The mission of UofL Brown Cancer Center is to generate knowledge relating to cancer, and to create new and more effective approaches to prevention, diagnosis and therapy, while delivering medical advances with compassion and respect to patients throughout our region.
While treating patients is our main focus, a large part of our mission is cancer prevention and screening so patients can be diagnosed earlier and have better outcomes. Our main form of outreach is conducting prevention and screening events in conjunction with the Kentucky Cancer Program and our mobile screening unit to reach populations that have low screening rates, high cancer health disparities, or other high risk factors for cancer.
As part of UofL Brown Cancer Center’s Cancer Committee, we monitor our community outreach efforts, which helps the cancer center meet national quality standards with the Commission on Cancer. It helps us address discrepancies in cancer care and treatment throughout the United States, with a focus on those in our community. Learn more about our screening and prevention efforts below.
Prevention Events
Harriett B. Porter Culinary Institute teaches kitchen ministry teams to prepare healthy food
Identified Areas of Community Need:
- High cancer rates among African Americans
- Consumption of traditional African American soul food often fried and prepared with high saturated fats, salt and sugar
Prevention Activity:
Kitchen ministry teams from all African American churches in metro Louisville were invited to the Harriett B. Porter Culinary Institute April 6, 2018. The interactive program, led by faculty and chefs from Sullivan University, is designed to create healthier culinary cultures among African American congregations. Held in their culinary training theater, the curriculum includes didactic presentations, demonstrations, kitchen experiences and tastings.Participants leave the institute with a certificate and a charge to return to their church to introduce new recipes and food experiences. The Culinary Institute is based on the National Cancer Institute's science-based Body and Soul program.
Effectiveness:
There were 89 participants from 19 churches/other organizations. A survey revealed more than half came seeking new healthy recipes focused on less salt, sugar and saturated fats, and respondents were complimentary of the chefs/curriculum. Participants found the step-by-step demonstrations helpful and liked the tips for healthy food preparations including alternatives to frying; enjoyed new recipes; and appreciated seasoning samples to take back to their churches.The institute has been offered for 12 years and remains very popular. Communication with the churches helps monitor institute-inspired events in the churches. Some have organized a summer culinary camp for children and a community garden to increase access to fresh fruits and vegetables.
Educating Smoketown residents about the importance of fruit and vegetable consumption to prevent cancer
Identified Areas of Community Need:
- High cancer rates among African-Americans
- Low consumption of fruits and vegetables
Prevention Activity:
UofL Brown Cancer Center sponsored a fruit and vegetable festival to educate about cancer prevention in the Smoketown neighborhood of Louisville, July 8, 2017. The neighborhood is considered a “food desert,” an area that lacks fresh fruit, vegetables and other healthful whole foods due to a lack of grocery stores, farmers’ markets and healthy food providers. Partnering with Bates Memorial Baptist Church, a prominent African-American church in the neighborhood, UofL Brown Cancer Center educated residents about the importance of eating fruits and vegetables for cancer prevention. Men from the church outreach team were trained to conduct pre- and post-surveys assessing knowledge, attitudes and behaviors regarding fruit and vegetable consumption. They presented an educational intervention, and free fruits and vegetables were given to residents. The training also addressed lifestyle behaviors for cancer prevention and recommended screening guidelines.
Effectiveness:
The pre-test results indicated a majority of participants were aware fruit and vegetable consumption can reduce your risk of cancer; however, less than 50 percent knew the recommended level of consumption.After the intervention, 52 percent reported they plan to eat 3-4 cups a day, and 26 percent planned to eat more than 4 cups a day.This event is the beginning of a partnership with Bates Memorial Baptist Church for future cancer control initiatives in this at-risk neighborhood. Engaging men from the community for peer-to-peer intervention proved to be a successful model to educate and encourage behavior change.
Lung cancer prevention program at Marsha's Place
Identified Areas of Community Need:
- High rate of tobacco use among pregnant women in Kentucky
- High rate of lung cancer in Kentucky
Prevention Activity:
A cancer control specialist conducted a "Plan to be Tobacco Free" class to a group of pregnant women on April 25, 2018 at Marsha's Place, a crisis pregnancy clinic in Henderson, Ky. The intervention targeted pregnant women who personally used tobacco or were frequently exposed to environmental tobacco smoke. Participants were asked to complete a survey assessing tobacco use and readiness to quit, were engaged in individual conversation using an eCO monitor equipped with a fetal monitor to assess the impact on the baby, received information about tobacco use and nicotine dependence, were oriented to available cessation resources, and referred to 1-800-QUITNOW as interested.
Effectiveness:
The class had seven participants, four of which reported tobacco use. After the class, two expressed interest in quitting and were referred for cessation counseling and free nicotine replacement products. Follow-up showed that one enrolled in the Quitline program. Calls to participants later revealed that two had quit and also reported a family member quit as a result of the class.The results indicate the intervention appears to have some success in reaching pregnant women and families. The eCO monitor with the fetal monitor was an effective strategy to engage women in conversation and a valuable teaching tool for showing the impact on the baby. It appears that pregnant women are often embarrassed to admit tobacco use. Focusing the intervention on family members, users, and individuals impacted by environmental smoke helps neutralize the intervention and engage reluctant participants.
Lung cancer prevention education at Fayette County horse farms
Identified Areas of Community Need
- High rate of tobacco use
- High rate of lung cancer
Prevention Activity:
UofL Brown Cancer Center and the mobile screening unit went to two Fayette County horse farms May 31 and June 2, 2017 to deliver a lung cancer prevention program.The intervention targeted tobacco users along with individuals exposed to secondhand smoke. Tobacco users received treatment counseling including an assessment of readiness to quit. They were engaged using a Smokerlyzer which non-invasively measures the amount of carbon monoxide on a smoker’s breath, helping to biochemically establish smoking status. They also received information about tobacco use and nicotine dependance, and given available cessation resource along with referrals to resources if interested.Individuals meeting eligibility for a low dose CT screening were referred to a patient navigator for further evaluation and follow-up.The eCO monitor was also used as an educational tool with non-tobacco users regarding the harmful effects of secondhand smoke.Many of the farm workers were Hispanic so bilingual staff provided interpretation.
