The Witness Project In Whitehall, OH

Abstract The Witness Project (WP) is an evidence-based breast cancer screening intervention that will be implemented in Whitehall, Ohio, at three different churches by the Franklin County Health Department. The WP will target African American women 50-74 years old who are non-compliant with current United States Preventative Services Task Force (USPSTF) breast cancer screening recommendations. African American women face disproportionately higher mortality rates from breast cancer when compared to other racial and ethnic groups in the United States and in Whitehall. African American women are less likely to discuss breast cancer and preventive screening services within their community. The WP uses Witness Role Models (WRMs) and Lay Health Advisors (LHAs) to run 1-hour educational sessions at the identified church locations. The WRMs are breast cancer survivors who share their stories and experiences about early breast cancer detection through screening. The WRMs serve as social support to the participants and can answer any questions they may have regarding their experience. The LHAs serve as a community resource to the participants by educating women about breast cancer screening and connecting participants with screening services. The WP will be partnering with The James Mobile Mammography Unit and the OhioHealth Eastside Health Center to connect participants to screening services. In order to measure the short-term outcomes (breast cancer screening knowledge, self-efficacy, social support, connections to community resources), a pre- and post-program survey will be collected prior and at the conclusion of the educational sessions. The results of the program will be disseminated to the Community Advisory Board (CAB), community partners and collaborators

Examining provider perceptions and practices for comprehensive geriatric assessment among cancer survivors: a qualitative study with an implementation science focus

Introduction: Cancer rates increase with age, and older cancer survivors have unique medical care needs, making assessment of health status and identification of appropriate supportive resources key to delivery of optimal cancer care. Comprehensive geriatric assessments (CGAs) help determine an older person’s functional capabilities as cancer care providers plan treatment and follow-up care. Despite its proven utility, research on implementation of CGA is lacking.Methods: Guided by a qualitative description approach and through interviews with primary care providers and oncologists, our goal was to better understand barriers and facilitators of CGA use and identify training and support needs for implementation. Participants were identified through Cancer Prevention and Control Research Network partner listservs and a national cancer and aging organization. Potential interviewees, contacted via email, were provided with a description of the study purpose. Eight semi-structured interviews were conducted via Zoom, recorded, and transcribed verbatim by a professional transcription service. The interview guide explored providers’ knowledge and use of CGAs. For codebook development, three representative transcripts were independently reviewed and coded by four team members. The interpretive process involved reflecting, transcribing, coding, and searching for and identifying themes.Results: Providers shared that, while it would be ideal to administer CGAs with all new patients, they were not always able to do this. Instead, they used brief screening tools or portions of CGAs, or both. There was variability in how CGA domains were assessed; however, all considered CGAs useful and they communicated with patients about their benefits. Identified facilitators of implementation included having clinic champions, an interdisciplinary care team to assist with implementation and referrals for intervention, and institutional resources and buy-in. Barriers noted included limited staff capacity and competing demands on time, provider inexperience, and misaligned institutional priorities.Discussion: Findings can guide solutions for improving the broader and more systematic use of CGAs in the care of older cancer patients. Uptake of processes like CGA to better identify those at risk of poor outcomes and intervening early to modify treatments are critical to maximize the health of the growing population of older cancer survivors living through and beyond their disease