Outreach and Engagement: Colleagues Come Together to Improve Community Care

Kiara Ellis, MSW

Taking part in community outreach and engagement conversations centered around key matters affecting National Cancer Institute (NCI)-designated cancer centers, such as Cancer Center Support Grants (CCSGs) and catchment, are crucial for community outreach offices, according to Kiara Ellis, MSW.

“[Working in community outreach], we serve as a key bridge in developing best practices that will be impactful,” Ellis said. “There are centers that do a lot of work with their patient population—how do we approach [them] about clinical trials? How do we share information about these complicated cancers? What is it they want to know? It’s the outreach offices that drive that work. Sometimes they can be underutilized or not tapped [into] for that expertise in all settings, but being able to bring relationships to the cancer centers anchors the center in their community. Without that component and great support for that component, it doesn’t give the cancer center the legs it needs to be interactive in its community.”

Bringing the members of different NCI-designated cancer center community outreach and engagement (COE) offices together serves to further extend an office’s impact in the community it serves. The Cancer Center Community Impact Forum (CCCIF), a national meeting of COE professionals in the US, has highlighted matters that are essential to a COE office since its formation in 2019. The 2023 CCCIF brought up several key topics such as catchment and CCSGs and gave community outreach professionals the opportunity to see how peers are engaging their community to extend the reach of the cancer center.

Ellis, the director of community outreach and engagement at the Masonic Cancer Center, University of Minnesota, in Minneapolis, is a founder of the conference, which was created to feel tactical and practical for staff in the cancer centers. “[Topics we discuss with colleagues include] how to build our community engagement boards, showcasing successful offices that got high marks in their CCSG,” Ellis said. “Who are those champions, and how did they highlight the wins that their office had in their CCSG to get that high score? We talk about catchment and connection with our clinical partners, [as well as] marketing and communications and the role that plays in lifting up the community outreach work that we do.”

The 5-year CCSG has proven to be instrumental for institutions, with the UCSF Helen Diller Family Comprehensive Cancer Center noting that the grant is a major source of federal funding for their center, equaling approximately $7 million in total costs per year.¹ Yale Cancer Center also reported that the CCSG provides the resources and infrastructure to aid in the coordination of 6 of the center’s interdisciplinary research programs that range from basic laboratory research to clinical investigations.²

Considering Catchment Areas

“[Catchment is] one of those huge and powerful topics because I don’t know that all our outreach staff and faculty are as immersed in geospatial mapping and that data piece [of it]. Catchment informs our work,” Ellis said.

The catchment area of the Masonic Cancer Center encompasses the entire state of Minnesota, and cancer is the state’s leading cause of death. Masonic noted that meeting diverse communities is essential, as Minnesota has the largest Somali American population in the US, the largest urban population of Hmong people in the world, and 11 federally recognized American Indian tribes.³

“The work we’ve done has been bringing awareness to our community partners about this amazing resource. [MCC is] a hidden gem in the Twin Cities; you don’t have to go far for great care, and you don’t have to go far if you’re interested or thinking about clinical research or being involved in it. We’re right in your city. There are ways you can engage with us, and meeting [the] community where they’re at is one of the biggest ways we’ve gone about doing it,” Ellis said.

Additionally, a recent catchment analysis conducted in Delaware characterized the geographic distribution of mammography sites and Breast Imaging Centers of Excellence. The study, which was published in Breast Cancer Research, identified census tract–level correlates of access and additional areas that could serve as mammography sites per breast cancer screening guidelines.⁴

For each standard deviation increase in the number of Black women in a census tract, the catchment analysis determined there were 89% (95% CI, 60%-98%) fewer Breast Imaging Centers of Excellence and 68% (95% CI, 38%-85%) fewer mammography units. Additionally, more rural counties comprised 41% of Delaware’s population; however, only 22% of the Breast Imaging Centers of Excellence were in rural counties. The study authors concluded that using catchment and location-allocation analytic tools may aid in reducing breast cancer disparities and selecting new locations for mammography facilities.⁴

Delving Into How Colleagues Bring Care to The Community

One of the preconference activities at the 2023 CCCIF meeting included a community tour. “This year at Sylvester [Comprehensive Cancer Center] in Miami during our social event, we got to see their ‘Game Changer’ mobile unit and how they’re doing screening in the community,” Ellis said. “They brought the unit [to the community], their staff was there, and we got to talk to them and ask questions focused on that example.”

