UCAN GENERAL MEMBERSHIP MEETING
MARCH 28, 2019
UpdateUCAN Strategic Plan
March 28, 2019
Input: 2018 Strategic Planning Process“To develop a strategy for UCAN to effectively implement the Utah State Cancer Plan.”
Output: 2018 Strategic Planning Process
Organizational Chart
Strategic Steps Presented at 2018 Q4 Mtg
✓ Release RFP for funded projects
✓ Codify by-laws
✓ Plan for State Conference
❏Develop Administrative Team
❏Develop sub-committees
Strategic Steps 2019➢ Plan for State Conference
Date: September 27, 2019Theme: “Public Health & Preventive Medicine: Translation in Action”
➢ Develop Administrative Team
➢ Develop Subcommittees
➢ Schedule Quarterly MeetingsQ1: Strategic Plan Update / UCAN Funded ProjectsQ2: Capacity BuildingQ3: State ConferenceQ4: Annual Plan / Celebration / Recognition / Awards
Cancer Survivor
Experiences Project
(CASES)
Judy Ou, PhD MPH
Evaluator/Analyst
Utah Cancer Registry
March 2019
Introduction
Utah Cancer Registry obtained funding from CDC to
partner with UDOH and UCAN to develop and
implement a survey assessing survivors' status on issues
such as access to health care and quality of life.
Short term goal:
–Develop and conduct a survey of cancer survivors
addressing issues including access to health care and
quality of life
Long term goal:
–Use survey data to support evidence-based policy changes
Partner Organizations and Data providers
Utah Cancer Action Network (UCAN)
Utah Department of Health (UDOH)• Utah Behavioral Risk Factor Surveillance System (BRFSS)
• Statewide survey administered every year to a random
sample of Utahans to monitor health status and identify
community health problems.
• Cancer Control Program
Utah Cancer Registry
University of Utah academic researchers
Utah Cancer Plan: Survivorship and Quality of
Life Targets for Change
Utah Cancer Plan: Survivorship and Quality of Life Targets for Change
Survey Methods
Eligibility
Aged ≥18 at diagnosis; diagnosed in Utah between 2012 and
2016; SEER-reportable invasive or benign brain/CNS tumor; living in Utah in 2018
Sampling strategy
Identified 807 potential participants
– 533 in small health statistical areas with highest percent with no
health care coverage (Low SES)
– 267 in small health areas with lowest percent with no health care
coverage (Higher SES)
Recruitment and data collection
Recruitment May to November 2018; participants aged 18 to 79
years sent a $2 incentive and letter with link to an online survey; participants aged ≥80 years sent a paper questionnaire; surveys
were in English
Differences Between BRFSS and CASES
BRFSS
Random sample of
Utah population
Participants asked if
they EVER had cancer
• If yes, administered
cancer survivor
module
Telephone survey
CASES
Random sample of
known cancer
survivor population
Diagnosed from
2012 to 2016
Online and paper
survey
Table 1. CASES participant characteristics, 2018
Eligible Sample Respondents
N % N %
Total1 807 485
Insurance coverage by small area
Highest % no health care coverage (Low SES) 515 63.8 289 59.6
Lowest % no health care coverage (High SES) 292 36.2 196 40.4
Sex
Female 448 55.5 276 56.9
Male 359 44.5 209 43.1
Age at diagnosis
0 to 39 years 97 12.0 43 8.9
40 to 64 years 399 49.4 243 50.1
65 to 95 years 310 38.4 199 41.0
Cancer Site2
Breast 145 18.0 103 21.2
Melanoma 107 13.3 72 14.9
Prostate 138 17.1 86 17.7
Colorectal 70 8.7 36 7.4
Brain And Central Nervous System 62 7.7 22 4.5
1Response rate = 60%; 2Five most common cancer sites shown
TargetBaseline
%1
Utah 2020
Target %
2018
CASES %2,3
Increase statewide cancer patient
enrollment in clinical trials.5.6 8.0 7.5
Increase the proportion of cancer patients
receiving survivorship care plans.44.5 50.0 60.24
Increase the proportion of cancer patients
and survivors reporting their pain is under
control.
