Cancer Outreach Programs for African-Americans

Developing and implementing cancer outreach programs for African-Americans takes planning and sensitivity, said Robin L. Hurdle, CSW, a social worker in charge of the African American Outreach Program at Cancer Care, Inc., in New York City. The key to building successful programs is what Ms. Hurdle calls “the parallel process,” ie, the planning that should go on 2 years before a program opens its doors.

“When you talk about underutilization, or people walking out and not coming back, being wary of even coming into your program, it is because the ‘parallel process’ has not been thought through,” said Ms. Hurdle at a recent Cancer Care seminar. Administrators often get sidetracked looking for money, space, and staff, and do not think enough about the demographics of the community, what its members want and need, or what the staff and the facility should offer them.

Getting “Into” the Neighborhood

“In many cases, people in these communities are going from crisis to crisis, basically just surviving,” said Ms. Hurdle. “Our staff has to be respectful of their situations and be able to understand and help them address their concrete issues and some of their psychosocial issues.”

The person who walks in the door is not just a possible breast cancer patient but may be a mother of three, the single head of a household, struggling not only to keep her children in school but also to keep food on the table.

“On some level, the program that you strive to create has to address some of these issues,” said Ms. Hurdle. “During your parallel process, if you know you can only do the screening and medical referral part, then build alliances with other organizations that can help in other ways. Church pantries may provide lunch or groceries to clients. Social agencies may be able to provide money for transportation. The National Cancer Institute’s Cancer Information Service, for example, would be able to answer general medical questions.”

Thought should also be given to making the community aware of where the facility is and how it can be reached. “People get hyper quickly when they can’t find things. Think about how you will make yourself known. You may be able to get the hospital or organization you are affiliated with to give you signs to put up in the neighborhood,” said Ms. Hurdle. Also, some people in the community might be able to pass out flyers to community residents to make them aware of the facility and its location.

Although funding for outreach programs is often low at first, administrators should not lose heart. “You must be willing to take those lemons and turn them into lemonade. You have to be able to start small and grow with it,” said Ms. Hurdle.

Assessing the Community

Ms. Hurdle and Redrick McFarlane, MPH,CHES, outreach manager of the Cancer Information Service at Memorial Sloan-Kettering Cancer Center developed a series of questions that can serve as a guide for those developing cancer support outreach programs for African-Americans:

What are the most pressing health issues in the neighborhood? (These issues should be prioritized.)

What other issues are specific to the neighborhood?

What is the community’s financial base?

Who or what represents the community’s political base?

What are the community’s resources? These might include hospitals, home care agencies, clinics/primary care centers, volunteer ambulance corps, businesses, and civic organizations.

What are the demographics of the neighborhood (languages spoken, age ranges, etc)?

How much assistance does outside business give the community?

Are there facilities and/or personnel in the community who are knowledgeable about cancer issues? Can partnerships be formed within these groups?

What is the neighborhood’s system of communication, formal and informal?

 Identify a potential volunteer base.

 Identify the cost of transportation and the frequency of service.

 Identify potential community spaces that can be rented for community health fairs.