Cancer Education and Screening Programs 2018

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1 Lakeshore Region Cancer Network Chicago, Illinois Cancer and Screening Programs 2018 A Partnership with Unite Here Health Mark M. Connolly Sheila & Robert Hulseman Center for Cancer and Specialty Care Center for Cancer Care Presence Saint Joseph Hospital Presence Saint Francis Hospital Center for Advanced Care 355 Ridge Avenue 2845 N. Sheridan Evanston, IL Chicago, IL 60657

2 Meeting the Health Needs of Unite Here Health Members Through Programs and Partnerships with Presence Health New Partnership with Unite Here Health Creates New Opportunities Unite Here Health is a local union which represents the hospitality industry, including hotels, airports and the general service industry. As a union, it oversees its member s benefits including their health coverage. Unite Here Health recently selected the Presence Health hospital system as the preferred hospital provider for their Local 1 union members. Consequently, as members utilized Presence Health physicians, the Lakeshore Region Cancer Network began to care for Unite Here members that were diagnosed with cancer. Their care at the Network Cancer Centers provided an opportunity to discuss the observations by the oncology nurses that when the Unite Here Health members presented for treatment several members were diagnosed at an advanced stage of cancer. As a result of these observations it was determined that we should explore developing a partnership with Unite Here Health to provide cancer education and screening on-site at the local hotels. This would allow clinicians to educate the employees regarding the value of cancer prevention and screening to increase the probability of detecting cancer in its earliest stage. Identifying Cancer-Related issues of Unite Here Health Members As a first step to developing the partnership we arranged for a conference call with the Unite Here Health administrator, several of the Chicago-area hotel s Human Resource managers and one of the Network s Oncology Nurse Navigator to discuss our observations and our proposal. The Network Oncology Nurse explained that several union members were diagnosed at an advanced stage of cancer and we wanted to offer cancer education and screening to decrease this from occurring. She discussed the benefits of cancer being detected early including reducing the amount of time a union member may be ill and unavailable for work. Early detection also may result in less aggressive treatment needed for the patient. We wanted the Human Resource managers to appreciate that if their employees are educated and screened per the cancer screening guidelines that everyone benefits. We proposed coming to the hotels during the lunch hour for employees and setting up a cancer education table in or near the employee cafeteria for visibility and convenience. We were fortunate that the Unite Here Health administrator and the Human Resource managers understood the importance of the issues and wanted to support their members receiving the cancer education and prevention information. This conference call with the hotel managers provided us with the necessary sponsorship to conduct these educational programs on-site at the hotels. We also agreed to participate in some of the hotel s Employee Health and Wellness Fairs if staff from the Network cancer centers were available to attend. 2 P age

3 Unite Here Health Administrator joins one of the Community Leadership Board Two additional opportunities also strengthened the relationship to work with key leaders of Unite Here Health. The Unite Here Health Medical Director was invited to be one of our guest speakers for our annual Dr. Martin Luther King Day addressing the importance of responding to health disparities. As the Medical Director he was able to share his insight about the health disparities affecting minorities, individuals with low incomes and immigrants and opportunities to address the issues. Additionally, the Presence Saint Joseph Hospital President invited the Unite Here Health Medical Director and then subsequently, the Regional Director of Unite Here Health to join the Community Leadership Board (CLB) at Presence Saint Joseph Hospital. The role of the CLB is to have key community leaders provide important insights and recommendations to help us ensure that our outreach programs effectively address the health needs of the community identified in the tri-annual Community Health Needs Assessment Report. By working in partnership with the CLB we can focus our efforts and limited resources to reduce inequity, improve access and collaborate to produce a measurable impact upon the issues identified. Addressing Health Disparities and Cancer A great deal of research exists regarding health disparities, particularly those related to the treatment, and the morbidity and mortality specific to cancer. Low-income populations and racial and ethnic minorities are particularly affected by health care inequities, including cancer. Delays in cancer screening among low-income minorities has been studied and recognizes that there is a lack of knowledge of resources, constraints in their time and obligations at work and home, denial and/or the fear of being diagnosed with cancer impedes them from being proactive. Other issues, such as poor health literacy, language and cultural beliefs also play a role. While the Unite Here Health members have access to health insurance, many work in entry level jobs, are minorities and speak limited English. The Network Cancer Committee recognized that we needed to provide outreach to focus on individuals who are low income, minorities, and immigrants since screening programs are particularly important for those most affected by health disparities. Thus, the opportunity to work with the Unite Here Health members are the target population that we particularly wanted to reach. This is important since one of the barriers the Network cancer patients identified that affected their delay in being screened for cancer was the day-to-day demands of their work and lives. With this in mind, the convenience for the employees to receive the cancer education at their work site is imperative in our goal to educate them and help them recognize the importance and value of cancer screenings. 3 P age