88.6 94.0 91.2
1Baseline established with the 2010 BRFSS data or age-adjusted using the 2014 BRFSS; 2Percentages
weighted to the 2000 US Standard Population and account for stratification by small health area; 3CASES and
BRFSS results are not directly comparable as CASES participants are diagnosed in 2012 to 2016; 4Only
includes cancer survivors who no longer receive treatment; 22.9% if all respondents included
Table 2. Targets for Change, 2016-2020 Utah State
Cancer Plan
TargetsBaseline
%1
Utah 2020
Target %
2018
CASES %2,3
Increase the proportion of cancer survivors
reporting “Excellent”, “Very Good”, or
“Good” physical health.
79.1 83.0 86.4
Decrease the proportion of cancer patients
and survivors who are current smokers.19.4 17.0 7.0
Decrease the proportion of cancer patients
and survivors reporting limitations in their
usual activities due to physical, mental or
emotional problems.
38.7 35.0 48.2
Decrease the proportion of cancer
survivors reporting life dissatisfaction.5.2 4.0 7.5
1Baseline established with the 2010 BRFSS data or age-adjusted using the 2014 BRFSS; 2Percentages
weighted to the 2000 US Standard Population and account for stratification by small health area; 3CASES and
BRFSS results are not directly comparable as CASES participants are diagnosed in 2012 to 2016
Table 2. Targets for Change, 2016-2020 Utah State
Cancer Plan
Next steps
2019 CASES study population will include
persons diagnosed from 2013 to 2017
2019 survey distribution will begin in April
–Spanish-language letter and survey
Evaluation of Utah State Cancer Plan using
2018 CASES data and 2010 and 2017 BRFSS
cancer survivor module
© U N I V E R S I T Y O F U T A H H E A L T H , 2 0 1 7
ACKNOWLEDGEMENTS
Utah Department of Health
Brad Belnap, MPA
Natalie Loots, MPH, CPH, CHES
University of Utah/Huntsman
Cancer Institute
Anne C. Kirchhoff, PhD
Utah Cancer Registry
Carol Sweeney, PhD
Lori Burke
Marjorie Carter, MSPH
Sandie Edwards, MA
Mandy Giles, BS
Kate Hak, BS
Kimberly Herget, MStat
Morgan M. Millar, PhD
Valerie Yoder Otto, BS
© U N I V E R S I T Y O F U T A H H E A L T H , 2 0 1 7
FUNDING
Utah Cancer Registry is supported by:
– National Program of Cancer Registries (NPCR)• Grant 5 NU58DP006320-02-00
– Surveillance, Epidemiology and End Results
program (SEER)
– University of Utah
– Huntsman Cancer Institute
20
State Cancer Plan Implementation Projects• Received 9 applications
• 4 PA/Nutrition, 2 Survivorship, 2 Skin, 1 Screening• 4 organizations new to UCAN
• Five applications selected for funding• Projects run June 30, 2019 – June 29, 2020• FY2020 (year 1) appropriation: $94,960
University of UtahGet Healthy Utah
Wasatch Community GardensAlliance Community Services
International Rescue Committee
Leveraging an existing mobile health clinic to
decrease structural and financial barriers to
colorectal cancer screeningCo-Principal Investigators: Jessica Cohan, MD, MAS & Sheetal Hardikar, MBBS, PhD, MPH
• Colorectal cancer is
the third most
common incident
cancer globally
• The American Cancer
Society estimates
101,420 new cases of
colorectal cancer in
the US in 2019
Colorectal cancer: global statistics
Top 10 cancer types for estimated cases and
deaths worldwide for both sexes combined
Global Cancer Statistics 2018:GLOBOCAN estimates
Colorectal cancer screening recommendations
Current USPSTF recommendations:
- Annual stool-based test (including FIT)
- CT colonography or flexible sigmoidoscopy every 5 years
- Colonoscopy every 10 years
No specific recommendations for those with a higher risk for CRC,
including family history of CRC
Shi L, et al. J Health Care Poor Underserved 2011;22:945-61.MMWR 2015. 64(17); 464-468.
