a “Train the Trainer” model for our breast cancer education initiative. Our “Tell a Friend” and “Kin-Keeper” programs are utilizing home visits as a venue to educate. During these visits we educate five women, who will then arrange similar educational seminars for another five women. These educational seminars were given in addition to our ongoing individual home visits. The International Conference on Health Issues in Arab communities Award Review Committee was very impressed by our Arab Women’s Breast cancer collaborative project and its contribution to cancer control in Michigan and selected us for presenting on their October 16-18, 2012 conference. We were very successful with our colorectal cancer project, educated 500 men and women on colorectal cancer and screened 50.

Alpena Regional Medical Center - Alpena

Cancer Center

In October of 2012 the 8th Free Women's Cancer Screenings were offered to women in our communities who were uninsured or under insured. Each woman was eligible for a clinical breast exam and pelvic exam with Pap smear and a mammogram as determined to be appropriate by the provider. Colorectal screening kits were also dispensed to the women participating in the clinics. Also, a total of 225 ColoCare kits were distributed among the community in 2012. A total of 97 men were screened this year in collaboration with Thunder Bay Urology and grant funding provided by the Region 9 Area Agency on Aging.


Division, Inc

Promoted screenings through Relay for Life events; Colorectal Action Network (CRAN), radio tours, newspaper articles, and other media outlets; speaking engagements and presentations; distribution of brochures, pamphlets, and other informational packets; sub-contracting to organizations serving disparate populations to raise awareness and increase screenings.


State University

The Institute provides community education throughout the tri-county area including missions, and the Wayne County Health on Wheels initiative.

Botsford Cancer Center Free screening events, free or low cost mammograms and counseling. An on-site oncology social worker in place who assists the uninsured and underinsured with financial issues.

Calhoun County Cancer Control Coalition

We work with the Pink Saturdays’ program in our area. Patient Navigation for free colonoscopies (scheduled into April/May) Lunch and Learn at Burnham Brook with Dr. Chalasani - March 20th brochures given to the Family Health Center to hand out to patients about getting screened.


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Table 1.3 cont’d.: Educational Activities for Populations Who Never or Rarely Receive Timely Breast, Cervical, or Colorectal Cancer Screening as described by MCC Organizations, 2012

Cancer Services

Reached out to targeted underserved men and women (we have a very low rate of minorities in our community) who are unemployed or underemployed by providing information about timely screening at Family Wellness Day at Midland Mall in February and other similar events at community centers around the county. Will ask Smoking Withdrawal Clients if they are taking advantage of the free screenings taking place in our region and encourage them to access these resources.

Cancer Support Community of Greater

Ann Arbor

CSC offered a free workshop called The African American Cancer Experience Panel presentation to our community during African American History Month which highlighted breast cancer screening with Dr. Lori Pierce. This also included the importance of psychosocial support and healthy behaviors.

Catherine’s Health Center BCCCP provider site.


Department

Had Press releases promoting BCCCP and Colorectal programs. Agency flyers and information given out for these programs at health fairs. Posted flyers and eligibility information in all kinds of public venues. Had preliminary talks with one of Native American tribes to promote the program with their health care workers and also feature promotion in October through their casino.

District Health Department #2 Attended Health fairs, put out PSA's, newspaper articles, flyers


DHD#10 is a provider of both the BCCCP and colorectal cancer early detection programs. Promotion of these services is ongoing within the health jurisdiction as well as with area providers.

District Health Department #4 Outreach education.

Genesee County Health Department Provided BCCCP and coordinate with own County health plan to encourage screenings.


Breast Cancer Screening event. Literature available and distributed addressing rationale, benefits and process for screening for breast and colorectal.

Gilda’s Club Grand Rapids

Offered an incentive program, along with nurse navigation for minority women to get mammograms.

Grand Rapids Clinical Oncology Partnered with local high-risk clinics and community education/outreach initiatives.


Promoted October Breast Health Month and March Colorectal Screening month with media and free screenings. Attended organizational group meetings to educate public on Breast and Cervical Cancer and Colorectal Cancer. Targeted Native American clinic to educate on BCCCP enrollment Partnered with county fund raising organizations to promote public awareness Partnered with grass-roots organization in Antrim County that had the 2nd highest leading breast cancer mortality in the state. They assist in education of that county among the low income and underinsured or uninsured population as well as all women/men in Antrim County urging annual breast screenings Partnered with area hospitals in promotion of cancer screenings

Henry Ford Health System Church and community educational programs.

Huron County Health Department

Attended health fairs in six county regions which provide Breast and Cervical Cancer Screening and Colorectal Cancer Screening to promote awareness and knowledge of services available. Minority population would be included in Saginaw and St. Clair Counties.

Ingham County Health Department

ICHD participates in the Breast and Cervical Cancer Control Program. Three of own FQHC clinics are screening sites. Promoted breast and cervical cancer awareness and screening throughout the year.


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Inter-Tribal Council of Michigan, Inc.

Promoted the BCCCP among all 12 tribal communities; community health events, provider training; navigation education and community events - all within Native American tribal communities.

Kalamazoo County Health & Community Services Department

Participated with Pink Saturdays which is a campaign to increase breast cancer screening.


BCCCP Pink Saturdays Free Mammogram Screening Southwest Michigan Cancer Control Coalition.


BCCCP, WW, CRC are all in Grand Rapids, and patients exposed to each of these programs get a triple dose of education and awareness regarding the other services, and timely access to this care. Outreach has been quadrupled by careful collaboration with all community partners to ensure adequate coverage of our entire county and to ensure own network reaches into every network.


Department

Attended health fairs and other community events; discussing/educating on the BCCCP program.

Marquette General Cancer Center

Partnered with the MCHD to enroll patients into BCCP - offer free colorectal cancer FIT tests (partnered with MCI) - free breast cancer risk clinics (2-MQT, 1 Houghton) - 4 free skin screens

McLaren Bay Regional Free Cancer Screening programs for uninsured or underinsured -- Partnerships with local health departments -- Financial assistance programs for treatment when patients of minority backgrounds are diagnosed with cancer.


Free Cancer Screening programs for uninsured or underinsured -- Partnerships with local health departments -- Financial assistance programs for treatment when patients of minority backgrounds are diagnosed with cancer.

McLaren Cancer Institute-Clarkston

Sister and Sister Free Mammogram Screening Program Free Prostate Screening Free Skin Screening Free Colorectal kits distributed during the month of March. Free Cancer Screening programs for uninsured or underinsured -- Partnerships with local health departments -- Financial assistance programs for treatment when patients of minority backgrounds are diagnosed with cancer.

McLaren Greater Lansing

Free Cancer Screening programs for uninsured or underinsured -- Partnerships with local health departments -- Financial assistance programs for treatment when patients of minority backgrounds are diagnosed with cancer.

McLaren Oakland Free Cancer Screening programs for uninsured or underinsured -- Partnerships with local health departments -- Financial assistance programs for treatment when patients of minority backgrounds are diagnosed with cancer.

McLaren-Macomb

Have a mobile outreach unit to provide health care and education to underserved men and women in our community. In 2012, implemented BRAvo For Women program, which provides free screening mammography to uninsured, financially qualifying women in our community. Also have partnered with MyCare to stretch our resources to include the diagnostic workup of abnormal mammograms which includes minimally invasive breast biopsy if indicated. Since 2010, held an annual breast cancer awareness event called BRAvo, which focuses on breast health education, breast cancer awareness, and the importance of early detection. Activities occur throughout the year that lead up to the event each October. Free Cancer Screening programs for uninsured or underinsured -- Partnerships with local health departments -- Financial assistance programs for treatment when patients of minority backgrounds are diagnosed with cancer.


