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Project 3 - Community Health Improvement Project

Current Status

Thus far, progress has been made in several areas to further understand and identify potential cancer risk affecting these populations. These includes conducting Geographic Information Systems mapping of asset resources in the counties under study; collecting most recent data on cancer incidence and mortality; developing cancer profiles for each county; contracting with TDH to hire a caner registry personnel to collect up-to-date information and partnering with local American Cancer Society representatives to conduct cancer health assessments.

The Project 3 team has submitted to the National Cancer Institute a revised grant application entitled: “The C-COAST Program, Community Cancer Outreach Alliance for Screening and Training” in response to PA Number PAR-05-026, Community Participation In Research.

Abstracts, Presentations:

  1. Edilma Guevara, Lilian Alvarez, Kellie Buchanan, James S. Goodwin, and Billy Philips. “Addressing cancer health disparities using the Community Health Improvement Process (CHIP) model” American Public Health Association, Philadelphia, December, 2005
  2. Billy Philips, Edilma Guevara, Lilian Alvarez, Kellie Buchanan, James S. Goodwin. “Commuting distance explains late-stage diagnosis of breast cancer in a community-based participatory research project on cancer health disparities” American Public Health Association, Philadelphia, PA
  3. John Sullivan, Stanford, Matthew. “It’s Broke. Can We Fix It? A Community Forum Theater. Dialogue on Disparities in Access to Health Care.” Academy Health 2005 Annual Research Meeting-Boston.
  4. Joanna Campbell, Edilma Guevara, Gayle Weaver, Lilian Alvarez, Billy Philips, James Goodwin. “Commuting Distance to the Nearest Mammogram Facility and Stage of Breast Cancer Diagnosis.” Center for Population Health and Health Disparities Annual Grantee’s Meeting, Santa Monica, CA.
  5. Edilma Guevara, Gayle Weaver, Kellie Buchanan, Sandra Ford, Lilian Alvarez, Billy Philips. “Application of the Community Health Improvement Process (CHIP) model to address health disparities in a rural county.” Center for Population Health and Health Disparities Annual Grantee’s Meeting, Santa Monica, CA
  6. John Sullivan. “Research as a Pretext for Action: using Theatre of the Oppressed to Anchor & Integrate Community-Based Research Collaborations.” University of North Carolina at Chappell Hill.
  7. Loree Primeau, John Sullivan. “Evaluating Transformative Effects of Participation in Theatre of the Oppressed: An Analytic Process Using Thematic Analysis & Grounded Theory Procedures.” Center for the International Theatre of the Oppressed.
  8. Billy U. Philips. “Cancer Control PLANET and Community Education – Are they in the same orbits?” American Academy of Cancer Education Conference.
  9. Edilma Guevara & Cecilia Romero. “Que dice la comunidad Hispana in Galveston?” Oral presentation to Health Ministry of the Sacred Heart Catholic Church.
  10. Edilma Guevara & Cecilia Romero. “Que dicen los Hispanos about their health care needs?” Department of Family Medicine Rounds, Galveston

Future activities

  1. Increasing cancer knowledge and awareness
    • Implementation of seven module community-based cancer prevention awareness education program in the constituent groups in Liberty County
    • Data, including evaluation of each module, will be collected, reported in the peer-review literature and serve as part of the basis for the continuation of Project 3 at the end of year five.
  2. Infrastructure Improvements
    • Work with the Liberty CAN, to influence the Board of the newly created Liberty-Dayton Hospital District toward opening another mammography facility in the Liberty-Dayton Hospital
    • Increasing physician availability and facilities that will provide colorectal and prostate screening to reenergize previous long-standing efforts in the County.
    • Collaboration with the Texas Cancer Council, Texas Comprehensive Cancer Control Coalition to fund the implementation of the Community Tool Kit for Cancer Control (an evidenced-based resource developed under CDCP Comprehensive Cancer Control funding)
    • Provide through the Texas Medical Association and its Physician Oncology Education Program a workshop for the Liberty County Medical Society physician education on colorectal cancer screening.
  3. Reduce and Eliminate Barriers
    • Providing on-call transportation services through the Liberty County Transportation Department in cooperation with the Goodman Company (a regional transportation contractor that employs Dr. Kellie Buchanan, the former local coordinator for Project 3).
    • Developing, implementing, and evaluating a plan for providing reliable transportation services to area hospitals for screening services and to local treatment facilities for follow-up and treatment services.
    • Obtain matching funds - initiate discussions about providing a fee scale based on ability to pay
    • Initiate a community dialogue to establish the moral basis for policy changes related to increasing the indigent health care budget
  4. Increase participation in cancer screening
    • Continue to develop mechanisms for monitoring screening utilization
    • Complete and publish the analysis of a three-wave community survey that informed the Liberty Cancer Plan that provides baseline estimates on breast, prostate and colorectal screening utilization
    • Complete studies of stage of diagnosis of breast cancer and distance to mammography facilities and a companion study regarding a “drive- by” phenomenon in the data
  5. Promote prompt treatment
    • Attempt to link participants in various aspects of the intervention project (community education) with screening utilization and treatment disposition.
  6. Publish in the peer-reviewed literature
    • Items 1 – 5 above focused in year 4
    • Year 5, devoted to:
      • Publishing:
        1. Empirical validation of the CHIP model in CBPR – Edilma Guevara
        2. Linking baseline assessment to community-based cancer control planning – Gayle Weaver
        3. The “drive by” phenomenon in screening and treatment decisions of breast cancer survivors – Is cultural competency the issue? – Billy Philips
        4. A community cancer awareness education program integrating PROMIS methodology in outcome assessment. – Kellie Buchanan
      • Grant submissions:
        1. The C-COAST Project – National Cancer Institute
        2. Komen Foundation – Community based education program
        3. Texas Cancer Council – Community moral imperatives and cancer control