Adherence to recommended colorectal cancer
screening guidelines in US adults (National Health
Interview Survey)
0%
25%
50%
75%
2000 2008 2013
Non-Hispanic White African-American Asian Hispanic
Colorectal cancer: Prevalence of screening
Colorectal cancer screening rates in Utah
Colorectal cancer screening rates in Utah
Rates of colorectal cancer screening in
Utah by county
Source: CDC www.statecancerprofiles.cancer.gov
What are Known Barriers/Facilitators?
https://www.thecommunityguide.org/sites/default/files/assets/Cancer-Screening-Multicomponent-Colorectal.pdf
Multi-component interventions:1. Increase colorectal cancer screening (by 15%)
2. Cost effective
People Don’t Know
People Face Financial or Structural Barriers
Provider Barriers
Utah Cancer Action Network Implementation grant
“Leveraging an existing mobile health clinic to decrease structural and
financial barriers to colorectal cancer screening”
Co-PIs: Drs. Hardikar and Cohan
Partner: The Wellness Bus
Funding period: July 2019 – June 2021
• Utah Population Database
• Health Fairs
• Wellness Bus
Year 1: Needs Assessment
• Administer FIT tests on the Wellness Bus
• Patient navigation
• Identify barriers and facilitators to FIT testing
Year 2: Implement FIT Testing
Utah Cancer Action Network Implementation grant
“Leveraging an existing mobile health clinic to decrease structural and
financial barriers to colorectal cancer screening”
• Utah Population Database (State-wide)
• Health Fairs (Surveys)
• Wellness Bus (Surveys)
Year 1: Needs Assessment
Method: Use state-wide data and surveys to understand
patterns of screening and reasons for non-screening.
Goal: Identify population-based and individual risk factors for
non-screening.
Rationale: Allow appropriate targeting and tailoring of FIT
intervention.
Utah Cancer Action Network Implementation grant
“Leveraging an existing mobile health clinic to decrease structural and
financial barriers to colorectal cancer screening”
• Administer FIT tests on the Wellness Bus
• Patient navigation
• Identify barriers/facilitators to FIT testing
Year 2: Implement FIT Testing
Baseline survey
• Attitudes Administer FIT
Patient Navigator
• Ensure test completion
• Follow up results
• Ensure proper follow up
Exit Interview
• Barriers/facilitators
The Wellness Bus
Miller Diabetes Initiative
• Every week:
– 4 sites
– 25 people
• Currently offer:
– HTN screening
– DM screening
– Nutrition
– Health counseling
– Social services
Eligible Individual
Survey and FIT Test
FIT Not Returned
FIT Returned
Result Normal
Annual Screening
Result Abnormal
Connect 2 Health
PCP
HCI
Identified through health counselorEducation through posters
Obtain baseline attitudesInstructions for FIT
Interview N~50
Interview N=100
ColonoscopyCancer Care
ColonoscopyCancer Care
CommunityHealth Educator
What are known barriers/facilitators?
https://www.thecommunityguide.org/sites/default/files/assets/Cancer-Screening-Multicomponent-Colorectal.pdf
Multi-component interventions:1. Increase colorectal cancer screening (by 15%)
2. Cost effective
Expected Outcomes
• Characterize state-wide screening behavior to guide future implementation projects
• Rich understanding of individual attitudes and beliefs toward screening
• Identify barriers and facilitators to FIT at every step of screening
• Sustainable mechanism for FIT on mobile clinics
Thank You
Acknowledgements:
- Utah Cancer Action Network
- Utah Department of Health
- Dr. Robin Marcus and Nancy Ortiz, The Wellness Bus, Miller Diabetes Initiative
- Dr. John Sweetenham, Director for Clinical Affairs, HCI
- Garrett Harding, Jennyffer Morales, and Donna Branson, Community Outreach, HCI
- Huntsman Cancer Institute
- University of Utah Department of Surgery
- University of Utah Department of Population Health Sciences
Chair
Greg Bell, CEO, Utah Hospital Association
Vice Chair
M. Locke Ettinger, Former Director Health Promotion and Wellness, Intermountain Healthcare
Secretary/Treasurer
Juliana Preston, Executive Director, HealthInsight
Board Members
Heather Borski, Division Director, Utah Department of Health
Kathleen Britton, Director of Child Nutrition Programs, Utah State Board of Education
Mike Clark, Hospital Administrator, McKay-Dee Hospital
Patty Cross, Health Promotion Director, Utah County Health Department
Nick Jarvis, COO, Utah League of Cities and Towns
Scott Langford, Hospital Administrator, Beaver Valley Hospital
Robin Marcus, Chief Wellness Officer, University of Utah Health Sciences
Trevor Smith, Director Health Promotion and Wellness, Intermountain Healthcare
Monica Whalen, Executive Advisor and Business Consultant
Get Healthy Utah Board Members
The mission of Get Healthy Utah is to create a culture of health
through engaging multi-sector stakeholders, building partnerships,
providing resources, and connecting efforts that support healthy
eating and active living.
