2006 Spirit of Collaboration Award Winners
Every year since 2001, the Michigan Cancer Consortium has presented its highest honor — the MCC Spirit of Collaboration Award — to member organizations that have done outstanding collaborative work to significantly move comprehensive cancer control activities forward in our state. During the 2006 MCC Annual Meeting, the following organizations were presented with 2006 MCC Spirit of Collaboration awards in recognition of their exceptional work leading collaborative efforts on behalf of the MCC Initiative.
Colorectal Cancer Early Detection Pilot Program Addressing: Colorectal Cancer
Collaborative partners in the project:
Project description: District Health Department #10 (DHD #10) and Spectrum Health – Reed City
Campus collaborated to provide services as part of a colorectal cancer
screening pilot project funded by the Michigan Department of Community
Health.
DHD #10 provided outreach, risk assessment, FOBT kit materials,
program planning, and coordination to uninsured residents in Lake and
Mecosta counties.
Spectrum Health provided colonoscopy screening, including physician services, pathology services, and treatment services to the uninsured project participants. Spectrum Health also provided a liaison contact, which functioned as a nurse case manager/patient advocate. Her role was to ensure an efficient process of scheduling, preparation, and follow up throughout the colonoscopy procedure. This liaison also served as the main contact person between the health department and the hospital by assisting with program implementation and billing issues.
Seventy-four (74) uninsured residents of Lake and Mecosta counties received risk assessment, screening, and education on colorectal cancer, including screening for risk factors and symptoms. Of the 74 residents, 21 received colonoscopies. Preliminary results show a significant number of participants needing polyp removal; no cancer to date.
In addition to the clinical outcomes, this collaboration also resulted in other numerous benefits. Through this program and partnership, a strong basis has been developed for continued screening efforts. For example, this concept has been shared with the Regional Cancer Steering Committee serving Northwest Central Michigan. The committee is developing a project proposal to provide broad cancer early detection screening opportunities to targeted communities. This proposal will be submitted as a federal Rural Outreach Grant this fall and will include screening for breast, cervical, prostate, and colorectal cancers, as determined by the committee.
Reviewer comments: “Great collaboration in an underserved area of the state, including a county with a significant colorectal cancer mortality rate.”
Project description: Members of the Breast Cancer Advisory Committee formed a workgroup to discuss the results of the Digital Mammographic Imaging Screening Trial (DMIST) conducted from 2001 to 2005 by the American College of Radiology Imaging Network. Dr. Murray Rebner, one of the researchers who participated in the study, was consulted to discuss the key findings from the study and implications that may impact mammography screening for Michigan women.
The workgroup then developed guidance regarding mammography screening in the form of position papers from the Michigan Cancer Consortium for both providers and consumers in the state of Michigan.
The provider paper was downloaded 313 times from the MCC Web site; the consumer paper was downloaded 201 times. The position papers were referenced in a May 30, 2006 Wall Street Journal article and also appeared in several newspaper articles in neighboring states.
Reviewer comments: “This collaboration was an example of how important research information can be relayed in a timely manner to the residents and health care providers of Michigan.”
Project description: For many years, local health departments have received complaints from tenants in apartment buildings on their exposure to second hand smoke, but the health departments had very little legal advice for these people. The MI SmokeFree Apartment Initiative was implemented by The Center for Social Gerontology through its Smoke-Free Environments Law Project (SFELP), which contracted with the Michigan Department of Community Health's Tobacco Section in 19 of Michigan's 83 counties in 2004-2005, in conjunction with 10 local health departments and their tobacco reduction coalitions.
This partnership matched legal advice with the local health departments' public awareness campaigns, which included an award-winning Web site (www.mismokefreeapartment.org), radio ads, billboards, and postcard mailers, to reduce secondhand smoke exposure, as well as provide yet another reason to quit smoking.
The MI SmokeFree Apartment Initiative became a great success and created an enthusiastic espirit de corps among its partners in the local health departments and coalitions. In the first nine months, over 200 smokefree apartments were identified, many landlords were assisted in going smokefree, and many tenants’ exposure to secondhand smoke was reduced. In nine months, the initiative dramatically raised public awareness of this issue in Michigan and began to change social norms about people's rights to smokefree living in multi-unit residences. In July 2005, new goals for this project were set and over-achieved.
Reviewer comments: “All I can say is, 'Wow!' They made an impact from the UP to SE Michigan!”
Project description: Community Outreach and Education, the American Cancer Society, and Beckman Coulter Inc. collaborated to promote colorectal cancer screening and education in mid-Michigan. Major results of the collaboration included:
Development of a single screening education message that covered the majority of a 22-county area in mid-Michigan by way of radio and newspaper advertising and television and newspaper feature articles.
