samuel m. lesko, md, mph regina schmid-allen, mha laura toole, lcsw
DESCRIPTION
TCCAP: a Targeted Awareness Program to Address Colorectal Cancer Disparities in Northeast Pennsylvania. Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW Northeast Regional Cancer Institute, Scranton, PA. Acknowledgement. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/1.jpg)
1
TCCAP: a Targeted Awareness TCCAP: a Targeted Awareness Program to Address Colorectal Cancer Program to Address Colorectal Cancer Disparities in Northeast PennsylvaniaDisparities in Northeast Pennsylvania
Samuel M. Lesko, MD, MPH
Regina Schmid-Allen, MHA
Laura Toole, LCSW
Northeast Regional Cancer Institute,
Scranton, PA
![Page 2: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/2.jpg)
2
AcknowledgementAcknowledgement
Supported by grants from:The Harry & Jeanette Weinberg Foundation, Scranton Area Foundation, Blue Ribbon Foundation, Margaret Briggs Foundation, Sordoni Foundation, Inc., Procter & Gamble Fund, Southern Union Co., Pennsylvania Department of Health, Pennsylvania Department of Community & Economic Development, and In-kind Support
![Page 3: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/3.jpg)
3
Northeast RegionalNortheast RegionalCancer InstituteCancer Institute
Non-profit, community based organization with a commitment to ease the burden of Cancer in Northeast Pennsylvania.
• Cancer Registry• Research• Education and Support• Cancer Risk
![Page 4: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/4.jpg)
4
Partner HospitalsPartner Hospitals
Community Medical CenterGeisinger South Wilkes-BarreMarian Community Hospital
Mercy Health PartnersMoses Taylor Hospital/
Mid-Valley HospitalWayne Memorial Health System
Wyoming Valley Health Care System
![Page 5: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/5.jpg)
5
Appalachia Community Cancer Network Appalachia Community Cancer Network (ACCN): Appalachian Areas of 7 States (ACCN): Appalachian Areas of 7 States
(KY, MD, NY, OH, PA, VA, WV)(KY, MD, NY, OH, PA, VA, WV)
![Page 6: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/6.jpg)
6
BackgroundBackground
Colorectal cancer• 4th most common Ca in US• 2nd leading cause of Ca deaths in US• Screening can prevent CRCa deaths
• Colorectal cancer in NEPA• Most commonly diagnosed Ca• 2nd leading cause of Ca death
![Page 7: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/7.jpg)
7
Cancer Cases, NEPA 1998-’02Cancer Cases, NEPA 1998-’02
0
500
1000
1500
2000
2500
3000
3500
Colon/Rectum Breast Lung Prostate Bladder NH Lymphoma Uterus
Ca
se
s
Women
Men
![Page 8: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/8.jpg)
8
CRCa SIRs, Both Sexes, CRCa SIRs, Both Sexes, 1998-’021998-’02
Monroe
Luzerne
Wyoming
Lackawanna
Pike
Wayne
Susquehanna131
139
74
136
95
126
123
![Page 9: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/9.jpg)
9
CRCa, Stage at Diagnosis,CRCa, Stage at Diagnosis,Both SexesBoth Sexes
0
10
20
30
40
50
60
Local Regional Distant
Lackawanna county 1998-2002
SEER 1995-2000
0
10
20
30
40
50
60
Local Regional Distant
Lackawanna county 1998-2002
SEER 1995-2000
Per
cen
t
![Page 10: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/10.jpg)
10
GoalsGoals
1.To improve colorectal cancer screening rates
2.To improve the stage at which new colorectal cancer cases are diagnosed
3.To decrease colorectal cancer mortality rates
![Page 11: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/11.jpg)
11
Methods (1)Methods (1)
Awareness Program• Multi-faceted• Community• Healthcare Providers• 3-year (2004-2006)
![Page 12: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/12.jpg)
12
Methods (2)Methods (2)Community Advisory CouncilCommunity Advisory Council
Ellen Althouse, RNWilliam Auriemma, MDJoseph Bannon, MDMichael Barrett, MDValerie Bell, RNMaureen BesanconDerry BirdM.R. Chowdhury, MDEdward Dzielak, MDMary Erwine, RN, MSNPat FinanMarcie Grello, BSLinda Gutierrez, MDMrs. Ceil HughesRita Ives, RN, AOCNDavid KalinoskiJamie KaneRobert Kearns
Susan Kennedy Doug Klamp, MDMichael Kondash, MDLisa KuterBob LamsonPat Lawless, MHAIna LubinGail Matisko, RN, BSNJohn McGeehan, MDSally McGuireJudge Carmen MinoraErin MoskelPeter C. Olden, PhDStacey OndikDipti Pancholy, MDBharat Patel, MDPaul Remick, MD
David D. Reynolds, MD
Judy Rogers, CRN
David Rutta, MD
Marie Santilli
Karen Saunders
Nayan C. Shah, MD
Eileen Sharp, PhD
Beth Taylor, RN, OCN
Kristin Tigue
Michael Turock, MD
Kim Vangarelli
Vera Walline, MPH, CHES
Ann Ward
Gloria Watson
Barbara L. Winters, PhD
Robert E. Wright, MD
Eileen Zuber
![Page 13: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/13.jpg)
13
Methods (3)Methods (3)
Community Interventions• Advertisements
– Print, Billboards, Broadcast• Direct Mail
– Screen for Life• Printed Materials• Educational Programs• CASUAL Day
![Page 14: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/14.jpg)
14
![Page 15: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/15.jpg)
15
![Page 16: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/16.jpg)
16
![Page 17: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/17.jpg)
17
SM
![Page 18: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/18.jpg)
18
Methods (4)Methods (4)
HCP Interventions• Didactic Presentations
– Grand Rounds– Continuing Ed.