4 Cancer and Screenings for Unite Here Health Members Summary of Results 2018 Hotel Hyatt Regency O Hare Date of the Event Type of Cancer or Screening 03/09/2018 Colo-rectal Cancer and Screening Park Hyatt 03/22/2018 Colo-rectal Cancer and Screening The Signature Room at the 95 th Hotel Hyatt Regency O Hare Chicago Hilton 10/05/2018 Breast Cancer 10/18/2018 Breast Cancer 10/19/2018 Breast Cancer Number of Participants 43 Free FIT kits distributed 54 Free FIT kits distributed 73 participants 57 participants 50 participants Demographics Hispanic: 23 (53%) Caucasian: 10 (23%) African American 9 (21%) Asian 1 (2%) Caucasian: 22 (41%) African American: 11 (20%) Hispanic 14: (26%) Asian 7 (13%) Hispanic: 60 (82%) Caucasian: 8 (11%) African American: 5 (7%) Hispanics: 41 (72%) Caucasian: 14 (25%) African American: 2 (3%) African American: 19 (38%) Hispanic: 18 (36%) Caucasian: 12 (24%) Asian 1 (2%) Key information about their knowledge regarding cancer prevention 58% did not know if and when they should have a colonoscopy. 88% had never had a FIT test or colonoscopy. 65% indicated that they did not know when and if they should have a colonoscopy. 87% had never had a FIT kits or colonoscopy. 42% felt that you could always feel a lump if you had cancer. 82% indicated that they planned to schedule a mammogram. 25% felt that you could always feel a lump if you had cancer. This hotel had a much high percentage of Hispanic employees. 38% believed that you would always be able to feel a lump if you had cancer. Number signed up for a screening n/a. Feedback from the employees indicated that they were very engaged and interested. Will provide a sign-up for future events. n/a. 100% indicated that they had learned something new about colo-rectal cancer. 8 (11%) signed up for a mammogram. The Central Scheduling Department will contact them to schedule the mammogram. 8 (14%) signed up for a mammogram at the event. 82% indicated that they plan to schedule one. 9 (18 %) signed up for a mammogram at the event. 4 P age

5 Key Highlights of Unite Here Health Cancer and Screenings 2018 Educated 277 Unite Here Health members in 2018, a 143 % increase from 2017 when we initiated the program and educated a total of 114 Unite Here Health members. Increased the number of Unite Here Health events held in 2018 with 5 on-site events. Initiated providing colo-rectal education in 2018 and free distribution of the FIT kit screenings at two hotels. 97 colo-rectal FIT kits distributed 76% of the employees that we educated on cancer prevention and screenings were minorities. 25 participants (9 %) signed up to receive a mammogram. The Central Scheduling Department for the Network hospitals will contact the employee to schedule a mammogram. Feedback from the employees indicated that they learned new information and felt they received helpful advice The Network Cancer staff believed the events were useful as it also provided an opportunity to address concerns, myths and cultural beliefs that affected their hesitation in obtaining cancer screenings. Factors Affecting the Prevention of Cancer In October/November 2018, the Network participated in its tri-annual Community Health Needs Assessment Survey being conducted for To solicit information specific to the Network patients with cancer we asked them information related to the prevention of cancer, barriers to treatment and resource needs. The recent survey from the Network cancer patients indicated that prior to their diagnosis of cancer that they lacked the knowledge of when to be screened. The issue of not knowing when to be screened and the lack of regular visits to the doctor were among the top reasons cited as affecting the prevention of cancer. (See Table 1 below). The patients identified a lack of a primary care physician to prompt a referral and encourage them to obtain cancer screenings may play a role in cancer not being detected until it is at an advanced stage. Top Factors that Affect the Prevention of Cancer Lakeshore Region Cancer Network Reasons Affecting the Prevention of Cancer # of Responses Lack of health insurance 19 Lack of knowledge of when to be screened 16 Fear of finding out you have cancer 16 Putting off making an appointment 12 Lack of time due to responsibilities at home or work 12 Lack of regular visits to the doctor 11 Difficulty in taking time off from work 10 Table 1: Lakeshore Region Cancer Network Feedback Oct /Nov 2018 The meetings with Unite Here Health proved very useful as we discussed both the cancer-related education and screening needs, as well as the overall health issues of their members. Since some union members have not designated a primary care physician, we will work with Unite Here Health to identify opportunities to encourage the members to designate a primary physician to take advantage of routine preventative care and the opportunity for regular follow-up and cancer screenings as recommended. 5 P age