444 people called to request a free FOBT kit by mail or to attend a seminar and receive a FOBT kit.
Personal contact (by phone, in person, or both) was made to 444 people in mid-Michigan regarding the screening process, FOBT instructions, and the importance of screening for colorectal cancer in order to prevent and cure this type of cancer in our communities.
61.1 percent of the people that requested an FOBT completed and returned it.
Identified 12 individuals that tested positive for fecal occult blood. All are being personally followed and have had a colonoscopy or have a colonoscopy scheduled.
Next year, the collaborative will attempt to commit gastroenterology groups in each major market area to provide a specific number of colonoscopies per group for individuals that test positive on a FOBT and do not have health insurance to cover the cost of their follow-up testing and care.
Reviewer comments: “Wow! This is an extremely well thought out and executed collaboration. This project seems to abound with cancer champions. The fact that they explicitly set up the project so that they could collect data was unusual all by itself.
Exceptional.”
Lauren Zoschnick, MD – University of Michigan Health System
Project description: According to the Centers for Disease Control and Prevention, 10 percent to 15 percent of invasive cervical cancer is due to women with abnormal Paps who are lost to follow-up.
The Cervical Cancer Advisory Committee (CCAC) felt that having labs contact women directly about abnormal Pap results (rather than assuming the clinician is doing so) might encourage the woman to have follow-up diagnostic testing. A subgroup of the CCAC designed a pilot project in which a clinical laboratory contacted women directly, in writing, of abnormal or unsatisfactory Pap test results.
Although process data were the primary focus of the pilot project, the team was able to document both process and outcome data. The lab was able to notify 99.8 percent of women of their abnormal or unsatisfactory results. The lab documented that 78 percent of women with abnormal Paps (HSIL, AGC, SCC, AIS) had appropriate follow-up pathology received by the lab. In some of the remaining cases, appropriate follow-up was done and not reported to the lab.
After implementation, about half of the providers who provided feedback on the system said that the pilot notification system "probably" or "definitely" reduced risk to them as a provider. Although there was mixed feedback about its value or impact, 61 percent of responding providers said this method of notification should be implemented on a permanent basis.
Reviewer comments: “This is a very striking collaborative project that accomplished what it set out to do: find out the feasibility and acceptability of launching a patient notification project. The findings of the project should open up the door for other health systems to consider that there may be gaps in their patient notification systems which could be closed by implementing this type of secondary notification system.”
2006 Spirit of Collaboration Awards — Honorable Mention
The Consortium also recognized the efforts of the following organizations with the presentation of 2006 MCC Spirit of Collaboration Honorable Mention Awards for their leadership of exemplary collaborative projects on behalf of the MCC Initiative and comprehensive cancer control efforts in Michigan.
Arabic Prostate Cancer Education Booklet Addressing: Prostate Cancer
Collaborative partners in the project:
Wael Sakr, MD – Wayne State University School of Medicine and the Detroit Medical Center
Project description: The prostate cancer decision aid, Making the Choice: Deciding What to Do About Early Stage Prostate Cancer, was developed by the Michigan Cancer Consortium Prostate Cancer Action Committee (PCAC) using a research-based developmental process. However, the PCAC recognized that there is a very large population of Arab men in Michigan and that Arab men develop prostate cancer but often are not provided information needed to understand their disease in their own language; therefore, they may not be fully informed about their options.
As a result, Dr. Sakr translated and back translated into Arabic the plain-language decision aid for men newly diagnosed with prostate cancer. ACCESS recruited Arab men from the community to become the models used in the booklet illustrations and unveiled the booklet at the Spring National Arab American Health Conference. A total of 250 booklets were distributed at the conference that attracted a number of health care systems that serve Arab Americans in Southeastern Michigan. Both Dr. Sakr and ACCESS are working to disseminate approximately 1,500 booklets to men and providers who serve them throughout the Arab community.
The overwhelming acceptance of the booklet among the Arab community is yet another piece of evidence that involving individuals from local communities in cancer control strategies creates ownership of the endeavor and community-wide awareness.
As a result of this collaboration, Arab speaking men in Michigan who are diagnosed with early stage prostate cancer now have access to a comprehensive educational tool. This tool informs men clearly about treatment options that are available and provides an explanation of side effects and advantages of each treatment modality and consequently allows Arab patients to make an informed decision on a timely basis.
Reviewer comments: “The project addressed a real need for material in Arabic and can be used for any Arabic population.”
Project description: Body & Soul is a health initiative to encourage congregations to eat more fruits and vegetables. Using evidence-based research, this program uses a four-pillar approach:
Pillar I – Pastoral;
Pillar II – Activities that promote healthy eating;
Pillar III – A church environment that promotes healthy eating; and
Pillar IV – Peer counseling that motivates church members to eat a healthy diet.