We do this by:
• Engaging high level leaders
• Partnering with public and private entities
• Addressing healthy equity
• Collecting, developing, and sharing best practices
• Promoting systems level change
• Providing funds and other resources
Project: Get Healthy Utah will work to improve fruit and vegetable consumption among elementary
school students in target United Way Community Schools in the Granite School District.
Target Population:United Way Community Schools. Community schools are made up of low-income populations
and are often Title I schools. The schools serve a highly diverse population, made up of many
immigrant and refugee families.
Partners: • United Way of Salt Lake
• Salt Lake County Health Department
• University of Utah
• Granite School District Nutrition Services
Strategies:• Smarter Lunchrooms
• Recess Before Lunch
• Key Messaging to Address Myths
Improving Fruit and Vegetable Consumption in Granite School District
Year 1 (July 1, 2019 – June 30, 2020)
Objective 1: The Health Initiative Team will implement 2-3 Smarter Lunchroom strategies in 3 target Granite School District
Community Schools by June 29, 2020.
Objective 2: The Health Initiative Team will use the Utah Health Values Study results to develop 3 key culturally appropriate
messages that address barriers to participation in the school meals program directed at parents, teachers, and school
administrators in the Granite School District by January 29, 2020.
Objective 3: The Health Initiative Team will work with 3 target United Way Community Schools in the Granite School District (not
the same schools targeted for Smarter Lunchroom strategies) to get a commitment that they will implement a recess before lunch
schedule for the 2020-2021 school year.
Objective 4: The University of Utah research team will collect baseline data using plate-waste studies in 3 target schools for
recess before lunch and 3 target schools for Smarter Lunchrooms by June 29, 2020.
BUDGET
Get Healthy Utah Staff 8,895.00
University of Utah evaluation 3,500.00
Marketing 6,080.00
Materials 1,525.00
TOTAL $20,000
Year 2 (July 1, 2020 – June 30, 2021)
Objective 1: The Health Initiative Team will implement 2-3 Smarter Lunchroom strategies in 3 additional target Granite School
District Community Schools by June 29, 2021.
Objective 2: The Health Initiative Team will continue work with the previously target schools to implement an additional 1-2
Smarter Lunchroom strategies by June 29, 2021.
Objective 3: The Health Initiative Team will work with 3 previously targeted schools from year 1 to implement and evaluate recess
before lunch starting in the 2020-2021 school year.
Objective 4: Get Healthy Utah will provide the 3 newly identified target schools with brochures featuring key messages developed
in year 1 by August 1, 2020.
BUDGET
Get Healthy Utah Staff 9,374.50
University of Utah evaluation 1,900.00
Marketing 3,705.00
Materials 1,050.00
TOTAL $16,029.50
Year 3 (July 1, 2019 – June 30, 2020)
Objective 1: The Health Initiative Team will implement 2-3 Smarter Lunchroom strategies in remaining 2-3 target Granite School
District Community Schools by June 29, 2022.
Objective 2: The Health Initiative Team will continue work with the previously targeted schools from years 1 and 2 to implement an
additional 1-2 Smarter Lunchroom strategies by June 29, 2022.