6 Encouraging Preventative Care for Unite Here Health Members More discussion is needed on how best to inform Unite Here Health members of the benefits of designating a primary care physician at the education events. Yet, if we can increase the number of individuals who have a designated physician we would help address the issues identified above i.e., lack of knowledge of when to be screened and the lack of regular visits to the doctor that would enable more timely referrals for screenings based on the cancer screening guidelines. Marketing the Program to Unite Here Health Hotel Employees We started our cancer education with the breast cancer program at the Park Hyatt Hotel. Our messaging centered on the theme that the value of the mammogram was that it can detect small lumps that might not be noticed during a self-breast examination. Additional marketing was done directly by the Unite Here Health HR managers to notify the hotel employees of the Network educational events. The Park Hyatt also held an annual Employee Wellness Fair and invited us to participate. As we reviewed our marketing of the breast cancer messages we wanted to convey to the participants that while self-breast examinations are beneficial, it is vitally important to still obtain a mammogram as recommended per the guidelines. The breast cancer flyer has been revised a couple of times continuing to stress our premise: We can find it, before YOU can feel it but we added additional information. In 2018, we wanted to more directly convey that a mammogram can detect cancer up to 2 years before it can be felt by either the patient or her physician. We felt that the message was more personal and it was an opportunity to address the common misbelief that a breast self-examination by the individual or a physician would always detect even the smallest cancer in its earliest stage. This was reinforced at our outreach events when we used the breast gel models that had a couple of lumps that often were missed by most of the participants. 6 P age

7 Breast Cancer at the Park Hyatt Chicago Employee Wellness Fair Wendy Starr, RN, OCN, Oncology Nurse Navigator Viviana Iglesias, LPN/Coordinator Community Health Summary The Network Cancer committee considers these on-site cancer education and screening programs to be an effective method of providing community outreach and should be continued. We are reaching our target audience and have educated close to 300 Unite Here Health members in When providing the on-site education for breast cancer we have consistently met a number of employees that shared that they have delayed obtaining a mammogram despite their age and risk factors. This is also true when we provided the FIT kits for the colo-rectal screening. Thus, it is important to have the members better understand and appreciate the benefits as previously discussed on the advantages of being screened when the cancer can be detected in its earliest stage. 7 P age

8 Lakeshore Region Cancer Network Presence Saint Joseph Hospital opened the new Presence Center for Advanced Care (PCAC) on the hospital campus directly across from the hospital in The PCAC is the central location for most of the hospital s outpatient services, including cancer. This resulted in a significantly improved experience for patients with cancer as it allowed patients to receive all of their cancer-related health care needs and physician care in one central location, the Mark M. Connolly Center for Cancer and Specialty Care. In addition to the convenience, the Center for Cancer allows treatment in an attractive and soothing space where the physicians and associates provide compassionate and patient-centered care. Presence Saint Joseph Hospital, Chicago, IL Mark M. Connolly Center for Cancer and Specialty Care In early 2016, Presence Saint Francis Hospital finished remodeling our state-of-the-art cancer facilities, which now includes a new linear accelerator. The new equipment offers more precise radiation therapy with technologies that conform radiation beams to the shape of cancer tumors. That means more effective radiation treatment with less damage to nearby healthy tissue and fewer side effects. The new linear accelerator adds these advanced technologies: Improved IMRT (intensity-modulated radiation therapy) IGRT (image-guided radiation therapy) Rapid Arc, a volumetric-modulated arc therapy also known as VMAT Saint Francis Hospital, Evanston, IL Sheila & Robert Hulseman Center for Cancer Care The Lakeshore Region Cancer Network provides expert medical cancer specialties including: Medical Oncology, Surgical Oncology, Hematology and Oncology, Interventional Radiology, Radiation Oncology, Thoracic Surgery, Colorectal Surgery, Gynecologic Oncology, Robotic Urology, Plastic and Reconstruction Surgery, Palliative Care and Hospice, Infusion Care, Genetic counseling and Clinical Trails. We are proud of our unique ability to offer this caliber of medical care and support services in a community teaching hospital. Accreditation Rely on our expertise. Interested in learning more, please contact P age