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Provided staff support for the Michigan Colorectal Cancer Early Detection Program (MCRCEDP). The MCRCEDP focuses on Michigan’s underserved and minority populations, providing CRC education, screening and patient navigation. The MCRCEDP is located in 39 counties, but may accept clients from other counties. Manage BCCCP program w/ a focus on providing services to minority and low-income women. MDCH provides CRC education for the MCRCEDP Coordinators about evidence based activities found in The Community Guide which increases CRC screening rates and reduces barriers to the underserved population. This includes providing information and in-servicing on the creation of small media which can be created on the Make It Your Own website. All small media may be targeted toward specific populations including minority populations: AA, Native Americans, and Hispanics. Provided CRC education and support to the Coordinators encouraging 1:1 patient navigation and CRC education to increase CRC screening rates. Statewide CRC PSAs on radio and television (Spanish and English). Breast Cancer Awareness Month (October 2012) - PSA's and press releases on the importance of breast cancer screening. Promotion of Breast Cancer Fact Sheet citing statistics on screening, incidence, and mortality related to breast cancer.


Twenty two Michigan Health Centers received funding to increase cervical cancer screening using the Patient Centered Medical Home model of care. This process will increase the number of women screened and tracked in health centers that serve the uninsured and under insured. MPCA partners with MDCH to offer two educational webinars on new screening guidelines and resources for treatment and care.

Michigan State University Breslin

Cancer Center

Provided educational lectures in partnership with community organizations (e.g. MGL HealthWise University) for targeted minority groups as described above

MidMichigan Medical Center - Midland

Participated in BCCCP program as well as offered free mammogram screenings for women enrolled in the Midland Health Plan

Midwest Health Plan

Sent Reminder mailings quarterly to members who are due for screenings. Providers can obtain "opportunity reports" on website for their patients. Opportunity Reports list the patients' recent visits and also any services that are due. Educational articles are published in member and provider newsletter yearly. Educational brochures are available to members who request more information.

Muskegon County Health Department

Distributed information about the BCCCP, Family Planning Project and Colorectal Cancer Screening to churches and doctor offices in areas of minority men or women.

Providence Cancer Institute

Have community programs that partner with the local community in Southfield the Mall walkers, an African American group that walks for fitness at Northland Mall. Provided breakfast and lectures. Lectured this group on colorectal cancer screening. Also have a community lecture series called “dinner with a doc”.

Saint Mary’s Health Care Super Colon exhibit was advertised in Hispanic and African American newspapers. Breast cancer educational sessions targeting Hispanic and African American clinics.

Sparrow Regional Cancer Center Prostate Cancer Education event.


Brought our mobile mammography unit to underserved areas and teach early detection education during the mammogram. Participate in many community events / health fairs and include early detection of all cancers education for participants. Mailing campaign for colon cancer screening and a community run supports this too.


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Table 1.3 cont.: Educational Activities for Populations Who Never or Rarely Receive Timely Breast, Cervical, or Colorectal Cancer Screening as described by MCC Organizations, 2012

Susan G Komen Race for the Cure, KCI

Komen Detroit recently conducted a community assessment to determine the impact of breast cancer across our service area of Wayne, Oakland and Macomb counties. From demographic information and breast cancer incidence and mortality data along with information on the level of poverty and access to health care services, determined the areas in need of the most outreach. Chose Detroit, Highland Park, Pontiac and Warren as target areas. An example is an outreach initiative in Highland Park, MI with a mini-grant from the American Psychological Association Socioeconomic Status Related Cancer Disparities (SESRCD) program. Hosted breast cancer education workshops throughout the city as community clinics, human service agencies, churches and businesses to provide information on breast cancer and healthy lifestyles to the citizens of Highland Park, along with linking them with free breast cancer screenings. Will continue similar efforts in the remaining target areas. Because focus of the community grants ($1.55M from the 2012 Komen Detroit Race for the cure) is underserved women and men, the grants intensify this focus in a very tangible way. Summary of current grants here: http://karmanoscancer.org/KomenDetroit/grants2012.aspx

Susan G Komen for the Cure, MidMichigan

Affiliate

Komen Mid-Michigan, while not a direct service provider, funds several programs that provide education and screening to these target populations. These included education programs through the Allen Neighborhood Center in East Lansing and the EMU Healthy Asian American Project. It also included outreach from screening programs to these populations from our programs run by St Joseph Mercy in Ann Arbor and Allegiance Women's Health Center in Jackson. Komen Mid-Michigan also provides educational materials and presentations at venues who are trying to reach minority and underserved women.

Susan G Komen for the Cure, West MI Affiliate

2012 grantees included Muskegon Family Care, Hackley Community Health, Metropolitan Hospital's "Mammo to go" bus, City on a Hill, Betty Ford Breast Health Center at Spectrum Hospital, The Lack's Cancer Center at St. Mary's Hospital and Genetics Counseling at Spectrum. Each of these organizations used Komen West Michigan funds to deliver educations, screening and diagnostics to under-served men and women in our 5 county areas of Muskegon, Kent, Ottawa, Newaygo and Montcalm. Education events, visiting churches, website information, newsletters, Facebook, materials given at fundraising events


Free pap and throat cancer screening days targeted those with no insurance. Provided interpreters for screens as needed in Spanish and Chinese.

UnitedHealthcare Community Plan

Identified the population and contact to schedule appointments at events at PCP office and or facility of choice


2,500 Pink Saturday’s posters were distributed. More than 75 program volunteers placed the posters at nearly 1,650 locations including stores, beauty shops, restaurants, and churches. Community kick-off press conference was held at a Kalamazoo church. Pink Saturday’s billboards were placed throughout Southwest Michigan. Radio ads in English and Spanish were played throughout August, September and October on stations serving Southwest Michigan. CME Event for providers on the importance of screening for minorities


Department

Keweenaw Bay Indian Community has sponsored many different health outreach activities in the Community. MTU Spirit of the Harvest Powwow - Pink Shawl Dancers KBIC Women's Dinner Health Heart Fair KBIC Women's Retreat Mother's Day Dinner Breast Cancer Awareness (Afternoon Tea)

ZIAD Healthcare for the Underserved, INC Primary care.

http://karmanoscancer.org/KomenDetroit/grants2012.aspx

Health Disparities and Policy Special Report Section I: Health Disparities Survivorship

18

Cancer Survivorship A goal of the MCC is to improve the quality of life for cancer survivors in Michigan. Of organizations that completed the 2012 IPR survey, 71.6% said that their organizations’ mission was compatible with this goal.

Figure 1.8: Promoted/Supported Organizational Partnerships to Decrease Barriers to Survivorship

Resources for Minorities and Underserved Populations, 2012

n=42

Yes 57.1%

Figure 1.9: Promoted/Supported Organizational Partnerships to Decrease Barriers to Survivorship Resources for Minorities and Underserved Populations by

Organization Type, 2012








19

Table 1.4: Activities Implemented to Promote or Support Organizational Partnerships to Decrease Barriers to Survivorship Resources for Minorities and Underserved Populations as

described by MCC Organizations, 2012


Division, Inc

ACS works with facilities that serve disparate populations including hospitals, FQHCs, and other health clinics and organizations promoting access to survivor resources by training staff in how to utilize the ACS resource data base and by direct referral to our Patient Resource Center.


State University

In 2012 KCI completed a Community Health Needs Assessment and received two Susan G. Komen grants. The CHNA has led to activities that will increase partnerships with the Middle Eastern and Hispanic communities. One grant provided from Komen allows the Institute to provide access to diagnostic and screening breast care for many who would otherwise not be able to afford it and who were not eligible for other programs due to age restrictions. The BCCCP grant allows them to buy additional case load from the state and provide continuing care for those diagnosed with cancer not eligible for Medicaid.

