Strategic Issue: Cancer

Description: Clay Co. residents (313 out of 381) overwhelming voted cancer as the most important health problem in our community (Clay Co. Healthy Survey 2011). Cancer is one of the leading causes of mortality in the county, surpassing heart disease as the leading cause of death in 2008. Specific cancers where Clay County has mortality rates higher than the state include colorectal cancer and lung/bronchus cancer among females. Cancer mortality for breast and prostate cancer are also higher than the Healthy People 2020 goal. Long-term, 5 yr. Goals
By 2017, improve the outcome for individuals diagnosed with cancer by decreasing cancer mortality by 5% (Baseline: 237.7 deaths per 100,000 for males in 2008; 156.2 deaths per 100,000 for females in 2008). By 2017, increase the number of Clay County residents over age 50 receiving a colonoscopy to 65.1%. (Baseline: 59.2%, BRFSS 2011) By 2017, increase the number of Clay County men over age 40 who have received a PSA test to 67.8% (Baseline: 61.6%, BRFSS 2011) By 2017, increase the number of Clay County women over age 40 who have received a mammogram in the past 12 months to 88.4%. (Baseline: 80.4%, BRFSS 2011) By 2017, increase the number of Clay County females over age 18 who have had a PAP smear in the past 12 months to 66.8%. (Baseline: 60.7%, BRFSS 2011) By 2017, decrease the number of Clay Co. adults who smoke to 21.9% (Baseline: 24.3%, BRFSS 2011) By 2017, decrease the percentage of Clay County youth who identify as smokers by 10%.

2 3 year Objectives
Clinical By 2014, increase the number of Clay County residents over age 50 receiving a colonoscopy to 62.2%. (Baseline: 59.2%, BRFSS 2011) By 2014, increase the number of Clay County men over age 40 who have received a PSA test to 64.7% (Baseline: 61.6%, BRFSS 2011) By 2014, increase the number of Clay County women over age 40 who have received a mammogram in the past 12 months to 84.4%. (Baseline: 80.4%, BRFSS 2011) By 2014, increase the number of Clay County females over age 18 that have had a PAP smear in the past 12 months to 63.7%. (Baseline: 60.7%, BRFSS 2011) By 2015, increase the proportion of men who have discussed PSA test with their health care provider by 10%. Community Health Education By 2014, decrease the number of Clay Co. adults who smoke to 23.1% (Baseline: 24.3%, BRFSS 2011) By 2014, decrease the percentage of Clay County youth who identify as smokers by 5%. Provide education on womens health issues to two school districts by December, 2014.

1-year Objectives
Clinical Establish local baseline for Healthy People 2020 goal Increase the proportion of men who have discussed with their health care provider whether or not to have a prostate-specific antigen (PSA) test to screen for prostate cancer by July, 2013. Develop an action plan to increase physician patient dialogue on recommended cancer screenings during clinic appointments by September 2012. Create and promote special pricings/promotions for cancer screenings by September 2012. Community Health Education Educate community on cancer risk and recommended screening guidelines using print, social, and broadcast media by submitting one educational item/public service announcement monthly beginning June 2012. Provide education on cancer risk reduction and womens health issues (self-breast exam, PAP smears, HPV immunizations) by being a guest speaker in at least one school in 2012-13. Increase number of participants in Quit Line program from 56 (as of 3/31/3012) to 65. Collect baseline tobacco use data for all Clay County youth grades 7- 12 by December 2012. Quality of Life Determine if burden of cancer on patients and their family is an issue in Clay County by December 2012. Determine if there is a need to start a cancer support group in Clay County by December 2012.

 2017 BRFSS data reflects 5-year objectives.

Measures of Success 2014 BRFSS data reflects 3-year objectives.

Clinical Data on Increase the proportion of men who have discussed with their health care provider whether or not to have a prostate-specific antigen (PSA) test to screen for prostate cancer is collected and recorded from health screenings. Providers develop and implement a strategy to increase dialogue of recommended cancer screenings to patients during clinic appointments. Special prices/promotions for cancer screenings are established and advertised annually through various media outlets. Community Health Education Copies of media schedule and 12 published articles by the Cancer SubCommittee (Deena). Program curriculum developed (Cradle program from Lawrence Co. Health Department suggested) with learning objectives and dates established to be in the classroom. Increase community awareness of the Break the Habit program and the Illinois Tobacco Quitline by promoting the program and Quitline number in six new locations each month in 2012 and 2013. Clay County youth tobacco, drug, and alcohol surveys are completed and results compiled into a summary report Quality of Life The results of literature review are compiled into a summary report. The Cancer Subcommittee convenes to review the summary report by September 2012.

Programs & Interventions: When/Whom Continue first year interventions.

Continue first year interventions. Clinical Collect data at health screenings to determine if males have seen a provider in the last year and if the provider discussed PSA / Colonoscopy by June 2012. (CCH will add to their forms for 8/12 screening & Clay County Health Department will add to form for all other screenings). Develop a strategy to increase physician recommendations and dialogue with patients to encourage patients to get recommended cancer screenings by July 2012 (CCH Coordinate with Teresa Warfel and providers). Promote special mammography pricing on/around the individuals birthday. (CCH on ongoing basis Marie & Linda). Promote mammography at Mothers Day price special? by May 2012 (CCH, hold message at CCHD, Facebook message Marie, Linda, Deena) Evaluate Check clinic computer system for availability of data on PAP smears (CCH, year end 2012) Community Health Education Establish schedule for Cancer Sub-Committee to provide cancer education to media by June 2012. (CCHD, CCH, Cancer Crusaders, Bridget) CCHD staff promotes Break the Habit program through community outreach and education. (Americorps volunteer?) Plan and implement a health education course on womens health issues self-breast exam, PAP smears, HPV immunizations in school setting. (CCHD - Public Health Nurse/PHAP, 2012-2013 school year; Coordinate with schools) Healthy Families Illinois staff will provide education on womens health issues to all mothers enrolled in their home visiting program beginning July 2012. (CCHD) Raise community awareness: Quitline, cost of cigarettes vs. cost of gas by June 2013. (CCHD) Promote Breast Cancer Awareness at Move for the

Cure promotion (CCH, annually in October). Conduct a survey of Clay Co. youth grades 7 12 on tobacco, drug, and alcohol use In October 2012 (CADA). Quality of Life Conduct a literature review to examine the quality of life issues among cancer patients, effect on caregivers of cancer patients, possible methods of assessment, and evidence-based practices that address these issues. (CCHD Gretchen). Identify persons who will participate in one-on-one facilitator training in American Cancer Societys Reach to Recovery training by December 2012 (American Cancer Society Angela Wenthe; Cancer Subcommittee).

Funding
Clinical CCH Community Health Education Media campaign through public service announcements for free/reduced pricing on radio. QuitLine promotional and educational activities funded through state grant. Quality of Life Utilize existing CCHD resources to conduct literature review. Search for funding opportunities to conduct a cancer quality of life assessment within Clay County.