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September 14 2016

Reducing the burden of cancer in communities that need it the most

In UW School of Medicine and Public Health news:

Madison, Wisconsin - The Cancer Health Disparities Initiative (CHDI) at the UW Carbone Cancer Center partners with Wisconsin’s underserved communities to learn how they can work together to improve the health of everyone who faces greater cancer risk.

 Advances recently highlighted CHDI’s long-running Rural project, through which they initially developed Cancer Clear and Simple (CC&S). CC&S is a three module health literacy informed curriculum on cancer basics, prevention and screening. This month, CHDI’s Latino Outreach Project is releasing the Spanish version of CC&S, El cáncer claro y sencillo (CCyS) following a rigorous process of translation, adaptation and testing. As with any CHDI project, the needs of the community were at the center of the process.

“CHDI can bring our experience with cancer education, prevention and behavioral recommendations, but we depend on our community partners to communicate to us what the needs and priorities of the community are and what assets already exist so that together we can create work that is really relevant and responsive,” said Sarah Brown, an MD-MPH student at UW who worked on the Latino Outreach Project at CHDI.

In 2013, CHDI staff met with members of Centro Hispano of Dane County and the Latino Health Council to identify cancer-related health needs of the area’s Latino community. With support from philanthropy funds, Centro and CHDI subsequently launched the Dane County Latino Cancer Education Pilot that summer.

“Centro wanted the pilot project to focus on health promotion with the long-term goal of lay health workers running the curriculum,” said Karen Menéndez Coller, Executive Director of Centro Hispano. “CHDI embraced our approach and we are delighted that our health and wellness staff are continuing to partner with CHDI in training community members in the new curriculum.”

The goal of the pilot was to adapt and test a hybrid of the CC&S cancer basics and cancer prevention modules for use in Latino communities. This adaptation was not simply translating the same material into Spanish; rather, the content, photos and illustrations had to be culturally adapted, made relevant to people from diverse Latin American cultures, and revised to be understood by a range of reading levels. The new hybrid curriculum was tested in three workshops at Centro and results showed that community participants increased their cancer knowledge and intent to adopt healthy behaviors. This version was ready for ongoing use in 2015.

Around this time, Saúl Juárez Aguilar, with ProHealth Care’s Hispanic Health Resource Center (HHRC) in Waukesha, was looking for ways to promote cancer education within the community, and he met Rick Strickland, CHDI’s Program Director, at the most recent Wisconsin Cancer Control Summit.

“We hold several health programs for the Hispanic communities in Waukesha and we support evidenced-based programs, but we didn’t have any specific cancer-related program,”Juárez Aguilar said. “The way Rick laid out this new initiative sounded very appealing, so I carried the information back to my organization and it was something we felt was a need in our community.”

Juárez Aguilar and CHDI’s Latino outreach coordinator, Dashni Sathasivam, worked together to determine how to adapt the remaining CC&S curriculum in order to best meet the needs of the Latino community served by HHRC. Juárez Aguilar recruited concerned community members from diverse Latin American backgrounds, as well as health promoters at ProHealth Care. Cultural adaptation is involved, complex and not at all quick – the two groups met separately to go through material line by line for a total of 46 sessions.

The end product: the entire CCyS curriculum, translated and culturally adapted for the Latino community throughout Wisconsin and beyond.

At a volunteer appreciation and wrap-up event, CHDI staff were gratified that the community members viewed themselves not just as focus group participants, but as contributors to an educational resource that would benefit the larger Latino community. Sonia Miranda, a breast cancer and leukemia survivor, was one of the community members Juárez Aguilar recruited.

“I so enjoyed translating, meeting new people, and being a part of helping others by having helped make this information accessible and understandable to everyone,” Miranda said. “Being part of a project like this keeps me going and keeps me proactive.”

With the El cáncer claro y sencillo adaptation complete, CHDI continues to work with both HHRC and Centro, training facilitators to teach the curriculum to Latino community members interested in learning more about cancer.

To deepen its Latino outreach and support future research, CHDI will next conduct a Latino Community Health Needs and Assets Assessment in 20 South Central Wisconsin counties. The long-term intention is to work closely with community members to identify areas of need and to translate the findings into community-based action to improve health outcomes.

Posted with permission from the UW School of Medicine and Public Health
Published: 09/13/2016

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For more than a century, ProHealth Care has been the health care leader in Waukesha County and surrounding areas, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes ProHealth Waukesha Memorial Hospital, ProHealth Oconomowoc Memorial Hospital, ProHealth Rehabilitation Hospital of Wisconsin, ProHealth Medical Group, the UW Cancer Center at ProHealth Care, Moreland Surgery Center, ProHealth AngelsGrace Hospice, ProHealth Home Care, ProHealth West Wood Health & Fitness Center and ProHealth Regency Senior Communities. Learn more at ProHealthCare.org.