Botsford Cancer Center We partner with the ACS

Cancer Services

We offer in collaboration with MidMichigan Medical Center-Midland a wide range of survivorship related services such as support groups, wellness activities including Gentle Yoga and Zumba Gold, financial aid for cancer related rehab costs and transportation at no charge.


Ann Arbor

CSC offers an African American Fellowship monthly that provides support and education to this group of people affected by cancer. CSC also has a Lay Health Advisor Program that is used to reach out to this minority population and educate them about the importance and value of seeking support around cancer.


We refer clients to available resources. If clients diagnosed with breast or cervical cancer through our program we can sign them up for Medicaid.


Partner with MDCH to offer Breast and Cervical Cancer, Family Planning and Colorectal Cancer Screening.


Educational reach out to these groups. Interaction with Social Work identifying barriers and opportunities to decrease, discussed at staff meetings.

Gilda’s Club Grand Rapids

Employ minority program coordinator Conduct a nurse navigation program for minorities Affiliate with local community churches and leaders Conduct support groups in the minority community

Health Department of Northwest MI

Partnerede with American Cancer Society to assist client with health concerns and barriers to health care. Make referrals for Michigan Medicaid eligible clients to receive health insurance during their treatment of breast or cervical cancer. Refer clients to hospital programs that provide cancer treatment and screenings and also refer them to their financial assistance programs


Community collaboration with patient navigators and local resources (Hope Lodge, Gilda's Club, Asian American Support Group (1st ever in area) has solidified BCCCP commitment to caring for our diverse communities in a transparent and action oriented vision.

Mary Free Bed Rehabilitation Hospital

Mary Free Bed Rehabilitation Hospital has actively participated with the Kent Co. Health Dept. in its county-wide Community Health Needs Assessment to identify barriers to minorities and underserved populations in regards to access to survivorship care services and for other services.

McLaren Bay Regional Riley Foundation at McLaren Oakland McLaren Cancer

Institute Riley Foundation at McLaren Oakland


Riley Foundation at McLaren Oakland; Patient Navigation system to reduce any and all barriers a patient might have


20

Table 1.4 cont’d: Activities Implemented to Promote or Support Organizational Partnerships to Decrease Barriers to Survivorship Resources for Minorities and Underserved Populations as

described by MCC Organizations, 2012

McLaren Greater Lansing Riley Foundation at McLaren Oakland

McLaren Oakland Riley Foundation at McLaren Oakland McLaren-Macomb Riley Foundation at McLaren Oakland

Michigan Breast Cancer Coalition

Supported survivorship resources for underserved populations with ACCESS an Arab population in Dearborn by taking participating in their health fair and with the Sisters Program and with U of M Outreach Cancer Program.


Partnered with McLaren Oakland via funding and support for the implementation of PATH program for cancer survivors transitioning from active treatment. McLaren Oakland is located in Pontiac, Michigan


Sister to Sister Program at Gilda's; In 2012 awarded Gilda's Club of Grand Rapids a small grant

The Leukemia & Lymphoma Society-Michigan Chapter

Collaborated with Henry Ford Health System's Institute on Multicultural Health and the National Arab American Nurses Association to present educational programs including bone marrow registry drives.

Figure 1.10: Organization Has a Patient Navigator/Nurse or Staff Providing Navigation Services to Help Reduce Barriers to Care and Coordinate Care

Services, 2012

n=47

Yes, a system is in place and

currently being implemented

78.7%

We are working toward

implementing a system 17.0%

No action taken yet

4.3%


21


Services by Organization Type, 2012

Community-based health care system (n=20)

Organizations representing hard-to-reach and/or special populations (n=3)

Health care insurance plan (n=2)




Health Disparities and Policy Special Report Section I: Health Disparities Equity in Care

22

Equity in Health A goal of the MCC is to reduce disparities in cancer outcomes among Michigan populations and to promote equity in cancer prevention, early detection, treatment, and survivorship. Of organizations that completed the 2012 IPR survey, 89.7% said that their organizations’ mission was compatible with this goal.

Figure 1.12: Primary Population Served by Organizations, 2012

n=70

5.7

2.9

34.3

1.4

15.7

50.0

44.3

American Indian

Arab American

Black orAfrican American

Disabled persons

Hispanic or Latino

White or Caucasian

All

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

Figure 1.13: Geographic Area Served by Organizations, 2012

Urban 52.2%

Rural 47.8%


23

Table 1.5: Patient/Client Demographic Data Currently Collected by Organizations, 2012 (n=68)

N % Age 54 79.4%

Gender 54 79.4% Geographic location 48 70.6%

Race 48 70.6% Ethnicity 46 67.6%

Income 31 45.6% Education level 27 39.7%

Primary language spoken at home 24 35.3% Disability 11 16.2%

Health literacy 5 7.4% All of the above 8 11.8%

Figure 1.14: Currently Use Office of Management and Budget (OMB) Data Standards to Collect Information

for Race and Ethnicity, 2012

n=48

Yes, a system is in place and currently

being implemented

33.3%


implementing a system

10.4%

No action taken yet

16.7%

Don't know 39.6%


24

Figure 1.15: Utilize Data on Patients'/Clients' Race,

Ethnicity, and Primary Language to Help Guide Cancer Prevention Services, 2012

n=45

Yes 51.1%

Figure 1.16: Utilize Data on Patients'/Clients' Race, Ethnicity, and Primary Language to Help Guide Cancer Prevention Services by Organization Type, 2012









25

Table 1.6: Utilization of Patients’/Clients’ Race, Ethnicity, and Primary Language Spoken to Help Guide Cancer Prevention Services as described by MCC Organizations, 2012


Coverage and Evaluation – Used descriptive data to examine the coverage, breadth and implementation of the campaign. 1.Evaluation tools developed to track and document campaign participants: a.# of participants b. Basic Demographics c. Campaign events (date, type of event, venue location, material presented) d. Evaluation estimated the # of contacts through home visits by individuals looking for access to screening and counted those with insurance coverage we educate and were referred for mammography screening. i. Outreach worker will capture process document 2.Campaign Evaluation Portfolio to collect the products developed. a. PSAs, Arab American Guide to Breast Cancer Screening Awareness; press release, web content, and the event marketing materials. Program Coordinator will analyze all implementation data; report


Division, Inc.

Calculated penetration rates based on the percentage of constituents served with patient information and programs to the expected percentage in a given area. This latter is either information gathered from Census Bureau demographic data and/or cancer incidence of a given demographic group. From there assessment of whether ACS is adequately serving a particular population is done and strategic plan crafted accordingly.


State University

Screening rates, cancer incidence and mortality, insurance status, access to health care were used in targeting when and where community based activities should occur. All messages are tailored according to these same criteria. Data is also used to assist decision making for Patient/Community education messaging and educational programs.

Botsford Cancer Center Completed a community assessment to identify target population and plan services based on community need.


Attempted to be sure that information is presented in a culturally sensitive manner and that translators are available if needed.


Had educational information available in different languages and utilized a language line service

Genesee County Health Department Assessed areas where more outreach may be needed.


Primarily if there is a language other than English, interpreters are found or forms are written in other languages, if possible. Compared race and ethnicity of county to patient population seen in our clinics and made adjustments if any is needed. Community Health Assessment done on regular basis which includes race and ethnicity

Inter-Tribal Council of Michigan, Inc.

Used Native specific demographics to inform policy, develop programs and apply for funding


Used for every plan/objective/goal by health education and health promotion services, as well as motivating guidance for agency overall priorities.

