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Oscar and Golden Globe-nominated actor Terrence Howard toured clinical and research areas of Dana-Farber before visiting the Madison Park Village housing complex last month to raise awareness about colon cancer. The ambassador for the Entertainment Industry Foundation and National Colorectal Cancer Research Alliance lost his mother to the disease.
The Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) is bringing fresh momentum to a community outreach program to increase colorectal cancer screening rates among racial and ethnic minority groups in the Boston area.
The program, Open Doors to Health, trains peer leaders in low-income housing complexes to work with residents on reducing their risk for colorectal cancer (CRC) and getting screened for the disease at local hospitals. In addition, DF/BWCC Care Coordination is adding a third patient navigator to ensure residents are able to get to their colonoscopy appointments and are adequately prepared for them.
“We’ve found that while pamphlets and peer leaders are helpful for encouraging people to schedule CRC screenings, many people fail to prepare properly or are unable to make their appointment because of transportation issues,” said Wanda McClain, executive director of Community Health and Health Equity at BWH. “There’s evidence, both from research and other patient navigator programs, that navigators can increase CRC screening rates in this population.”
The project expands on a study that began in 2004 in 12 low-income housing sites in greater Boston. Half of the sites had peer leaders to help residents increase physical activity, improve their diets and schedule colonoscopies, and the other sites received pamphlets on the importance of those actions. The program was started by Dr. Karen Emmons, the principal investigator for the project, and project leader Elizabeth Gonzalez Suarez conducted peer educator training.
Although the results are still being analyzed, it’s clear that “peer leaders have had a very positive influence in their communities,” said Anne Levine, vice president for External Affairs at Dana-Farber.
Now, peer leaders and patient navigators work at 10 sites, and patient navigators also will work with patients at BWH’s Southern Jamaica Plain Health Center and Brookside Community Health Center. The navigators guide patients through the colonoscopy process and help them overcome some common barriers, such as transportation issues, anxiety and inadequate preparation, to a successful screening. In addition to working with staff and patients in the community health centers, the patient navigator team also will work with administrative and clinical leaders on system issues at the health centers to identify patients who are eligible for screening.
Levine and McClain worked with Selwyn Rogers, Jr., MD, MPH, director of the center for Surgery and Public Health at BWH, to get the program running, and a search is underway to recruit candidates for the navigator position.
“This is an excellent example of how Dana-Farber and Brigham and Women’s can come together to address a community need,” Levine said. “Its impact on the health of traditionally underserved groups should be far-reaching.”
Colorectal cancer is highly preventable if detected early, but some racial and ethnic minorities and the uninsured are much less likely to be screened. Death rates from CRC are higher among blacks than whites – with 27 black men and 19 black women per 100,000 dying of the disease, compared to 25 white men and 17 white women.