Maryland Cigarette Restitution Fund Public Health Grant at Johns Hopkins

New Pathways for Care: A Model for Delivering Prostate Cancer

Screening to Men in Need

Charlotte Neuhaus, MHS

Program ManagerCommunity-based Research

Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsNovember 12, 2003

Age-adjusted Prostate Cancer Rates in Baltimore City, 1999

Incidence Mortality

0

50

100

150

200

250

Black men White men

Per 100,000 population

Source: Maryland Cancer Registry, 2002

237

169

77

37

Prostate Cancer Screening Practices, Baltimore City, Males over Age 40

Yes65%

No35%

Source: Maryland BRFSS, 2001

Never Checked

37%

2 Yrs or More6%

Within 2 Yrs57%

Have you ever had a PSA test? When did you have your last PSA test?

Baltimore City: Significant Facts

25% of residents have no health insurance.

African-Americans twice as likely uninsured.

57% of uninsured men age >40 report having no health coverage in over 5 years.

Source: City of Baltimore, 2000

Source: City of Baltimore, 2000

Source: Maryland BRFSS, 2001

The Community-based Research team

is dedicated to cancer prevention and control

through innovative community-based programs

and research.

Mission Statement

Public Health Grant:Goals

Implement new model for community-based cancer education, screening diagnosis and treatment.

Reduce prostate cancer disparities in Baltimore City.

Improve access to prostate cancer screening.

Leverage existing resources through partnerships to increase men’s access to other health services.

Public Health Grant:Who We Are

Johns Hopkins partnership with 7 organizations: 5 community-based organizations, a community-based health provider, and a historically black university.

Recruited and trained staff from communities to: – Increase community awareness about prostate cancer– Outreach and provide education – Ensure informed decision-making prior to screening,

Provide prostate cancer screening, diagnosis, and treatment services to eligible men.

Plan OverviewPrevention, Education, Screening

Develop and expand community infrastructure for cancer awareness and screening

Sites– Credible presence in the communities and a

commitment to cancer prevention and control

Assess individual community needs through a qualitative and quantitative methods

Screening methods– Prostate: PSA & DRE

Delivery of Services

Region A

Region B

St. Clare Medical Outreach Van

Urban Medical Institute

Plan OverviewDiagnosis and Treatment

Individuals with suspicious and/or positive cancer screening results:

- For those with health insurance, covered via their existing health insurance plan

- For those without health insurance or who are underinsured and meet eligibility requirements, covered via Federal/State medical assistance programs

Plan OverviewDiagnosis and Treatment (cont’d)

For those without health insurance or who are underinsured and do not meet eligibility requirements for Federal/State medical assistance programs, covered via the CRF/JH Diagnosis and Treatment Program

A New Roadmap: Pebbles in the Road

New pathway for providing care

Budget cuts

Interface with– 7 partners– Baltimore City Department of Health– Baltimore City Cancer Coalition– Department of Health and Mental Hygiene– Clinical providers

Serving as health insurer, health educators, case managers, outreach workers, patient navigators

Necessary Components for a New Pathway

Community capacity building– CLAM

A shared vision for health promotion

Sustainable service programs in the community

Clear and honest communication

Public Health Grant Progress

Total educated 20071

Total screened 1101 –FY04 Screening Goal by June 30, 2004 500–Total screened since July, 2003 (FY04) 200

Case management Number of men provided with

diagnostic and treatment services for prostate cancer

56

Diagnosed with prostate cancer 6

On the Road: Maintaining Success

On the Road: Maintaining Success

On the Road: Maintaining Success

On the Road: Maintaining Success