McLaren Bay Regional Community needs assessments at all COC certified sites include this information. McLaren Cancer

Institute Community needs assessments at all COC certified sites include this information.

McLaren Cancer Institute-Clarkston Community needs assessments at all COC certified sites include this information.

McLaren Greater Lansing Community needs assessments at all COC certified sites include this information.

McLaren Oakland Community needs assessments at all COC certified sites include this information. McLaren-Macomb Community needs assessments at all COC certified sites include this information.


Data were used to guide program outreach and to tailor cancer prevention materials and messages.


26

Table 1.6 cont’d: Utilization of Patients’/Clients’ Race, Ethnicity, and Primary Language Spoken to Help Guide Cancer Prevention Services as described by MCC Organizations, 2012


About 92% of our population is Caucasian and therefore spent the majority of our focus on this race. Provided educational and other literature in other languages as needed. Our major focus / target group includes: urban, rural, inner city with supporting documents in Hispanic. Have a strong translation and interpreting service so that is available for patients who are on site and needing this service.

Susan G Komen for the Cure, West MI Affiliate Guides which materials are used at specific education events


Dentistry

African-Americans have an especially high risk of developing oral cancer. Our Oral, Head and Neck Cancer awareness events include specific educational materials that target this population. We also have some Tobacco Prevention and Treatment materials available in other language, with culturally sensitive information.


From the prior services, the individuals were asked how they found about the screening and this was utilized to increase the number of individuals screened. All material was available in English and Spanish

Table 1.7: Barriers in Collecting Demographic Data as described by MCC Organizations, 2012

American Cancer

Society, Great Lakes Division, Inc.

Demographic data is self-reported and subject to error. However, of 16,484 unique constituents served in 2012, we gathered data as follows for the four areas we collect: race/ethnicity 75.4%; gender 90.1%; age 82%; and insurance type 66.2%. All are considered valid samples of the population.


State University Not everyone chooses to provide information.

Barry Eaton District Health Department Limited to fields on EMR

Blue Cross Blue Shield of MI

Not currently on a health care claim form because this information it not necessary to pay a claim for services.

Cancer Services We have a very low incidence of ethnic groups in our county. This makes it difficult to justify spending extremely limited funds to track these individuals.

Catherine’s Health Center Patients do not always understand or answer questions.

Coalition of Michigan Organizations of Nursing This is not in our mission vision

Genesee County Health Department Many mixed racial Not always provided

Gilda’s Club Grand Rapids Funding

Grand Rapids Clinical Oncology

Most of this data is collected by the health care partners we work with, as opposed to our office. It's dependent on systems and process.

Greater Detroit Area Health Council

GDAHC would like to collect data across organizations for comparison purposes and community reporting, but the health systems are not ready to provide that info


Clients’ failure to answer these questions. Computer system not supportive of these questions as being required but as being voluntary.

Ingham County Health Department

Oftentimes clients will skip over because the racial/ethnic categories do not accurately reflect their perception.


27

Table 1.7 cont’d: Barriers in Collecting Demographic Data as described by MCC Organizations, 2012

Inter-Tribal Council of Michigan, Inc. Funding to do comprehensive data collection


Many patients choose not to share this information.


Language (forms in every language is very challenging) Distrust by populations (overall, not just minority but historically under-served groups generally distrust government and most things that are 'too good to be true') Staff to coordinate and compile data


We are currently implementing a new EMR system in our inpatient setting. Unfortunately, the new EMR system does not office an outpatient EMR system. Thus, we will be working with two different EMR systems that will not be interoperable. The outpatient EMR is not sufficient to meet our data collection needs, so we will have to create a separate database for this purpose in the outpatient area. The latter will be more time-consuming vs. having an interactive, interoperable EMR system in both the outpatient & inpatient setting.

McLaren Bay Regional System wide EMR not launched, but to be launched summer 2013 McLaren Cancer

Institute System wide EMR not launched, but to be launched summer 2013

McLaren Cancer Institute-Clarkston System wide EMR not launched, but to be launched summer 2013, no barriers

McLaren Greater Lansing System wide EMR not launched, but to be launched summer 2013

McLaren Oakland System wide EMR not launched, but to be launched summer 2013 McLaren-Macomb System wide EMR not launched, but to be launched summer 2013


Integrating Affordable Care Act and Office of Management and Budget race, ethnicity, other standards across all MDCH programs.

Michigan Health & Hospital Association Poorly captured


Cancer Center

We are collecting demographic data but not yet being used to target a specific population

MPRO

We work primarily with other EHRs of other health systems/physician practices and currently, though collected for Meaningful Use, race & ethnicity are very difficult to stratify amongst particular measures. The EHRs are not yet robust enough with reporting to provide good, actionable data for analysis on disparities of care.

Providence Cancer Institute Not enough translators


There are no barriers that I'm aware of. We have not chosen to embrace this project within the cancer program. It may be happening in other departments / service lines in the system.


Our organization does not collect this data but rather relies upon our grantees to collect it once they start working with the individual.


Racial and ethnic demographic data is optional

ZIAD Healthcare for the Underserved, INC Staff and resources are limited


28

Table 1.8: Solutions to Address Barriers to Collecting Demographic Data by Organization, 2012


Division, Inc

Just commit yourself to doing it. Somehow we feel that these questions may seem offensive or intrusive. This is not the case. Most people are willing to share demographic information for a legitimate reason. Train your intake person to be sensitive but also to be able to state that the information gathered helps assess how the organization is serving - and ways to better serve - a particular population.


State University Translators are used when applicable.


Department Use of EMR

Gilda’s Club Grand Rapids We continue to apply for grants and donors to fund our minority program.

Grand Rapids Clinical Oncology Systems and definitions

Henry Ford Health System We use patient provided information.

Inter-Tribal Council of MI, Inc Cancer specific data is available through our partnership with the State Cancer Registry


Tenacity open dialogue with communities trying to serve honesty with why trying to serve (high HIV rates for instance, under-diagnosed breast cancers, etc) and hope for interventions (better quality of life with tx, more treatment options (possibly less death) with earlier dx cancer, etc)


Currently, we are creating our own databases (based on current OMB guidelines) to capture the essential information that we need.


A committee has been established to further consider data collection according to ACA and OMB standards and to also understand possible strategies to increase awareness and adoption activities.


Cancer Center Implementing meaningful use criteria of EMR

Providence Cancer Institute Phone line translator services

West Michigan Cancer Center Provide Hispanic translators in the call center


29

Figure 1.17: Have Policies in Place to Increase Access to Cancer Prevention

Services and to Meet Patients'/Clients' Needs 2012

n=61

73.8%

62.3%

52.5%

44.3%

26.2%

Education/awareness materialsin primary language spoken by

populations served

Translation services

Require staff to be trained andreceive continuing education

on cultural competencyRecruit, hire, and retain staffthat is representative of all

populations served

Weekend or extended hours

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

Figure 1.18: Organization Supports Programs/Interventions with Focus on Minority or

Special Populations, 2012

n=57

Yes 78.9%


30

Figure 1.19: Organization Supports Programs/Interventions with Focus on

Minority or Special Populations by Organization Type, 2012









31

Table 1.9: Programs/Interventions with Focus on Minority or Special Populations as described by organizations, 2012


The Arab Community Center for Economic and Social Services (ACCESS) is a community-based organization that combines advocacy, direct services, and community organizing in addressing the needs and concerns of the Arab American community in Southeastern Michigan. ACCESS provides services in the following areas: family counseling, cultural arts, education, emergency food and shelter program, employment and training, legal services, translation, and an environmental health program. ACCESS functions as a community center for a range of community social and cultural activities. We are a human services organization committed to the development of the Arab-American community in all aspects of its social, economic and cultural life.


