Systems Approaches for Mapping Public Health and Clinical Partnering for Cancer Control in Rural Communities
Project Dates: 2019-2021
Rural populations in the United States have increased prevalence of cancer risks, including poverty, limited access to healthcare, tobacco use, physical inactivity, obesity, and excessive alcohol use. Underuse of cancer screening results in excess late–stage diagnoses and cancer mortality in rural and other underserved populations. Hospitals and local public health departments each separately conduct periodic community health needs assessments and create implementation plans, but implementation is limited due to low funding for non–reimbursable community services. Community–based cancer prevention is under–resourced, especially in rural and other underserved areas (e.g., poor urban African–American neighborhoods), making the use of evidence based interventions (EBIs) all the more important. Local collaborative networks can coordinate or combine limited implementation staffing, funding, and other resources from public health, hospitals, and non–health sector partners to increase the use of evidence–based community–based cancer prevention approaches and discard ineffective approaches. Local public health departments can serve as conveners and chief health strategists for community–based cancer prevention to stimulate meaningful partnerships to address cancer disparities. But many smaller departments and those in rural areas are often under–resourced and inadequately trained for these expanded public roles
- Identify implementation of community cancer prevention EBIs, mis–implementation (lack of EBI uptake and inappropriate continuation of ineffective approaches), and capacity to implement EBIs
- Quantify partner network characteristics, extent of collaboration, and centrality of local public health departments as conveners and drivers of collective action in implementation of community cancer prevention EBIs in counties served by the BJC Healthcare system.
Implications for Research and Practice:
This study will further our understanding of local health department and BJC HealthCare organizational characteristics, contextual factors, and influences shaping decision making for cancer prevention.
Project Contact: Peg Allen, PhD
Project Staff: Ross Brownson, Bobbi Carothers, Laura Kliethermes, Ed Tsai, Callie Walsh-Bailey, Jean Wang, Sarah Pritchard