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Development of community plans to enhance survivorship from colorectal cancer: Community-based participatory research in rural communities

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Abstract

In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE–PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar’s test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure the impact of such initiatives on the long term health and well being of cancer survivors in rural locations.

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Acknowledgements

The authors are grateful to the Planning Committee which included Marcia Anderson, Bonnie Bixler, Haley Justice, Diane Sheehan, Deirdre Weaver, and Laura Zauderer. In addition, the authors are particularly appreciative of the participating cancer coalitions and hospitals including ACTION Health Colorectal Cancer Task Force, Chautauqua County Partners for Prevention, Coalition for People Against Cancer, Crawford County Cancer Coalition, Delaware County Cancer Coalition, Elk County Cancer and Tobacco Education Coalition, Greene County Cancer Coalition, Indiana County Cancer Coalition, Lancaster General Hospital, Lawrence County Cancer Coalition, Mount Nittany Medical Center, Wellness Council of the Southern Tier, Wyoming County Cancer/Tobacco Coalition, and York Cancer Center. Erik Lehman analyzed data for this study. This study was partially supported by a Community Planning Grant from the Lance Armstrong Foundation and by the Appalachia Community Cancer Network (U01 CA114622 from the National Cancer Institute).

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Authors and Affiliations

  1. The Pennsylvania State University – Public Health Sciences, P. O. Box 855, Mail Stop A210, Suite 2200, 600 Centerview Drive, Hershey, PA, 17033, USA

    Eugene J. Lengerich, Brenda C. Kluhsman, Marcyann Bencivenga & Elana Farace

  2. The Penn State Cancer Institute, Hershey, PA, USA

    Eugene J. Lengerich, Brenda C. Kluhsman & Elana Farace

  3. Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA, USA

    Eugene J. Lengerich

  4. Northeast Regional Cancer Institute, Scranton, PA, USA

    Regina Allen

  5. Department of Pathology and Laboratory Medicine, The Pennsylvania State University, Hershey, PA, USA

    Mary Beth Miele

  6. Department of Neurosurgery, The Pennsylvania State University, Hershey, PA, USA

    Elana Farace

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  1. Eugene J. Lengerich
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  2. Brenda C. Kluhsman
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  3. Marcyann Bencivenga
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  4. Regina Allen
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  5. Mary Beth Miele
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  6. Elana Farace
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Correspondence to Eugene J. Lengerich.

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Lengerich, E.J., Kluhsman, B.C., Bencivenga, M. et al. Development of community plans to enhance survivorship from colorectal cancer: Community-based participatory research in rural communities. J Cancer Surviv 1, 205–211 (2007). https://doi.org/10.1007/s11764-007-0025-y

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