MCC 2010 Spirit of Collaboration Award Winner Detroit Community Network Program to Reduce Cancer Health Disparities among Older, Underserved African Americans
About the Initiative The Detroit Community Network Program (CNP) is aimed at reducing cancer
health disparities among older African Americans in Detroit. This
population disproportionately experiences higher rates of many cancers
and is first diagnosed at later stage disease. The importance of the
establishment of a network in this complex urban setting is vital due to
the area’s great need and few resources. By bringing together organizations from the aging arena, the general health arena, and the cancer arena, the Detroit CNP can effectively reduce cancer health disparities among older African Americans in Detroit.
The Detroit CNP is an exemplary collaboration by
virtue of the partners involved. Not only does the network proudly count
20 community-based organizations among its partners, but also three
universities, and both of the major cancer centers within the City of
Detroit. Organizations that often are in competition with one another have been willing to set that competition aside for the greater good.
Impetus for the Collaboration Compared to whites, at every point of their life span, African Americans have greater morbidity and mortality due to cancer. Data from the Detroit region indicate that African Americans experience higher cancer rates, are first diagnosed at later stage disease, and suffer higher mortality rates than their white counterparts. By bridging the aging, health and cancer arenas, it was anticipated that the Detroit CNP would allow all involved to bring critical community organizing skills, public health experience, and related resources to this high-risk population.
Results During the five years of the program, Social Network Analysis (SNA) techniques have been applied to measure the effectiveness of the Detroit CNP coalition. CNP partners have been surveyed through in-person structured interviews annually over four years to assess each organization’s interactions with coalition members. These interviews elicited perceptions of communication and information sharing, as well as the subjects discussed and extent of interactions among members. Survey results serve as measures of: 1) the extent to which partner interactions were reciprocal; 2) the change in network density, as measured with successive annual surveys; 3) the extent to which reported linked relationships increased in complexity; and 4) specific cancer programs and disparity reducing activities resulting from these interactions.
SNA measurements, as well as graphical chartings, provide a measure of coalition development over time and insight on how the CNP coalition has fostered interorganizational communication and increased collaboration to address cancer-related health needs of Detroit’s elderly African Americans.
Below are diagrams showing relationships in Year 1 compared to relationships in Year 4. The red lines indicate unreciprocated links, and the blue lines indicate reciprocated links. As evidenced by the diagrams, during the course of the CNP, reciprocated links have intensified as the network has strengthened. This increase reflects the multiplex nature of some of the partner relationships developed in the context of specific program collaborations.
When the Detroit CNP was started, only a few of the partners were actively working together. Five years later, many of the partners have collaborated on high-level projects. Further, cancer prevention and control was not part of most of the partners’ missions, but has now been formally incorporated by many of the partner organizations.
Over the course of five years, the Detroit CNP partners have collectively offered nearly 1,000 cancer awareness and education programs. Below are specific examples of their work.
Many of the Detroit CNP partners worked together to orchestrate a faith-based cancer awareness event, “Facing Cancer With Faith, Hope, and Knowledge,” which was aimed at empowering faith leaders, parish nurses, lay health ministry workers, and chaplains to raise awareness in their congregations about breast and prostate cancers and the importance of screening and early detection. The event proved to be an outstanding collaborative effort, and results from the CEU evaluations indicated that it was very well received by more than 80 attendees.
The “Power of Collaboration: Enhancing Existing Infrastructures to Bring Breast Health Awareness and Screening to Underserved Women” is a Detroit CNP project that brought together five organizations to provide breast health awareness, mammography screening, and system navigation to underserved African American women in the City of Detroit and the surrounding area.
Funded by the Komen Detroit Race for the Cure, the collaboration was comprised of a network of organizations committed to reducing cancer health disparities for this population. Three community organizations from within the Detroit CNP (the Detroit Area Agency on Aging 1A, Neighborhood Service Organization, and Adult Well Being Services), as well as the Detroit CNP at Karmanos Cancer Institute and the NCI Cancer Information Service – Midwest Region have enhanced existing infrastructures to provide training for health educators, nurses, case managers, and volunteers to incorporate breast health awareness messages into existing operations.
The partner organizations provide an array of services to special populations, including the homebound, developmentally disabled, blind/visually impaired, deaf/hearing impaired, homeless, nursing home residents, grandparents raising grandchildren, and others. Breast education is being provided to women from these special populations, with case managers following up to facilitate mammography and transportation and provide navigation for further diagnostic work when needed. This project leads to earlier screening, thereby finding breast cancers at earlier, more treatable stages among the hardest of the hard to reach.
Lessons Learned In order to build an effective, sustainable partnership, trust is essential. Trust is built over time, time to get to know one another, time to work with one another. The sum of the whole is greater than the sum of its parts. More can be accomplished together.
There are many individuals and organizations passionate about their work, willing to incorporate cancer activities into their infrastructures and work to better the lives of those they serve.
“Detroit Community Network Program to Reduce Cancer Health Disparities among Older, Underserved African Americans” received the Michigan Cancer Consortium’s 2010 Spirit of Collaboration Award. The annual award is presented to member organizations that have done outstanding collaborative work to significantly move comprehensive cancer control activities forward in Michigan.