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Goal is to eliminate disparity
Efforts are under way in two states to eliminate disparity in cancer death rates between African-Americans and Caucasians.
This problem has led five universities in Ala-bama and Mississippi to form a network with federal, state, and local agencies to provide better education about cancer and early detection.
The Deep South Network for Cancer Control was funded by a $5.2 million grant from the Bethesda, MD-based National Cancer Institute (NCI) in April 2000. The network targets African-Americans in underserved areas by using men and women from the various communities as peer counselors or advisors after they have completed an eight-week training program. The community health advisors know the available local resources and are able to help their neighbors navigate the system. They offer advice, assistance, and provide an action plan.
"They assist women in getting the screening and services they need, and they will often do the actual work that is required to initiate the screening," says Claudia M. Hardy, MPA, program manager for the Deep South Network at the University of Alabama at Birmingham.
The health advisors currently are educating women about the importance of early detection of breast and cervical cancer. The Centers for Disease Control and Prevention in Atlanta has a program in place that provides free breast and cervical cancer screenings. As other types of early cancer detection programs for the underserved become available, the health advisors also will help people in their communities take advantage of them.
One of the Deep South Network’s top priorities is to train 600-700 community health advisors within the next five years. Other goals include promoting African-American participation in clinical trials and to encourage minority students to go into cancer research.
The universities involved in the network provide information on the clinical trials they are recruiting for so the community health advisors can be kept abreast of the various opportunities and advise the appropriate people in their communities. When the advisors recruit participants from their communities for the clinical trials, they often receive an incentive for referrals.
A part-time county leader, one who is well-respected and often sought for advice by his or her neighbors, recruits men and women for the community health advisor program. There are eleven rural counties and one urban county in Alabama and twenty rural counties and one urban county in Mississippi that are part of the network.
The role of education
To effectively change the health behavior of the African-Americans living in the Deep South, the community health advisors receive extensive training. For two months, they attend a weekly two-hour class. Local health care professionals, who follow curriculum created by the Deep South Network staff, teach the classes. Some of the topics covered include cancer awareness, breast health, breast cancer treatment options, cervical cancer, community resources, and les-sons on recruiting people for cancer screening such as mammograms, or for clinical trials.
There are many obstacles to early detection of cancer within the African-American community that the health advisors must overcome to reach the people in their communities. "Fear is the No. 1 reason people are not screened. They are afraid that if they are screened, they will discover a diagnosis of cancer," says Lydia Cheney, MEd, CHES, cancer education specialist at the University of Alabama at Birmingham’s Comprehensive Cancer Center and Deep South Network staff member.
Many believe that cancer is an automatic death sentence; so if they have it, they don’t want to know. Therefore, education is a key component in helping people understand the value of early detection and treatment. To make sure that the community health advisors have the knowledge they need to teach people the steps for early cancer detection, they are given a pre-and post-training test.
Although the community advisory program covers an expansive area and is a large undertaking, several small pilot projects provided the facts needed to support its viability when the grant proposal was written. Also, the team consists of many health care professionals who have years of experience working with underserved communities.
To help determine the effectiveness of the Deep South Network for Cancer Control, the number of women referred to the breast and cervical detection program to be screened are tracked. "County coordinators in each community help advisors keep a running list of the women they contact and refer to a health care program," says Hardy.
For more information about the Deep South Network for Cancer Control, contact:
• Lydia Cheney, MEd, CHES, Cancer Education Specialist, University of Alabama at Birmingham Comprehensive Cancer Center, LNB 1001, 1530 3rd Ave. S., Birmingham, AL 35294-0001. Telephone: (205) 934-5772. Fax: (205) 975-9666. E-mail: Lydia.Cheney@ccc.uab.edu.
• Claudia M. Hardy, MPA, Program Manager, Deep South Network for Cancer Control, University of Alabama at Birmingham Comprehensive Cancer Center, LNB 1001, 1530 3rd Ave. S., Birmingham, AL 35294-0001. Telephone: (205) 975-5454. Fax: (205) 975-9666. E-mail: Claudia.Hardy@ccc.uab.edu.