• Academic Detailing– PCPs
![Page 19: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/19.jpg)
19
![Page 20: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/20.jpg)
20
![Page 21: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/21.jpg)
21
EvaluationEvaluation
• Questionnaires• HCP Follow-up Calls• Population Survey• Cancer Registry Data
![Page 22: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/22.jpg)
22
Results: Community (1)Results: Community (1)
Community• 206 total community programs - 8,017
attendees• 46,510 targeted mail pieces• 59,725 total pieces of educational
materials• 38,712,582 total individual market
impressions
![Page 23: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/23.jpg)
23
Results: Community (2)Results: Community (2)
Programs
97% Reported Knowledge Gain
96% Planned to Change Behavior
Direct Mail
65% Reported Knowledge Gain
86% Planned to be Screened
![Page 24: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/24.jpg)
24
C.A.S.U.A.L. Day C.A.S.U.A.L. Day 2004-20062004-2006
• Team Captains – more than 400 businesses engaged
• Participants – more than 12,000 • Money Raised – more than $124,000 raised to
support Cancer Institute colon cancer awareness programming
![Page 25: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/25.jpg)
25
Results: HCP (1)Results: HCP (1)
Health Care Professionals• 21 hospital-based CME accredited
programs - 852 attendees• 9 non-hospital programs - 250 attendees• 38 non-physician healthcare groups - 876
attendees• 230 physician “detailing” sessions
![Page 26: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/26.jpg)
26
Results: HCP (2)Results: HCP (2)
CME Programs
98% Reported Knowledge Gain
95% Planned to Change Behavior
Detailing Sessions
44% Requested Additional Materials
75% Reported increased Patient Request for Screening
70% Reported Increased Screening
![Page 27: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/27.jpg)
27
Prevalence of Screening Lower Prevalence of Screening Lower Endoscopy* by Year, 2001-2006Endoscopy* by Year, 2001-2006
0
10
20
30
40
50
60
2001 2002 2003 2004 2005 2006
Endoscopy
Pe
rce
nt
Pe
rce
nt
* Proportion of Adults Reporting Having Had a Screening Lower Endoscopy in the Previous Five Years
![Page 28: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/28.jpg)
28
Colorectal Cancer Stage at DiagnosisColorectal Cancer Stage at Diagnosisby Year*, 1998-2007by Year*, 1998-2007
0
1 0
2 0
3 0
4 0
5 0
6 0
1 9 9 8 1 9 9 9 2 0 0 0 2 0 0 1 2 0 0 2 2 0 0 3 2 0 0 4 2 0 0 5 2 0 0 6 2 0 0 7
Pe
rce
nt
% l o c a l % r e g i o n a l % d i s t a n t
* NEPA, 6 counties* NEPA, 6 counties
![Page 29: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/29.jpg)
29
Results: MortalityResults: Mortality
Too Early to Tell!
![Page 30: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/30.jpg)
30
ImplicationsImplications
Based on:• Change in Stage @ Dx• Stage-specific Survival• Stable Incidence
13 Fewer Deaths per Year• $4,102/Year of Life Saved
![Page 31: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/31.jpg)
31
DiscussionDiscussion
• Sustainable – Cost/YOLS Modest• Community Effort – Media, CASUAL Day• Limitations – No Control
– FOBT Use • Long Term Effects - Unknown
![Page 32: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/32.jpg)
32
![Page 33: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/33.jpg)
33
![Page 34: Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW](https://reader036.vdocuments.net/reader036/viewer/2022062518/56814c08550346895db90938/html5/thumbnails/34.jpg)
34