NEW YORKDeveloping and implementing cancer outreach programs
for African-Americans takes planning and sensitivity, said Robin L.
Hurdle, CSW, a social worker in charge of the African-American
Outreach Program at Cancer Care, Inc., the New York-based program
that provides emotional support, information, and practical help to
people with cancer and their loved ones free of charge.
The key to building successful programs is what Ms. Hurdle calls
the parallel process, ie, the planning that should go on
2 years before a program opens its doors.
When you talk about underutiliza-tion, when you talk about
people walking out and not coming back, being wary of even coming
into your program, it is because the parallel process has not been
thought through, Ms. Hurdle told a group of oncology social
workers from hospital outreach programs in the New York metropolitan
area at a seminar sponsored by Cancer Care.
Often administrators get side tracked looking for money, space, and
staff, Ms. Hurdle said, and do not think enough about the makeup of
the community, what its members want and need, or what the staff and
the facility itself should convey to them.
To aide those developing cancer support outreach programs for
African-Americans, Ms. Hurdle and Anita Redrick McFarlane, MPH, CHES,
outreach manager of the Cancer Information Service, Memorial
Sloan-Kettering Cancer Center, have developed a series of questions
known as the Community Needs Assessment Tool (see table).
The Community Needs Assessment Tool
The outreach facility in its appearance should incorporate cultural
representations, photos, paintings, or other elements of interior
design that reflect the cultural identity of the community. Special
holidays such as Black Solidarity Day should be kept in mind when
schedules are planned.
The programs staff, in addition to providing information about
the program, should also be able to communicate its knowledge of the
culture of the community and be mindful of the communitys
In many cases, people in these communities are going from
crisis to crisis, basically just surviving, Ms. Hurdle said.
Our staff has to be respectful, to be able to understand and
help them address their concrete issues and some of their
The person who walks in the door is not just a possible breast cancer
patient, but may be a mother of three, the single head of a
household, struggling not only to keep her children in school but to
put food on the table.
On some level, the program that you strive to create has to
address some of these issues, Ms. Hurdle commented. During
your parallel process, if you know your program can only do cancer
screening and medical referral, then build alliances with other
organizations that can help in other ways.
Church pantries, for example, may provide lunch to clients, she said.
Social agencies may be able to provide money for transportation to
the programs facility. The National Cancer Institutes
Cancer Information Service is available to answer general medical questions.
During the parallel process, thought should also be given to how
clients will be able to find the actual location of the outreach
If prospective clients have to ask five or six different people
on the street for the outreach program for ovarian cancer, many of
them will give up before ever getting there, Ms. Hurdle said.
People get very hyper quickly when they cant find
things. She suggested that planners think about how you
will make yourself known. You may be able to get the hospital or
organization you are affiliated with to give you signs you can put up
in the neighborhood.
Though money may be limited, there may be ways to supplement it, Ms.
Hurdle suggested. Toy manufacturers could give small grants to create
playrooms in the outreach facility for children whose mothers are
being screened. Local bakeries might be willing to donate day-old
baked goods for clients to snack on. In return, the outreach program
could offer cooperating merchants on-site health education and
screening, she said.
Although members of the community might not be able to donate money
to the outreach program, they might be able to donate time. A young
woman with some extra time on her hands could take care of the
children in the playroom. Some people in the community might be able
to give out flyers letting the community know about the facility.
Others might know about low-cost or no-cost spaces in the area the
program could occupy.
Though funding for outreach programs is often low at first,
administrators should not lose heart, Ms. Hurdle said. You must
be willing to take those lemons and turn them into lemonade. You have
to be able to start small and grow.