A Socio-Ecological Framework for Cancer Control in the Pacific: A Community Case Study of the US Affiliated Pacific Island Jurisdictions 1997–2017
Year: 2018
Type: article
Abstract: The United States Affiliated Pacific Island Jurisdictions (USAPIJ) are politically linked to the United States (US) as US Territories (Guam, American Samoa), a US Commonwealth (Northern Mariana Islands), and as sovereign nations linked to the US through Compacts of Free Association (Federated States of Micronesia-FSM, Republic of the Marshall Islands-RMI, Republic of Palau). Cervical cancer incidence in the RMI is the highest in the world, mammography services are not available in the FSM and only Guam has on-island oncology services. Cancer risk factors such as obesity, tobacco, Hepatitis B are prevalent. Twelve years of nuclear testing in the RMI adds to the cancer burden. A community-based, multi-national coalition with multi-system external partners the Pacific Regional Cancer Control Partners (PRCP) was developed to address cancer prevention and control in the USAPIJ. Through the PRCP, local cancer coalitions, a regional cancer registry, 12 years of regional cancer control plans, and cancer prevention programs and research has been implemented. Methods: The PRCP is the subject of this community case study. The PRCP is analyzed through a socio-ecological theoretical framework to describe its typology, building blocks, and management. The respective roles and work of each partner and organization will be described and aligned with the levels of the socio-ecological framework. Results: The USAPIJs evolved a community-focused internal and external regional cancer prevention and control network over 20 years. The form and structure of the PRCP fit within a socio-ecological framework for cancer control. An adaptive management strategy has been used within the PRCP to manage its multi-national, multi-level, and multi-system partners. Conclusion: The PRCP has been able to advance cancer prevention and control programs with a community-centric model that functions in a multi-national, multi-cultural, low-resource, geographically dispersed environment over the last 20 years. The PRCP operates with a structure and management style that is consistent with a socio-ecological framework for cancer control. This case study provides a blueprint for the PRCP organizational structure and a mechanism for its function. The PRCP concept, a community-centric model for cancer control in multi-national resource-limited environments, may be scaled to similar global environments.
Source: Frontiers in Public Health
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Awards: G1119776208, GUAM BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM AND GUAM COMPREHENSIVE CANCER CONTROL PROGRAM, G2074506954, G2194120129, G2213390710, NATIONAL COMPREHENSIVE CANCER CONTROL PROGRAM, USAPI COMMUNITY HEALTH INTERVENTIONS PROJECT (CHIP), IMPLEMENTING COLLABORATIVE PROJECTS TO REDUCE CANCER INCIDENCE, MORTALITY AND MODIFIABLE RISK FACTORS IN THE CNMI., G6164067804, G6249807119, FSM COMPREHENSIVE CANCER CONTROL PROGRAM- WAY FORWARD IN IMPLEMENTING FSM'S CCC PLAN TO REDUCE CANCER BURDEN IN FSM - THE FEDERATED STATES OF MICRONESIA (FSM) INCLUDES THE FOUR STATES OF CHUUK, KOSRAE, POHNPEI AND YAP, WITH 102,624 (CENSUS 2010) PEOPLE RESIDING IN OVER ONE MILLION MILES OF WESTERN PACIFIC OCEAN. IN THE FSM, THERE ARE THREE LEVELS OF GOVERNMENT- NATIONAL, STATE AND LOCAL. THE SET UP MIRRORS THAT OF THE US GOVERNMENT. THE DEPARTMENT OF HEALTH AND SOCIAL AFFAIRS (NATIONAL) IS APPLYING FOR PROGRAM 2 OF THE FOA (CDC-RFA-DP17-1701), THE NATIONAL COMPREHENSIVE CANCER CONTROL PROGRAM (NCCCP) AND IS ALSO APPLYING ON BEHALF OF THE FOUR STATES OF FSM. ALTHOUGH THE CANCER BURDEN REMAINS HIGH WITH