Objective 3: The Health Initiative Team will work with the 3 target schools who implemented recess before lunch to help provide
solutions to at least 1 identified barriers for sustainability by January 31, 2022.
Objective 4: Get Healthy Utah will provide the 3 newly identified target schools with brochures featuring key messages developed
in year 1 by August 1, 2021.
Objective 5: The University of Utah research team will comparison using plate-waste studies in 3 target schools for Smarter
Lunchrooms by June 29, 2022.
BUDGET
Get Healthy Utah Staff 9,374.50
University of Utah evaluation 5,050.00
Marketing 2,955.00
Materials 1,100.00
TOTAL $18,479.50
• Beginning in Year 1, the University of Utah research
team will collect baseline data using plate-waste
studies in 3 target schools for recess before lunch
and 3 target schools for Smarter Lunchrooms.
• The University of Utah researchers will conduct a
focus group with one of the schools that implemented
recess before lunch. Information from the focus group
will be used to provide support for sustainability.
Evaluation
SABORES DE MI PATRIA
FLAVORS OF MY HOMELAND
Examples of the recipe books that were created from the parent recipes last year. Each parent that participated received one.
Three Sisters at a Title I school.
Three Sisters at a Title I school.
Parent gathering vegetables from a school garden.
Hispanic Breast Cancer
Support Group2002-2017
Sara Carbajal-Salisbury, BS, Program Director
Jeannette Villalta, CHW, Karla Arroyo, LCSW, Gabriela Portugal, MD
March 28, 2019
Utah Cancer Action Network
Mental Health Facts among cancer
survivors
• Co‐occurring depression in women with cancer can complicate cancer
treatment, lead to poor treatment adherence for both conditions, and
decrease survival if left untreated.
• Several risk factors for depression have been identified and research has
highlighted the need for intervention programs to help women normalize
emotions and thoughts related to cancer and its treatments, and to improve
their cognitive abilities to overcome, accept, and positively reframe cancer
and other difficult situations women face throughout the cancer continuum.
• Cancer survivors have been identified to be at a higher risk of psychological
problems including suicidal ideation.
Mental Health Facts among Latina
cancer survivors• More attention is warranted in assessing and assisting survivors with their quality of life,
physical, and emotional needs. Mental health counseling and primary care providers trained
in post–cancer treatment care and survivorship concerns are critical needs for Hispanic
breast cancer survivors as well as other groups of minority women.
• Compared to interventions that focus on cancer prevention and control among Hispanics,
fewer interventions have targeted Hispanics diagnosed with cancer and those who have
completed cancer treatment and transitioned to survivorship.
• Evidence-based psychosocial interventions such as cognitive behavioral therapies that focus
on stress management, relaxation skills, coping skills, communication skills and social
support have been associated with improved emotional well-being, reduced depressive
symptoms, and reduced symptom burden among Hispanic patients diagnosed with cancer.
Project Overview
From Treatment to “Survivorship with Mental
Health”
An innovative format of group educational sessions focused in
mental health for Latina Cancer Survivors and caregivers.
Main Goals:
Identify mental health issues that affect the health of Latina
cancer survivors and what are
the needs to reduce them.
Increase awareness and education
regarding mental health and facilitate
resources.
“Survivorship with Mental Health Among
Latina Cancer Survivors from “Triunfadoras”
Target Population:
Latina cancer survivors and their
caregivers 21 years and older,
underserved and uninsured that
reside in the Wasatch Front.
“Triunfadoras”
Hispanic Cancer Support Group
Breast cancer support group founded in 2002 by Alliance
Community Services a non-profit 501-c-3 organization
that addresses service gaps directly and indirectly
related to the Hispanic community.
Created by bringing together a group of dedicated
experienced professionals with a wide array of skills and
experiences.
The program began with 10 patients in 2002 serving
Hispanic women in the Wasatch Front. Currently we
have served close to 600 patients with an increase of an
average of three + new members every month that
reside in different counties in Utah.