Division, Inc

Provided funding and support services to two FQHCs in Detroit to increase breast cancer screenings to their constituents; provided funding and support to a Detroit FQHC look alike to increase breast cancer screenings to their constituents; provided funding and support to a clinic in Detroit serving disparate populations in increasing breast and colorectal cancer awareness and screenings; provided funding and support services to the Inter Tribal Council of Michigan to raise awareness and screening rates in tribal communities; provide training to tribal health clinics in the Circle of Life program, a curriculum that raises awareness and education on cancer and healthy lifestyles among native peoples. Our Body & Soul faith-based program supported 76 primarily African American and Hispanic churches with cancer information and healthy lifestyle information. Cooperative ventures with the Mexican Consulate in Detroit in providing information and service referrals. We provide support to organizations serving special populations through normal, regular, and customary relations including hospital systems, state and local agencies, specialized population organizations, etc.


State University

Research Projects: Clinic based communication intervention; community based partner project: SEMPAC; community based Witness Detroit project, community based Latina breast cancer awareness, community based Orthodox Jewish Community cancer awareness project, community based understanding issues related to bio-specimen donation in the African American community.

Botsford Cancer Center Our multiple free screening events focused on the uninsured and underinsured population.

Calhoun County Cancer Control Coalition

Partnered with the Nursing Clinic for the free colonoscopy patients. Targeted the under and in-insured.


Ann Arbor

CSC offers a monthly African American Fellowship designed to meet the unique needs of African Americans and their families who are affected by cancer. CSC has also offered specific educational workshops on the African American Cancer experience.

Catherine’s Health Center BCCCP

Coalition of Michigan Organizations of Nursing Participated in cancer fundraising activities i.e. Relay for Life


Cancer prevention services, BCCCP and colorectal, are promoted and provided equally across the health jurisdiction

District Health Department #4 Outreach to low-come, uninsured and underinsured populations

Genesee County Health Department Media releases to outlets that serve minority populations

Gilda’s Club Grand Rapids Support groups in the community; nurse navigation services.


We looked at available NCI Clinical Trials educational materials. We continue to partner with community agencies and groups to increase awareness.


32

Table 1.9 cont’d: Programs/Interventions with Focus on Minority or Special Populations as described by organizations, 2012


We have service agreements with Migrant Clinic for free breast and cervical exams and follow-up. Also have relationship with Native American Clinics to receive referrals from them if there is a breast or cervical cancer issue.

Henry Ford Health System We participate in an NCI sponsored Community Network Program.

Huron County Health Department BCCCP

Ingham County Health Department We do targeted breast education programs during Breast Cancer Awareness Month.

Inter-Tribal Council of Michigan, Inc All programs target Native Americans


Outreach to minority populations; BCCCP Pink Saturdays Southwest Michigan Cancer Control Coalition


Many options to choose - brining the services to populations underserved (mobile mammography) Bringing education to location prior to screenings to better educate the 'why' of a service (i.e. going to primarily Spanish speaking church 2 weekends before mobile unit to emphasize education) Extensive review of program brochures to be literacy and culturally appropriate to communities serving


Department

BCCCP program -- Sault Tribe of Chippewa Indians is an enrolling provider for this program -- four tribal locations.

McLaren Bay Regional

Screening programs target underserved populations. -- Patient Connect, our in house education service, tailors our promotional and educational materials to represent patients from diverse backgrounds. -- Strong work from the Riley Foundation in Pontiac toward programs that serve minority populations and address disparities.





McLaren Greater Lansing


McLaren Oakland


McLaren-Macomb



Staff support of MCC Health Disparities Workgroup; staff support of MDCH BCCCP and MCRCEDP; and funding of local comprehensive cancer control projects.


33

Table 1.9 cont’d: Programs/Interventions with Focus on Minority or Special Populations by Organization, 2012


We are working on a bridge case management program to facilitate continuity of care and treatment in the Migrant population

Michigan Society of Hematology and

Oncology We participate in the SEMPAC research projects

Muskegon County Health Department 1. Immunization 2. WIC 3.Health Education 4.BCCCP

Susan G Komen for the Cure, Detroit Affiliate

Susan G. Komen for the Cure has two campaigns focused on eliminating health disparities in the African American and Hispanic/Latina communities called the Circle of Promise and Lazos Que Perduran. Culturally appropriate materials related to these programs are always available for distribution at all community outreach events and during the annual Race for the Cure. We also have educational materials available in multiple languages for those with limited English proficiency. Komen Detroit also funds grant programs related to breast cancer. Some of these programs are focused on specific minority communities, including African Americans and Hispanics. These programs continue to have great success in helping people from these groups access timely breast cancer education, screening and follow-up care. Additionally, Komen Detroit Race entry forms are available in Spanish and Arabic as well as English. ASL signers are used at major Komen Detroit recognition events and in various locations at the Race site, along with Spanish and Arabic translators.

Susan G Komen for the Cure, MidMichigan

Affiliate

Breast Cancer screening programs at Allegiance Women's Health Center in Jackson and St Joseph Mercy hospital in Ypsilanti.


Bone marrow registry drives; education programs


Men's Fellowship Breakfast events and Hats and High Tea events focus on minority populations. We also participate in Spanish Healthcare outreach and organize Dia de la Familia health event each year. We work with Asian and Arabic speaking populations through health fair participation and sending out materials on cancer prevention with brochures/posters translated for non-English speakers.


Pink Saturdays--Breast Cancer Screening Here is data on the impact of minority outreach: 1) Minority group screened: African-American women--22% increase over 2011 and Latino Women--84% increase over 2011 2) Service to the underserved: African-American women--8.6% of the population and 12.8% of mammograms; Hispanic women--5% of the population and 7.5% of mammograms Blue Ribbons--Colon Cancer Screening--All of the free colonoscopies were to the underserved population Lung cancer Screening Education--Lectures to minority church groups & attended the church health fairs

ZIAD Healthcare for the Underserved, Inc Wayne counties Health expo at Cobo Hall

Health Disparities and Policy Special Report Section I: Health Disparities Bio-Specimens

34

Bio-Specimens Cancer researchers need access to an ample supply of high-quality bio-specimens (blood, tissue, urine, plasma, or saliva) in order to explore new ways to diagnose and treat disease. Samples from members of minority ethnic groups are essential to help understand, at the molecular level, cancer-related differences and similarities observed for these populations. Of organizations that completed the 2012 IPR survey, 26.7% said that their organization was involved in the collection of bio-specimens for cancer research.

Figure 1.15: Organization Collects Bio-Specimens for Cancer Research by Organization Type, 2012








35

Figure 1.15: Implement Activities to Increase Culturally Appropriate Community/Patient Education on Bio-

Specimen Collection, 2012

n=39

Yes 25.6%


36

Table 1.10: Activities Relevant to Bio-Specimen Collection for Cancer Research as described by organizations, 2012


Division, Inc.

ACS enrolled 4,089 people in 2012 at 13 sites across the state in the Cancer Prevention Study 3 (CPS-3) a nationwide prospective cohort study. Blood samples and other information was gathered from each enrollee


State University Stem cell collection for clinical trials.

Genesee County Health Department We had representative from MDCH present information at 2 forums in the community.


Every clinical trial we have open has a tissue and specimen component. This has only increased in intensity and complexity. Our research team actively works with patients and providers to explain, obtain informed consent, collect, process and submit required materials as defined by several hundred cancer clinical trials, currently with patients on or in follow-up.

Henry Ford Health System This is a component of our NCI sponsored Community Network Program (CNP).


