We Are the Champions: Resources for Increasing Health Care Provider Awareness About Cancer Prevention

Innovative Provider Education on Lung Cancer in the Most Affected State: What Works?

Authors:

Celeste Worth (Presenter)
University of Louisville

Ruth Mattingly, University of Louisville
Morel Jones, University of Louisville
Jamie Studts, University of Kentucky
Connie Sorrell, University of Louisville

Public Health Statement: Kentucky’s lung cancer burden is 50% higher than the national average. In fact, Kentucky leads the nation in the incidence and mortality from lung cancer each year. Kentucky is also ranked #1 in the U.S. for smoking prevalence—the top risk for lung cancer. Lung cancer screening recommendations have created an opportunity for providers to offer patients early detection and a possible cure for a most often fatal disease. Provider education on screening, tobacco cessation, treatment advances, and survivorship care can have a tremendous public health impact on the leading cause of cancer death.

Purpose: The Kentucky LEADS Collaborative is dedicated to reducing the burden of lung cancer in Kentucky and beyond through development, evaluation, and dissemination of novel, community-based interventions to promote provider education, survivorship care, and prevention and early detection regarding lung cancer. Collaborating with an extensive network of community partners, this interdisciplinary team of lung cancer prevention and control experts create a unique opportunity for Kentucky to lead in research and programming for lung cancer control.

Methods/Approach: The provider education component of LEADS developed and implemented four unique continuing education interventions: an interactive online course, didactic presentations with audience response system, academic detailing with a LEADS Primary Care Toolkit, and a webinar. The interventions target primary care providers (PCPs) to address smoking cessation and the screening, initial referral and ongoing care of patients diagnosed with lung cancer.

Results: More than 2,000 health professionals have participated in one or more of the educational offerings. This includes more than 1,000 PCPs, nearly 20% of the state’s total. Most PCPs self-reported practice behavior changes related to lung cancer prevention, screening, and care in the months following the intervention. Experiences and lessons learned from each intervention will be shared.

Conclusions/Implications: LEADS has increased use of best practices among primary care providers of evidence-based lung cancer care across the continuum. PCPs play a pivotal role in determining the care pathways for their patients who are at risk for, or diagnosed with, lung cancer.

Knowledge and Practice Regarding Hereditary Cancer Syndromes among Family Physicians

Authors:

Emily Fields (Presenter)
Colorado Department of Public Health and Environment

Joseph De Nagy, State University of New York at Buffalo
Randi Rycroft, Colorado Department of Public Health and Environment
Lisen Axell, University of Colorado
Lisa Ku, University of Colorado
Jan Lowery, Catholic Health Initiatives

Public Health Statement: Primary care doctors play an important role in identifying persons who may be at increased risk of cancer due to hereditary syndromes. Once identified, these patients can be referred for genetic counseling and testing to determine mutation status, and recommended for screening using guidelines specifically designed for persons at increased risk of cancer.

Purpose: To assess current knowledge and practices around hereditary cancer among family physicians.

Methods/Approach: We surveyed a random sample of 300 family practitioners in Colorado to assess: knowledge and comfort in management of at-risk patients, use of family history to inform clinical decisions, guidelines used for screening and genetic referral and frequency of referrals with and without involvement of genetic counselors. We generated descriptive statistics and compared physicians that reported greater knowledge around management of high risk patients and routine use of family history to inform practices, to those who did not, with respect to demographic and practice characteristics.

Results: A minority of physicians reported high knowledge of hereditary cancer syndromes, recommendations for screening high risk patients, and risk assessment; only 10% reported high level of comfort in referring their patients for genetic risk assessment. Physicians who collected complete family histories were more likely to report high knowledge about hereditary cancer, and to use family history to guide recommendations. Few physicians reported using recommendations for screening and genetic risk assessment from organizations focused on high risk.

Conclusions/Implications: Provider-focused education initiatives should focus on raising awareness of hereditary cancer syndromes, use of risk-appropriate guidelines, and the importance of collecting comprehensive family histories.

Cancer Survivorship Care Plans: A Toolkit for Health Care Professionals: Providing Education and Resources to Help Incorporate Survivorship Care Plans into Systems of Care

Authors:

Michelle House (Presenter)
California Department of Health Care Services

Shauntay Davis, California Department of Public Health
Joanna Morales, Triage Cancer
LeeAnn Timbrook, California Department of Public Health
Judith Polakoff, California Department of Public Health

Public Health Statement: Implementing survivorship care plans remains a challenge for some health care providers and cancer programs, including those pursuing CoC accreditation; additional education, resources, and effective systems change strategies must be employed in order to ensure cancer survivors receive survivorship care plans.

Purpose: To design a tool to assist health care professionals and cancer programs with understanding and implementation of survivorship care plans.

Methods/Approach: Cancer Survivorship Care Plans: A Toolkit for Health Care Professionals was developed over seven months by subject matter experts who participated in California’s state cancer control coalition. Development was informed by a literature review, assessment of available tools and resources, and expert contributions.

Results: Feedback was solicited from 30 coalition members and health care professionals, with a 20% response rate. Preliminary evaluation results indicate the toolkit is useful for increasing understanding of survivorship care plans. A common theme was that the toolkit is a beneficial starting point; however, some respondents indicated needing more information specific to implementation within their cancer program.

Conclusions/Implications: Cancer Survivorship Care Plans: A Toolkit for Health Care Professionals is a valuable tool to begin a systems change within cancer programs. Next steps include conducting formal assessments with health care professionals and cancer programs in order to identify specific barriers to implementation of survivorship care plans. Once identified, a collaborative approach should be utilized to ensure an effective systems change.

Learning to Love Mondays: Weekly Strategies to Quit Smoking

Authors:

Joanna Cohen (Presenter)
Bloomberg School of Public Health at Johns Hopkins University

Peggy Neu, The Monday Campaigns (Co-Presenter)
Ron Hernandez, The Monday Campaigns/Grace Communication Foundation

Public Health Statement: A large variance exists on the advice smokers receive on when to quit smoking.

Purpose: This study explores using Monday as an effective quit date because of its fit with existing smoker preferences and also as a built-in weekly cue to engage quitters and reduce relapse rates.

Methods/Approach: Researchers used a peer-reviewed study on weekly patterns in internet searches, an analysis of weekly call patterns to 28 state quitlines, online questionnaires, two pilots of community and state programs, and data analysis on weekly participant engagement with a major smoking cessation initiative’s signature program.

Results: Of questionnaire respondents, 53% preferred Monday as their quit day. Data from the peer-reviewed study and online quit programs showed a 25% increase in queries, initial contacts, and engagement with cessation programs on Mondays. Quitters choosing Monday increased self-efficacy: smokers engaging with one state quitline had a 47% higher quit rate, with another state-run group experiencing higher confidence and success rates.

Conclusions/Implications: These studies reveal a pattern of greater interest and engagement in quitting smoking at the beginning of the week. Tobacco cessation programs can leverage this pattern by 1) recommending Monday as a quit, recommit and re-quit day; 2) leveraging Monday “fresh start” mindset in communications; 3) focusing resources on times when smokers are most likely to quit and 4) using Monday sustaining messaging to help people stay quit. Free marketing resources are available to tobacco cessation groups that want to adopt the Monday concept in their settings.