PREVENTABLE OR EARLY DETECTABLE CANCERS AS LEADING CAUSES OF MORTALITY(CERVICAL CANCER, BREAST,LUNG & BRONCHUS, UTERUS, TOBACCO-RELATED ORAL CAVITY & PHARYNX, PROSTATE, LIVER, COLON & RECTUM, LEUKEMIA) MUCH PROGRESS HAD BEEN MADE SINCE FSM WAS AWARDED ITS FIRST IMPLEMENTATION FUNDING. FSM NOW HAS CANCER REGISTRIES IN ALL THE FOUR STATES INCLUDING THE NATIONAL GOVERNMENT THAT ARE LINKED TO THE PACIFIC REGIONAL CENTRAL CANCER REGISTRY. ANOTHER MILESTONE IS THE DEVELOPMENT OF THE NATIONAL STANDARDS OF CARE GUIDELINES FOR BREAST AND CERVICAL CANCER WHICH WAS REVISED AND UPDATED IN 2015. THESE NATIONAL GUIDELINES ARE USED TO GUIDE THE DEVELOPMENT OF TRAINING MODULES ON CANCER PREVENTION, EARLY DETECTION, PALLIATIVE CARE AND SURVIVORSHIP. COLLABORATIVE EFFORTS ARE UNDERWAY BETWEEN THE FSM CCC PROGRAM AND FSM MATERNAL AND CHILD HEALTH (MCH) PROGRAM AS THE IMPLEMENTATION OF VIA IS ACCEPTED FOR CERVICAL CANCER SCREENINGS. ALL FOUR STATES HAVE VIA-TRAINED HEALTH PROVIDERS WITH THREE OF THE STATES ALREADY IMPLEMENTING IT AS THE PRIMARY SCREENING METHOD FOR CERVICAL CANCER. PROGRAMS UNDER THE NCD UMBRELLA CONTINUE TO LEVERAGE RESOURCES AND COLLABORATE ON CROSS-CUTTING ISSUES, AS EVIDENCED WITH THE NCD ANNUAL SUMMIT. THE NATIONAL AND STATE CCC PROGRAMS CONTINUE TO LEAD THE WAY IN CHRONIC DISEASE COLLABORATION. A COLLABORATIVE AGREEMENT WAS ESTABLISHED IN 2016 BETWE EN THE FSM CCC PROGRAM AND THE FSM NATIONAL IMMUNIZATION PROGRAM TO ENSURE IMPLEMENTATION AT THE STATE LEVELS IN INCREASING HPV IMMUNIZATION COVERAGE.WITH THIS APPLICATION, THE NATIONAL AND STATE CCC PLANS ARE NOW COMBINED INTO ONE COORDINATED PLAN FOR THE NATION THAT WILL RESULT IN REDUCED DUPLICATION OF EFFORT AND MORE COORDINATED IMPLEMENTATION OF PLAN PRIORITIES WHICH WILL ENABLE IMPROVED MONITORING, TRACKING AND EVALUATION OF THE PRIORITIES. THE FSM COORDINATED CCC PROGRAMS BOTH AT NATIONAL AND THE STATES, IN CONJUNCTION WITH THE PACIFIC REGIONAL CCC EFFORT, HAS MADE PROGRESS TOWARD THE LONG TERM GOAL OF RAISING THE STANDARD OF CANCER CARE IN THE FSM AND THE PACIFIC REGION AND WILL CONTINUE TO WORK TOWARD A CANCER-FREE FSM.WITH FUNDING THROUGH THE NCCCP, FSM NATIONAL AND THE STATES WILL WORK TO ACCOMPLISH THE FOLLOWING OBJECTIVES:PRIMARY PREVENTIONO HPV VACCINATION? VACCINATION REQUIREMENTS FOR SCHOOL ATTENDANCE? VACCINATION PROGRAMS IN SCHOOLS? INTERVENTIONS TO INCREASE VACCINATION RATESEARLY DETECTION AND SCREENINGO FOCUS ON CERVICAL CANCER SCREENING? PATIENT NAVIGATION SYSTEMS? ONE-ON-ONE EDUCATIONS? PROVIDER ASSESSMENTQUALITY OF LIFE OF SURVIVORSO ENHANCED ACCESS TO /AND QUALITY OF/ SERVICES FOR SURVIVORS? PATIENT NAVIGATION SYSTEMS? EDUCATION OF HEALTHCARE PROVIDERS? ASSESS / ENHANCE PALLIATIVE SERVICESADDRESS DISPARITIES:ADDRESS DATA GAPS O ENHANCING METHODS TO IDENTIFY AND DESCRIBE HEALTH DISPARITIES (SCREENING, PREVENTION)LOWER % OF POPULATION WITH POOR HEALTH STATUSO LINGUISTICALLY AND CULTURALLY APPROPRIATE HEALTH EDUCATION MATERIALSO CULTURALLY COMPETENCY TRAINING FOR PROVIDERS, G6802647151, (1/2) Pacific Island Partnership for Cancer Health Equity (PIPCHE), G6952967560, AMERICAN SAMOA GOVERNMENT DEPARTMENT OF HEALTH CANCER PREVENTION AND CONTROL PROGRAM, G7869639427, G8043877302, G8158925033, G8573887968, G8973297126, CANCER PREVENTION AND CONTROL PROGRAMS FOR STATE, TERRITORIAL, AND TRIBAL ORGANIZATIONS - THIS PROJECT IS A CONTINUATION OF ACTIVITIES INITIATED IN 2017 AND BUILDS UPON SUCCESSES AND LESSONS LEARNED IN CANCER PREVENTION AND CONTROL. ACTIVITIES AIM TO TARGET BOTH GENERAL AND DISPARATE POPULATIONS UTILIZING EVIDENCE BASED STRATEGIES TO INCREASE DEMAND IN SCREENABLE CANCERS AND PROMOTE HEALTHY LIFESTYLES BY IMPLEMENTING SUCH STRATEGIES TO STRENGTHEN HEALTH SYSTEMS, CHANGE THE ENVIRONMENT, AND INCREASE COMMUNITY AND CLINICAL LINKAGES.
OpenAlex ID: W2896394290