Worked greatly with Van Andel and Clinical Oncology to ensure BCCCP patients diagnosed with fully informed of why specimens would be helpful and were not harmful or ethically compromising their care or outcomes.

Marquette General Cancer Center We participated in the total cancer care, brain tumor tissue banking


The Michigan Bi-Trust for Health collects and stores newborn screening dried blood spots indefinitely from Michigan newborns for multiple purposes including cancer research. Parental consent is now required. Consent for participation can be withdrawn at any time. Educational outreach activities are conducted statewide.


Cancer Center

My organization participates in intergroup cancer trials as well as our own research at the university

Muskegon County Health Department None

Saint Mary’s Health Care Collect bio-specimens for the Van Andel Research Institute and The Cancer Genome Atlas Project.

Spectrum Health Cancer Program All cancerous tissue is reserved as a bio specimen.


Bio-Specimens via clinical trials; Dr Mirro, CEO / CMO was the community champion and a total of 581 individuals were enrolled into Cancer Prevention Study 3 via ACS.

Health Disparities and Policy Special Report Section II. Policy

37

Section II. Policy

Health Disparities and Policy Special Report Section II: Policy Prevention: Tobacco Control

38

Cancer Prevention: Smoking Cessation A goal of the MCC is to reduce tobacco use among adults and youth in Michigan. Of organizations that completed the 2012 IPR survey, 85.7% said that their organizations’ mission was compatible with this goal.

Figure 2.1: Provided Patients/Clients with Advice and Counseling on the Harms of Tobacco Use and Exposure

during Routine Office Visits, 2012

n=61

Yes 90.2%

Figure 2.2: Provided Patients/Clients with Advice and Counseling on the Harms of Tobacco Use and Exposure during Routine Office Visits by Organization Type,

2012









39

Figure 2.3: Assessed Patients/Clients Tobacco Use as Part of a Written Checklist or Health Risk Assessment in all Routine

Office Visits, 2012

n=50

Yes, a system is in place

and currently being

implemented 90.0%



8.0%

No action taken yet

2.0%

Figure 2.4: Assessed Patients/Clients Tobacco Use as Part of a Written Checklist or Health Risk Assessment in all Routine Office Visits by Organization Type,

2012




Health education/evaluation & research (n=1)





40

Figure 2.5: Assessed Patients/Clients with Exposure to Tobacco Smoke as Part of a Written Checklist or Health Risk

Assessment during Routine Office Visits, 2012

n=51


and currently

being implemented

60.8% We are working toward


17.6%

No action taken yet

21.6%

Figure 2.6: Assessed Patients/Clients with Exposure to Tobacco Smoke as Part of a Written Checklist or Health Risk Assessment During Routine Office Visits by










41

Figure 2.7: Implemented a Referral System to Help Patient/Clients Access Tobacco Resources and Services, 2012

n=54


and currently

being implemented

87.0%



11.1%

No action taken yet

1.9%

Figure 2.8: Implemented a Referral System to Help Patient/Clients Access Tobacco Resources and Services by Organization Type, 2012








Health Disparities and Policy Special Report Section II: Policy Prevention: HPV Vaccination

42

Cancer Prevention: Human Papilloma Virus (HPV) Vaccination A goal of the MCC is to increase the initiation and completion of the human papillomavirus (HPV) vaccine series among adolescents and younger adults. Of organizations that completed the 2012 IPR survey, 69.5% said that their organizations’ mission was compatible with this goal.

Figure 2.9: Provided Counseling to Age Appropriate Girls/Young Women and/or Their Parents/Legal Guardians

About the Need for HPV Vaccination, 2012

n=37

Yes 89.2%

Figure 2.10: Provided Counseling to Age Appropriate Boys/Young Men and/or Their Parents/Legal Guardians About

the Need for HPV Vaccination, 2012

n=32

Yes 68.8%


43

Figure 2.11. Organizations Who Provided Counseling to Age Appropriate Adolecents or Young Adults and/or Their Parents/Legal Guardians About the Need for HPV Vaccination by


90.9

33.3

50.0

100.0

100.0

50.0

100.0

84.2

50.0

50.0

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

Community-based health systems

(n=11)

(n=6)

Organizations representing hard-to-reach or special populations

(n=2)

(n=2)

Health care insurance plans

(n=2)

(n=2)

Public health organizations

(n=19)

(n=19)

University-based health systems

(n=2)

(n=2)

Females Males


44

Figure 2.12: Assessed Patients’/Clients’ Need for HPV Vaccination as Part of a Written Checklist or Risk Assessment

in Routine Visits, 2012

n=32


and currently

being implemented

71.9%



18.8%

No action taken yet

9.4%

Figure 2.13: Assessed Patients’/Clients’ Need for HPV Vaccination as Part of a Written Checklist or Risk Assessment in Routine Visits by Organization, 2012








45

Figure 2.14: Implemented a Referral System to Help Patients/Clients Access Appropriate HPV Vaccination

Services, 2012

n=36


and currently

being implemented

66.7%



11.1%

No action taken yet

22.2%

Figure 2.15: Implemented a Referral System to Help Patients/Clients Access Appropriate HPV Vaccination Services by Organization, 2012







Health Disparities and Policy Special Report Section II. Policy Risk Assessment: Cancer Genomics

46

Risk Assessment: Cancer Genomics A goal of the MCC is to increase the availability of cancer-related genetic information to the Michigan public and to decrease barriers to risk appropriate services. Of organizations that completed the 2012 IPR survey, 67.5% said that their organizations’ mission was compatible with this goal.

Figure 2.16: Encouraged Completing Family History Questionnaire to Assess Patients’/Clients’ Risk as Part of a

Written Checklist or Health Risk Assessment in All Routine Office Visits, 2012

n=34


and currently

being implemented

70.6%



8.8%

No action taken yet

20.6%

Figure 2.17: Encouraged Completing Family History Questionnaire to Assess Patients’/Clients’ Risk as Part of a Written Checklist or Health Risk Assessment

in All Routine Office Visits by Organization Type, 2012








47

Figure 2.18: Used Results of Family History Assessments to Recommend Referral to Genetic Counseling, 2012

n=32


and currently

being implemented



9.4%

No action taken yet

28.1%

Figure 2.18: Used Results of Family History Assessments to Recommend Referral To Genetic Counseling by Organization Type, 2012







48

Figure 2.20: Offer Genetic Counseling Services, 2012

n=33

Yes 42.4%

Figure 2.21: Offer Genetic Counseling Services by Organization Type, 2012






49

Figure 2.22: Implemented a Referral System to Help Patients/Clients Access Appropriate Genetic Counseling

Services, 2012

n=35


and currently

being implemented

65.7%



8.6%

No action taken yet

25.7%

Figure 2.23: Implemented a Referral System to Help Patients/Clients Access Appropriate Genetic Counseling Services by Organization Type, 2012







Health Disparities and Policy Special Report Section II: Policy Early Detection

50

Early Detection of Cancer A goal of the MCC is to decrease the cancer death rate in Michigan by increasing the proportion of the population receiving appropriate cancer screening and follow-up of abnormal screening results for breast, cervical, and colorectal cancers. Of organizations that completed the 2012 IPR survey, 86.4% said that their organizations’ mission was compatible with this goal.