Effectiveness:
Of the 32 identified tobacco users, the cessation specialist enrolled 5 in Kentucky’s 1-800-QUIT-NOW service. Two were referred to a patient navigator for further assessment and scheduling of a lung cancer screening.The farm workers and owners were pleased to have the mobile screening unit visit their farms to provide services and have asked UofL Brown Cancer Center to return since tobacco use is high among this population.
Screening Events
Pink Ribbon program reaches uninsured Hispanic women needing a mammogram
Identified Areas of Community Need:
- High cancer disparities rate
- High rate of the uninsured population
- Low mammography screening rates among Hispanic women
Screening Activity:
A new Pink Ribbon breast cancer education and screening program for Hispanic women brought the mobile screening unit to Zion United Church of Christ, Evangel Christian Church, and Hispanic Seventh Day Adventist Church on June 9 and 16, and July 14, 2018.
Bilingual trained staff from Cultivanda la Salud (a science-based Hispanic outreach program developed by the National Center for Farmworker Health, Inc., and funded by the Centers for Disease Control and Prevention) conducted educational programs at these churches. Participants were asked to complete a breast cancer survey, including personal screening history and interest in getting a mammogram. Program-eligible women received follow-up calls to schedule a screening.
Effectiveness:
There were 70 Hispanic women who attended four educational programs. Fifty-five of these women received mammograms at the three screening events and 13 who were uninsured also received clinical breast exams. Five patients were referred for follow-up diagnostic mammograms and three for ultrasounds. One received a biopsy, which was malignant.
The Pink Ribbon program received new Hispanic women in new churches. The sessions attracted the target age group with 65 participants being 40 or older. In addition to being a successful recruiting strategy, they were successful in attracting a hard-to-reach population. Surveys revealed that 23 were uninsured and had never received a mammogram. The churches were pleased with the response and are interested in offering it again.
Mammography screening among Hispanic women in Southwest Louisville
Identified Areas of Community Need:
- High cancer disparities rate
- High rate of the uninsured population
- Low mammography screening rates
Screening Activity:
UofL Brown Cancer Center brought the mobile screening unit to St. Rita Catholic Church in the underserved Southwest area of Louisville, on July 14, 2017, to perform mammography screening among Hispanic women.
Bilingual trained staff from Cultivanda la Salud (a science-based Hispanic outreach program developed by the National Center for Farmworker Health, Inc., and funded by the Centers for Disease Control and Prevention) promoted the screening in advance through one-on-one contacts with women at community locations and events, distributing flyers and scheduling appointments. They also provided interpretation services at the event.
Effectiveness:
Twenty-four Hispanic women received services, all of whom received screening mammograms and nine also received clinical breast exams. Two were referred for follow-up diagnostic mammograms and ultrasounds. Patients were also counseled about cervical and colon cancer screenings.
The program coordinator of the Hispanic ministry at St. Rita Catholic Church feels annual visits with the mobile screening unit have helped increase access to services and build trust among the Hispanic members of the congregation.
Increasing mammography screening access for Medicaid recipients
Identified Areas of Community Need:
- High cancer health disparities rate among African Americans
- Low mammography screening rates among Medicaid recipients
Screening Activity:
A partnership with Medicaid Managed Care Organization worked to increase mammography screening among Medicaid recipients. The event on July 9, 2018, focused on African American women in a private practice in West Louisville owned by an African American primary care provider. This special screening event was offered in collaboration with Kentucky African Americans Against Cancer (KAAAC), a community coalition started in 1990 in affiliation with the National Cancer Institute's National Black Leadership Initiative on Cancer.
Effectiveness:
During the event, 19 women were screened, three of whom were covered by Medicaid. Two were referred for a diagnostic mammogram and two for ultrasounds.
Taking the mobile screening unit to medical offices appears to be an effective strategy in serving women with insurance in these practices; however, scheduling the hard-to-reach Medicaid population appears to remain a challenge. Other screenings with PCPs have now been scheduled with Wellcare and Anthem Blue Cross Blue Shield to continue this pilot effort to increase access for Medicaid recipients. Having the support of KAAAC appears to lend credibility to this outreach effort, particularly among West Louisville women.
Mammography screening among African-American women in Newburg
Identified Areas of Community Need:
- High cancer disparities rate
- High rate of the uninsured population
- Low mammography screening rates
Specific Screening Activity:
Partnering with Kentucky African-Americans Against Cancer and Forest Tabernacle Church, UofL Brown Cancer Center brought the mobile screening unit to the church to focus on mammography screening in African-American women in the community of Newburg in metro Louisville, on March 18, 2017.
The event was promoted through outreach workers, church volunteers, and members of the Kentucky African-Americans Against Cancer (a community coalition that started in 1990 in affiliation with the National Cancer Institute’s National Black Leadership Initiative on Cancer). The outreach workers also scheduled appointments and assisted with registration and navigation of the event.
Effectiveness:
Twelve women received screening mammograms, and two also received clinical breast exams. One was referred for follow-up. All patients were counseled regarding cervical and colon cancer screening.
Health ministry teams within African-American churches have learned the importance of early detection and are eager to host the mobile screening unit for their congregations. Building these relationships with church leadership increases participation, and the support of Kentucky African-Americans Against Cancer lends vital credibility.
