A Population Health Assessment in a Community Cancer Center Catchment Area: Triple negative breast cancer, alcohol use, and obesity in New Castle County, Delaware

BACKGROUND

The National Cancer Institute (NCI) requires designated cancer centers to conduct catchment area assessments to guide cancer control and prevention efforts designed to reduce the local cancer burden. We extended and adapted this approach to a community cancer center catchment area with elevated rates of triple negative breast cancer (TNBC).

METHODS

Cancer registry data for 462 TNBC and 2,987 Not-TNBC cases diagnosed between 2012 and 2020 at the Helen F. Graham Cancer Center & Research Institute (HFGCCRI), located in New Castle County, Delaware, were geocoded to detect areas of elevated risk ('hot spots') and decreased risk ('cold spots'). Next, electronic health record (EHR) data on obesity and alcohol use disorder (AUD) and catchment-area measures of fast-food and alcohol retailers were used to assess for spatial relationships between TNBC hot spots and potentially modifiable risk factors.

RESULTS

Two hot and two cold spots were identified for TNBC within the catchment area. The hot spots accounted for 11% of the catchment area but nearly a third of all TNBC cases. Higher rates of unhealthy alcohol use and obesity were observed within the hot spots.

CONCLUSIONS

The use of spatial methods to analyze cancer registry and other secondary data sources can inform cancer control and prevention efforts within community cancer center catchment areas, where limited resources can preclude the collection of new primary data.

IMPACT

Targeting community outreach and engagement activities to TNBC hot spots offers the potential to reduce the population-level burden of cancer efficiently and equitably.

A community-based collaborative approach to improve breast cancer screening in underserved African American women

Although African American women in the United States have a lower incidence of breast cancer compared with white women, those younger than 40 years actually have a higher incidence rate; additionally, African American women are more likely to die from breast cancer at every age compared with white women. Racial disparities in breast cancer mortality rates are especially significant in Maryland, which ranks fifth in the nation for breast cancer mortality, and in Baltimore City, which has the second highest annual death rate for African American women in Maryland. To address this disparity in care, Med-IQ, an accredited provider of CME, collaborated with Sisters Network Baltimore Metropolitan, Affiliate Chapter of Sisters Network® Inc., the only national African American breast cancer survivorship organization, to sponsor their community-based educational outreach initiative. The collaborative mission was to engage at-risk African American women, their families, local organizations, healthcare professionals, and clinics, with the goals of increasing awareness, addressing fears that affect timely care and diagnosis, and encouraging women to obtain regular mammograms. Intervention strategies included (1) a "Survivor Stories" video, (2) patient outreach consisting of neighborhood walks and an educational luncheon, and (3) a community outreach utilizing direct mailings to local businesses, community groups, and healthcare professionals. Trusted and well-known community resources were presented as mediums to promote the initiative, yielding achievement of broader and more effective outcomes. As a result of this patient-friendly initiative, two (2) of the women who sought screening were diagnosed with breast cancer and underwent treatment.

Recruiting future nurses: a collaborative project

Society as a whole must be involved in making certain there are enough professionals in the future to provide care for the health needs of both rural and urban communities. As a result of this need, Area Health Education Centers (AHECs) across North Carolina have expanded their health care career awareness efforts. One AHEC focused on the concept of awareness of nursing careers by the community, for the community. This project is ongoing and, through collaborative efforts, keeps nursing career awareness in the forefront.

Nurse Responses to Re-tooling Practice, Education, and Management Roles

BACKGROUND

The purpose of this article is to report the results of a survey conducted by one of the nine Area Health Education Centers in North Carolina to inform regional work force planning by ascertaining nurses' views of the need to re-tool for practice, education, and management roles.

METHOD

A work force planning group represented by nursing service and education surveyed 1,050 nurses. Four hundred thirty-two (41%) nurses responded: 87% believed they needed to re-tool and 92% were willing to do so.

RESULTS

Critical thinking was rated as very important to nurse managers, staff RNs, and LPNs, and educators rated teaching as the area most in need of re-tooling.

CONCLUSION

Nurses are clearly interested in re-tooling. Staff development, continuing education, and degree programs can respond to this willingness.

Recruiting future nurses: a collaborative project

Society as a whole must be involved in making certain there are enough professionals in the future to provide care for the health needs of both rural and urban communities. As a result of this need. Area Health Education Centers (AHECs) across North Carolina have expanded their health care career awareness efforts. One AHEC focused on the concept of awareness of nursing careers by the community, for the community. This project is ongoing and, through collaborative efforts, keeps nursing career awareness in the forefront.

Factors perceived to facilitate and impede learning in the workplace

A study was conducted to determine factors that facilitate and impede learning in a hospital nursing staff development department. Data were collected through interviews, observations, critical incidents, and document reviews. Findings show that factors perceived to facilitate learning are (1) support for education by nursing administration, (2) availability of education, (3) the inviting atmosphere of the staff development department, (4) small class size, (5) informal learning, (6) the expert instructor, and (7) support of education by first-line managers. Factors perceived to impede learning are fewer: (1) written tests, (2) short staffing, and (3) first-line managers.

Workplace education: adult education in a hospital nursing staff development department

There is limited research-based information about the use of adult education principles in workplace education programs. A case study was conducted in a hospital nursing staff development department to provide recommendations for the current practice of adult education. The instructors used many of the principles of adult education, but problems stemmed from a lack of common understanding of adult education concepts.