Developing 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., in New York City. 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 underutilization, or 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, said Ms. Hurdle at a recent Cancer Care seminar.
Administrators often get sidetracked looking for money, space, and
staff, and do not think enough about the demographics of the
community, what its members want and need, or what the staff and the
facility should offer them.
Getting Into the Neighborhood
In many cases, people in these communities are going from
crisis to crisis, basically just surviving, said Ms. Hurdle.
Our staff has to be respectful of their situations and be able
to understand and help them address their concrete issues and some of
their psychosocial issues.
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 also to keep
food on the table.
On some level, the program that you strive to create has to
address some of these issues, said Ms. Hurdle. During
your parallel process, if you know you can only do the screening and
medical referral part, then build alliances with other organizations
that can help in other ways. Church pantries may provide lunch or
groceries to clients. Social agencies may be able to provide money
for transportation. The National Cancer Institutes Cancer
Information Service, for example, would be able to answer general
Thought should also be given to making the community aware of where
the facility is and how it can be reached. People get hyper
quickly when they cant find things. 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 to put up in
the neighborhood, said Ms. Hurdle. Also, some people in the
community might be able to pass out flyers to community residents to
make them aware of the facility and its location.
Although funding for outreach programs is often low at first,
administrators should not lose heart. You must be willing to
take those lemons and turn them into lemonade. You have to be able to
start small and grow with it, said Ms. Hurdle.
Assessing the Community
Ms. Hurdle and Redrick McFarlane, MPH,CHES, outreach manager of the
Cancer Information Service at Memorial Sloan-Kettering Cancer Center
developed a series of questions that can serve as a guide for those
developing cancer support outreach programs for African-Americans:
What are the most pressing health issues in the neighborhood? (These
issues should be prioritized.)
What other issues are specific to the neighborhood?
What is the communitys financial base?
Who or what represents the communitys political base?
What are the communitys resources? These might include
hospitals, home care agencies, clinics/primary care centers,
volunteer ambulance corps, businesses, and civic organizations.
What are the demographics of the neighborhood (languages spoken, age
How much assistance does outside business give the community?
Are there facilities and/or personnel in the community who are
knowledgeable about cancer issues? Can partnerships be formed within
What is the neighborhoods system of communication, formal and informal?
Identify a potential volunteer base.
Identify the cost of transportation and the frequency of service.
Identify potential community spaces that can be rented for
community health fairs.