The University of Michigan Comprehensive Cancer Center, Progressive Baptist Churches, Ford Hospital – Your Journey to Wellness, and American Cancer Society (ACS) all came together to support this program effort in their respective areas. ACS implemented all of the training, and the University of Michigan provided training for the peer counseling and physical activity component. Sixteen churches and over 30 peer counselors were trained.
Churches implementing Body & Soul are seeing marked interest in the health of their congregations. The churches are even planning programs to educate their members on health issues that most affect the African American community. They are also setting policy to establish a healthier church environment that will impact these churches for years to come.
Reviewer comments: "The program is an innovative and effective way to influence lifestyle changes to improve health and cancer prevention in a special population that can be replicated nationwide.”
University of Michigan – Comprehensive Cancer Center, Program for Multicultural Health, and University Students Against Cancer
Washtenaw County Department of Public Health
Project description: The Colorectal Cancer Awareness Network (CRAN) of Washtenaw County is a diverse group of community members, cancer survivors, worksite organizations, universities, and health care centers in Washtenaw County that joined forces in 2005 to raise awareness of colorectal cancer screening guidelines and to increase early detection of colorectal cancer.
CRAN of Washtenaw County developed a 45- to 60-minute prevention and education program (road show) that includes an agenda, PowerPoint slide show, quiz, evaluation, and speaker notes. The following eight presentations were conducted during March and April 2006: Eastern Michigan University (Ypsilanti); Business & Professional Women (Monroe); NSF International (Ann Arbor); Pfizer Inc. (Ann Arbor); Frenchtown Senior Center (Monroe); JC Penney Retirees (Monroe); Washtenaw County Government Retirees (Ypsilanti); and Brighton High School Media Center (Brighton).
Reviewer comments: “Excellent community participation and support.”
Project description: Over two years, a panel of prostate cancer experts and advocates assessed progress made since 1998, the current state of the science, and the collective experience of the panel members to develop new prostate cancer control recommendations to guide the Michigan Department of Community Health and the Michigan Cancer Consortium for the next few years.
The Advisory Committee on Prostate Cancer formed three workgroups to focus on: 1) primary and secondary prevention; 2) treatment; and 3) survivorship issues. Cross-cutting issues of epidemiology, accessibility, disparities, and genetics were also considered. A goal was identified for each of the three focus areas, accompanied by specific measurable objectives and strategies to achieve the desired goal. Panel members worked together to reach consensus on difficult issues, such as screening/early detection, genetics, and risk assessment and controversies about watchful waiting and late-stage treatment. The clear consensus was reached that the greatest unmet need was to address long-term survivorship.
Prostate cancer remains a difficult disease to address. It is possible to detect the disease early, but there is no evidence that such early detection will reduce mortality. When prostate cancer is detected, a man is faced with difficult treatment decisions, each of which leads to side effects that need to be managed. Emotions run high around each of these issues. The collaborative consensus to focus on improving quality of life for the more than 80,000 prostate cancer survivors will re-direct local regional and statewide activities toward a unified goal guided by Michigan men and their families that will benefit most.
Reviewer comments: “Truly a collaboration with so many health systems, community organizations, and individuals.”
Hospices of Henry Ford and several other area academic and service programs
Wayne State University – Center to Advance Palliative-Care Excellence (CAPEWAYNE), Department of Anthropology, Department of Sociology, End-of-Life Interdisciplinary Project, Library and Information Science Program, Interdisciplinary Studies Program, College of Medicine, College of Nursing
Project description: An interdisciplinary end-of-life (EOL) graduate course was initiated in 2001 in response to an identified need to address EOL education issues in the Wayne State University (WSU) community. The course was developed by a grassroots group (EOLIP) with a long-term goal of improving EOL care in the Detroit Metropolitan area via education and collaboration between academics and service providers.
This course is the product of an ongoing collaboration of academics and service providers representing 16 units of WSU and a dozen care provider organizations serving the WSU community. Begun as the WSU Interdisciplinary End-of-Life Project, the collaboration has now become a vital part of the WSU Center to Advance Palliative-Care Excellence (CAPEWAYNE) and has produced a number of products, including the graduate course and a book (Gelfand, et al 2005)
This successful graduate (and upper division) course on EOL issues is cross-listed by five university departments and programs and is fully enrolled each time it is offered. Student evaluations of teaching for the course and other forms of feedback suggest that this course has been a life-altering experience for many students and growth producing for most.
Reviewer comments: “This collaboration shows that end-of-life care is just as complex and in need of interdisciplinary teamwork as preventative and chronic medical care.”