Project Overview Action Plan
From Treatment to “Survivorship with
Mental Health”
Year 1:
• Run a needs asessment
• Run mental health screening (specifically, suicide, depression and anxiety)
• Analyze results for the development of a curriculum based on
pshycoeducational model
Behavioral Screening: Anxiety, Depression, & Suicide
(GAD7, PHQ9, CSSR)
Needs Assessment: Self-esteem, Resources, Awareness,
Barriers, Behavior, & Knowledge
Analysis of Results
Develop Psycho-educational Curriculum
Survivorship With Mental Health
Among Latina Cancer Survivors From “Triunfadoras”
Year 1
Project Overview Action Plan
Year 2:
• Training ACS team for the implementation of the
curriculum.
• Implementation of the curriculum by providing pshyco-
educational clases regarding mental health and healthy
coping mechanisms in a closed group setting (identify
triggers).
• Incorporate social and emotional support group
sessions.
Evaluation:
- Number of participants impacted by this program
- Run a pre and post evaluation regarding the curriculum.
Project Partners
• Main Collaborators in this program are:
• Multicultural Counseling Center
• Intermountain Medical Center
Findings from this project will give us the basis to further develop an
evidence based intervention to better meet the mental health needs of
Latina cancer survivors that reside in Utah.
Research CollaborationsAlliance Community Services has partnered with the University of Utah
and Huntsman Cancer Institute in research projects to determine best
practices for eliminating health disparities and improvement of our
programs:
• A Community-Based Approach to Assessing the Physical, Emotional, and
Health Status of Hispanic Breast Cancer Survivors
First Published November 8, 2017 Research Article
• Addressing Disparities: The Alliance Breast Cancer Community-Based
Program for Hispanic Women. Clinical Journal of Oncology Nursing
20(5):481-486 · October 2016
• A Workplace-Based Intervention to Improve Awareness, Knowledge, and
Utilization of Breast, Cervical, and Colorectal Cancer Screenings Among
Latino Service and Manual Labor Employees in Utah.
Article Oct 2018 Journal of Community Health
• Latino Parents’ Perceptions of the HPV Vaccine for Sons and Daughters.
Journal of Community Health 40(3) · October 2014
“Triunfadoras” – Our Vision
• “Nadie debe de enfrentar el cáncer solo”
• “No one should face cancer alone”
Questions & Answers
From Harm to Home | Rescue.org
IRC New Roots
Utah State Cancer Plan Implementation
Grant - 2019UCAN General Meeting - 3/28/2019
James Hunter – New Roots Program Manager
2
From Harm to Home | Rescue.org
Who we are…
The International Rescue
Committee responds to the
world’s worst humanitarian
crises and helps people
whose lives and livelihoods
are shattered by conflict and
disaster to survive, recover,
and gain control of their
future.
3
From Harm to Home | Rescue.org
The IRC has New Roots programs in 12 cities in the US.
New Roots in SLC is a broad-based agricultural program founded in 2010:
• Community Gardens
• Farmer Incubator Program
• Farmers Market
New Roots - SLC
4
From Harm to Home | Rescue.org
UCAN
State Cancer Plan Implementation Grant
3 Year Program:
• Healthy Eating &
Nutrition Education
• Community Garden
Expansion
• Neighborhood Farm
Stand Development
5
From Harm to Home | Rescue.org
Healthy Eating and Nutrition Education
• Developing curriculum
for a series of healthy
eating and nutrition
education workshops
• Delivering curriculum to
New Roots community
garden participants
each year
• 474 individuals reached
6
From Harm to Home | Rescue.org
Community Gardens
Expansion
• Expansion of 2 gardens
in South Salt Lake in
Year 1
• 10 additional beds
• Maintaining access to
garden spaces in Yrs. 2/3
• 67 refugee families
reached
7
From Harm to Home | Rescue.org
• Operating in South Salt Lake
• Development and Planning in
Year 1
• Implementation in Year 2
• Operation and Expansion in
Year 3
• 1,050 individuals reached
• Increase availability of fresh,
culturally appropriate
produce
• Accept SNAP and DUFB
Neighborhood Farm Stand
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From Harm to Home | Rescue.org
Thank you!