Sylvester Comprehensive Cancer Center’s three 40-ft Game Changer vehicles have been bringing free cancer screenings to neighborhoods in South Florida since 2018, which was made possible by support from community organizations and philanthropic donors. Multilingual health care professionals from Sylvester travel to local libraries, businesses, or community events such as health fairs where they offer screening for HIV and prostate, colorectal, gastric, and head/neck cancers.⁵

In the first 7 months of 2023, Sylvester reported that they screened more than 300 adults, identified 33 positive results, and referred all those with positive results for follow-up care.

“One of the bigger impacts from this conference is that connection to NCI, how decisions are made, and [what] future planning is happening for various areas. Community outreach—in any space, not just cancer centers—sometimes is a topic that can be glossed over,” Ellis said. “The way that our groups have come together has shown us how essential these offices are and how supporting that infrastructure can push forward and make a large impact in the communities we serve, which is our goal.”

Moreover, at the 2022 CCCIF meeting, Simona Kwon, DrPH, MPH, an associate professor in the Department of Population Health, director of the section for health equity, and vice chair for diversity, equity, and inclusion in the Department of Population Health at NYU Langone Health Perlmutter Cancer Center, served as a panelist who discussed innovative methods of COE. A method of community engagement employed by Kwon and colleagues at Perlmutter Cancer Center in New York includes the Stamp Out Cancer Brooklyn initiative, which engages local communities on cancer prevention, early detection, care, and survivorship topics. Stamp Out Cancer and the Brooklyn Public Library hold 4-part virtual workshops once a month encompassing a variety of cancer awareness topics.^6,7

Forming A COE Gathering

Ellis explained that the CCCIF began after the Masonic Cancer Center hosted the Cancer Center Administrators Forum in 2019, which focused on administrative leadership in NCI-designated centers and those seeking NCI designation.⁸ After the event, she realized she had never met any other COE leaders. Ellis then connected with Julie HT Dang, PhD, MPH, an assistant adjunct professor in the Department of Public Health Sciences and the executive director in the Office of Community Outreach and Engagement at UC Davis Comprehensive Cancer Center, to begin planning the CCCIF. Discussions at the American Society of Preventive Oncology annual meetings also inspired the creation of the location-rotating CCCIF meeting, as COE was discussed frequently.⁹

“[Community outreach for cancer centers] is vital,” Ellis said. “Research in a laboratory or even behind the scenes can only go so far. It advances the scientific community and the way the medical community approaches treatment and support, but it’s the outreach office that is the wheels on the bus. [The outreach office] brings knowledge into the community, listens and relates to community voices, and brings that information back to the cancer centers.”

References

1. Understanding the CCSG. University of California San Francisco. Accessed December 19, 2023. bit.ly/47m8kQx
2. The Cancer Center Support Grant (CCSG/P30). Yale Cancer Center. Accessed December 19, 2023. bit.ly/3RPsSMv
3. About community outreach and engagement. University of Minnesota. Accessed December 19, 2023. bit.ly/3TrqrRD
4. Webster JL, Goldstein ND, Rowland JP, Tuite CM, Siegel SD. A catchment and location-allocation analysis of mammography access in Delaware, US: implications for disparities in geographic access to breast cancer screening. Breast Cancer Res. 2023;25(1):137. doi:10.1186/s13058-023-01738-w
5. Sylvester’s Game Changer vehicles bring free cancer screenings to underserved South Florida communities. News release. Newswise. August 23, 2023. Accessed December 19, 2023. bit.ly/48HW5Pl
6. Community outreach & engagement core. NYU Langone Health. Accessed December 19, 2023. bit.ly/41rlxpL
7. Stamp out cancer: how can we do it? Brooklyn Public Library. Accessed December 19, 2023. bit.ly/476kgWb
8. Leader AE, Brandt HM, Briant KJ, et al. Community outreach and engagement at U.S. cancer centers: notes from the third Cancer Center Community Impact Forum. Cancer Epidemiol Biomarkers Prev. 2023;32(12):1777-1782. doi:10.1158/1055-9965.EPI-23-1017
9. CCAF Cancer Center Administrators Forum. Cancer Center Administrators Forum. Accessed December 19, 2023. bit.ly/3trI2OQ