Figure 2.24: Implemented Any Policy/System Change Interventions for Early Detection of Breast, Cervical or

Colorectal Cancer, 2012

n=49

Yes 26.5%

Figure 2.24: Implemented Any Policy/System Change Interventions for Early Detection of Breast, Cervical or Colorectal Cancer by Organization Type, 2012









51

Figure 2.25: Evaluated the Impact of Policy/System Change Intervention, 2012

n=12

Yes, an evaluation

was completed

25.0%

We are in the process

of an evaluation

50.0%

No evaluation is

planned 25.0%


52

Table 2.1: Policy/System Change Interventions for the Early Detection of Breast, Cervical, or Colorectal Cancer Implemented by Organization, 2012


ACCESS has developed and evaluated a culturally specific and competent cancer awareness program for cancer prevention/cancer screening activities to encourage appropriate health seeking behavior. This model takes into consideration many socio-economic and cultural conditions and allows for the collection of cancer prevalence data which is not available for many ethnic groups including Arab Americans who are not considered a minority. By educating Arab American women through a culturally tailored Arab American cancer awareness program, ACCESS is able to collect additional prevalence and screening data. The process evaluation used descriptive data to examine the coverage, and implementation of the campaign. Evaluation tools were developed to track and document campaign participants (number of participants, basic demographics), campaign events (date, type of event, venue location, material presented) and the work of our monthly meetings (agenda, meeting minutes, lessons learned, rationale for changes in implementation). The evaluation estimated the number of contacts by individuals looking for access to screening through the ACCESS Medical Clinic and was compared to the number of clients enrolled with the BCCCP Program after receiving their education in a private home visit. The outreach workers capture the processed data weekly, and reconcile the intake forms with the schedule to evaluate effectiveness of the home visits. The outcome of this model illustrates the relationship between culture, spirituality and health across the life course of Arab Americans. Cultural concepts, values, and beliefs shape the way health symptoms are expressed and how individuals and their families respond to such distress. The campaign implementation evaluation reports shared with the Steering Committee project improvement, corrective action planning, and documentation of project achievements and lessons learned.


State University

Institute staff review all patient/public information sources annually, including Fact Sheets, presentations and web site. As well as the Susan G. Komen for the Cure, Detroit affiliate, the Institute partners with CRAN, BCCCP, Project Health Living and various corporations.

Catherine’s Health Center Formal process for making sure that every woman is offered yearly screening

Genesee County Health Department Information is given out as part of enrollment for our County Health Plan.


Changed Pap screenings as per the recommendations that came from MDCH and the ASCCP. Shared changes in Medical Protocol with all providers. Moved to a new computer system called Insight that allows better tracking of follow-up to abnormal tests Update written policies annually or as needed

McLaren-Macomb As stated previously regarding the BRAvo For Women free mammogram program. For CRC screening, we implemented the FIT kits in replacement of the FOBT. We found improved participant compliance with the FIT kits in 2012.

Michigan Cancer Genetics Alliance

Not exactly, but we did include a new goal/activity for our MCGA Policy Committee and MCGA Membership Committee; this new goal was focused on recruiting/encouraging more health plan policy staff members to join MCGA and to participate in our educational meetings twice per year. In addition, we are trying to engage those new health plan members in our Policy Committee work.


53

Table 2.1 cont.: Policy/System Change Interventions for the Early Detection of Breast, Cervical, or Colorectal Cancer Implemented by Organization, 2012


The MCRCEDP collaborated with the following organizations: Integrated Health Partners: Funded provider education about CRC guidelines, options for risk appropriate CRC screening through the Physician Learning Collaboratives (PLC). Supported development and implementation of IHP’s patient registry/provider CRC screening reminder systems which tracks current and past screening/results and next screening interval; Provided the Coordinator of the Calhoun County Cancer Coalition (5Cs) with education about CRC patient navigation. Patient navigation implemented and CRC screening rates increased; Collaborated with Local Health Departments (LCAs) providing education about the Make It Your Own system to develop CRC small media for both MCRCEDP and Medicare clients; Provided staff support for the MCC Policy and MCC Health Disparity Committee (HDC). The HDC and Policy Committee developed priorities in FY12 and plans to work with the Policy Committee in distribution and implementation of MCC priorities. Work began in December for a March CRC Health Disparities and Policy Webinar; Collaborating with the MCC Challenge: Five MCC organization implemented policies within their worksites to increase CRC cancer screening rates; Collaborated with the following organizations on CRC screening and provider education programs; McLaren Health System; 5Cs - Calhoun County Cancer Control Coalition – implemented patient navigation; Saint Joseph Mercy, Ann Arbor – implemented patient navigation and provider education in the clinics to both med students and provider clinical staff; Western Michigan Cancer Center (WMCC) and Kalamazoo County Cancer Control Coalition implementation of patient navigation (PN) and CRC provider and client reminder systems in two primary care clinics. All clients will be tracked by the PN for CRC screening. CRC Screening: MCRCEDP Grantees (Health Departments): Barry- Eaton, Central Michigan, Huron County, DHD #4, DHD #10, , Muskegon County, Northwest and Grand River Gastroenterology (GRG), Private GI Practice in Grand Rapids, MI; Provided support and CRC resources to private PCP practices (Dr. Plonka’s office): MIYO, Community Guide, and CRC screening guidelines. Provided resources/education /examples about how they could utilize MIYO’s small media (patient reminder) with their patient registry system; Provided education and CRC resources (current literature searched) to Coordinator of the Inter Tribal Council (ITC) staff and providers: CRC screening options, literature on increasing CRC screening rates by offering risk appropriate screening options, discontinuation of an office DRE as a CRC screening tool, discussed the collection upcoming QI data for the ITC; Collaborating with MDCH Genomics to develop and tape a webinar for providers and community members about Lynch Syndrome in March FY13.


Cancer Center As part of core measures of meaningful use of EMR

Providence Cancer Institute Through our employee smart health benefits.

U of M Comprehensive Cancer Center As guidelines for Cervical Cancer screening were changed, we adjusted policy.

ZIAD Healthcare for the Underserved, INC Guidelines in Practice fusion


54

Figure 2.26: Assessed Patients’/Clients’ Screening History for Colorectal Cancer as Part of a Written Checklist or Health Risk

Assessment in All Routine Visits, 2012

n=37

Yes, a system in in place

and currently

being implemented


implemetning a system

16.2%

No action taken yet

27.0%

Figure 2.27: Assessed Patients’/Clients’ Screening History for Colorectal Cancer as Part of a Written Checklist or Health Risk Assessment in All Routine Visits by

Organization, 2012








55

Figure 2.28: Implemented a Referral System to Help Patients/Clients Access Appropriate Colorectal Cancer

Screening Services, 2012

n=39


and currently

being implemented

59.0%



17.9%

No action taken yet

23.1%

Figure 2.29: Implemented a Referral System to Help Patients/Clients Access Appropriate Colorectal Cancer Screening Services by Organization, 2012








56

Figure 2.30: Maintain a Provider Reminder System to Ensure Providers Know Which Patients/Clients Are Eligible for

Colorectal Cancer Screening Services in a Timely Manner, 2012

n=34


and currently

being implemented

35.3%



14.7%

No action taken yet

50.0%

Figure 2.31: Maintain a Provider Reminder System to Ensure Providers Know Which Patients/Clients Are Eligible for Colorectal Cancer Screening Services in a

Timely Manner by Organization Type, 2012








57

Figure 2.32: Maintain a Patient Reminder System to Ensure Providers Know Which Patients/Clients Are Eligible for

Colorectal Cancer Screening Services in a Timely Manner, 2012

n=35


and currently

being implemented



17.1%

No action taken yet

31.4%

Figure 2.33: Maintain a Patient Reminder System to Ensure Providers Know Which Patients/Clients Are Eligible for Colorectal Cancer Screening Services in a









58

Figure 2.34: Maintain a Provider Reminder System to Ensure Providers Know Which Patients/Clients Are Eligible for Breast

Cancer Screening Services in a Timely Manner, 2012

n=34


and currently

being implemented

76.5%



11.8%

No action taken yet

11.8%

Figure 2.36: Maintain a Provider Reminder System to Ensure Providers Know Which Patients/Clients Are Eligible for Breast Cancer Screening Services in a








59

Figure 2.37: Maintain a Patient Reminder System to Ensure Providers Know Which Patients/Clients Are Eligible for Breast Cancer Screening Services in a








Figure 2.36: Maintain a Patient Reminder System to Ensure Providers Know Which Patients/Clients Are Eligible for Breast

Cancer Screening Services in a Timely Manner, 2012

n=46


and currently

being implemented

82.6%



8.7%

No action taken yet

8.7%


60

Figure 2.38: Instituted ‘Provider Assessment and Feedback’ on Appropriate and Timely Provision or Referral for Colorectal

Cancer Screening Services, 2012

n=37


and currently

being implemented



13.5%

No action taken yet

32.4%

Figure 2.39: Instituted ‘Provider Assessment and Feedback’ on Appropriate and Timely Provision or Referral for Colorectal Cancer Screening Services by








61

Figure 2.40: Organization Follows Specific Guidelines/Recommendations for Follow-up Care of

Patients/Clients with Abnormal Colorectal Cancer, 2012

n=36

Yes 88.9%

No 2.8%

Don't Know 8.3%

Figure 2.41: Offer Information and Counseling to Patients/Clients To Help Make Informed Decisions About

Being Screened for Prostate Cancer, 2012

n=36


and currently

being implemented



16.7%

No action taken yet

30.6%


62

Figure 2.42: Offer Information and Counseling to Patients/Clients To Help Make Informed Decisions About Being Screened for Prostate Cancer by Organization

Type, 2012







Health Disparities and Policy Special Report Section II: Policy Survivorship

63

Cancer Survivorship A goal of the MCC is to improve the quality of life for cancer survivors in Michigan. Of organizations that completed the 2012 IPR survey, 71.6% said that their organizations’ mission was compatible with this goal.

Figure 2.43: Ensure That All Cancer Survivors Have a Current Survivor Care Plan Including a Cancer Treatment Summary,

2012

n=30


and currently

being implemented

6.7%



66.7%

No action taken yet

26.7%


64

Figure 2.44: Ensure That All Cancer Survivors Have a Current Survivor Care Plan Including a Cancer Treatment Summary by Organization Type, 2012








65

Figure 2.45: Organization Has a Patient Navigator/Nurse or Staff Providing Navigation Services to Help Reduce Barriers to

Care and Coordinate Care Services, 2012

n=47


and currently

being implemented

78.7%



17.0%

No action taken yet

4.3%


Services by Organization Type, 2012







Health Disparities and Policy Special Report Section II: Policy Equity in Care

66

Equity in Care A goal of the MCC is to reduce disparities in cancer outcomes among Michigan populations and to promote equity in cancer prevention, early detection, treatment, and survivorship. Of organizations that completed the 2012 IPR survey, 89.7% said that their organizations’ mission was compatible with this goal.

Figure 2.47: Currently Use Office of Management and Budget

(OMB) Data Standards to Collect Information of Race and Ethnicity, 2012

n=48


and currently being

implemented 33.3%


implementing a system 10.4%

No action taken yet

16.7%

Don't know 39.6%


67

Figure 2.48: Currently Use Office of Management and Budget (OMB) Data Standards to Collect Information of Race and Ethnicity, 2012









68

Figure 2.49: Utilize Data on Patients'/Clients' Race, Ethnicity, and Primary Language to Help Guide Cancer

Prevention Services, 2012

n=45

Yes 51.1%

Figure 2.50: Utilize Data on Patients'/Clients' Race, Ethnicity, and Primary Language to Help Guide Cancer Prevention Services by Organization Type, 2012









69

Table 2.2: Utilization of Patients’/Clients’ Race, Ethnicity, and Primary Language Spoken to Help Guide Cancer Prevention Services by Organization, 2012


Coverage and Evaluation – Use descriptive data to examine the coverage, breadth and implementation of the campaign. 1.Evaluation tools developed to track and document campaign participants: a.# of participants b. Basic Demographics c. Campaign events (date, type of event, venue location, material presented) d. Evaluation to estimate the # of contacts through home visits by individuals looking for access to screening and count those with insurance coverage we educate and were referred for mammography screening. i. Outreach worker will capture process document 2.Campaign Evaluation Portfolio to collect the products developed. a. PSAs, Arab American Guide to Breast Cancer Screening Awareness; press release, web content, and the event marketing materials. Program Coordinator will analyze all implementation data & report


Division, Inc

We calculate penetration rates based on the percentage of constituents served with patient information and programs to the expected percentage in a given area. this latter is either information gathered from Census Bureau demographic data and/or cancer incidence of a given demographic group. From there we assess if we are adequately serving a particular population and craft our strategic plan accordingly.


State University

Screening rates, cancer incidence and mortality, insurance status, access to health care are used in targeting when and where community based activities should occur. All messages are tailored according to these same criteria. Data is also used to assist decision making for Patient/Community education messaging and educational programs.

Botsford Cancer Center We have completed a community assessment to identify our target population and plan our services based on community need.


Attempting to be sure that information is presented in a culturally sensitive manner and that translators are available if needed.


We have educational information available in different languages and we utilize a language line service

Genesee County Health Department To assess areas where more outreach may be needed.


Primarily if there is a language other than English, interpreters are found or forms are written in other languages, if possible. Compare race and ethnicity of county to patient population seen in our clinics and make adjustments if any is needed Community Health Assessment done on regular basis which includes race and ethnicity

Inter-Tribal Council of Michigan, Inc

Use of Native specific demographics to inform policy, develop programs and apply for funding


used for every plan/objective/goal by health education and health promotion services, as well as motivating guidance for agency overall priorities.

McLaren Bay Regional Community needs assessments at all COC certified sites include this information. McLaren Cancer

Institute Community needs assessments at all COC certified sites include this information.

McLaren Cancer Institute-Clarkston Community needs assessments at all COC certified sites include this information.

McLaren Greater Lansing Community needs assessments at all COC certified sites include this information.

McLaren Oakland Community needs assessments at all COC certified sites include this information. McLaren-Macomb Community needs assessments at all COC certified sites include this information.


Data is used to guide program outreach and to tailor cancer prevention materials and messages.


70

Table 2.2 cont.: Utilization of Patients’/Clients’ Race, Ethnicity, and Primary Language Spoken to Help Guide Cancer Prevention Services by Organization, 2012


We know that about 92% of our population is Caucasian and therefore spend the majority of our focus on this race. We provide educational and other literature in other languages as needed. Our major focus / target group includes: urban, rural, inner city with supporting documents in Hispanic. We have a strong translation and interpreting service here so that is available for patients who are on site and needing this service.

Susan G Komen for the Cure, West MI Affiliate Guides which materials are used at specific education events


Dentistry

African-Americans have an especially high risk of developing oral cancer. Our Oral, Head and Neck Cancer awareness events include specific educational materials that target this population. We also have some Tobacco Prevention and Treatment materials available in other language, with culturally sensitive information.


From the prior services, the individuals were asked how they found about the screening and this was utilized to increase the number of individuals screened. All material was available in English and Spanish

Figure 2.51: Have Policies in Place to Increase Access to Cancer Prevention Services and to Meet Patients'/Clients' Needs, 2012

n=61

73.8%

62.3%

52.5%

44.3%

26.2%

Education/awareness materialsin primary language spoken by

populations served

Translation services

Require staff to be trained andreceive continuing education

on cultural competencyRecruit, hire, and retain staffthat is representative of all

populations served

Weekend or extended hours

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

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