Designing Culturally Sensitive

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• Designing Culturally Sensitive
• Outpatient Cancer Programs
• Sept 17, 2009

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Context

• Champlain LHIN
• Large geographical area of Eastern Ontario
  covering the counties of Renfrew, City of Ottawa,
  Prescott-Russell, Stormont Dundas Glengarry,
  North Grenville and parts of Lanark
• Population 1.2 million (9.5 of Ontario), 70
  reside in Ottawa
• Diverse mix of urban/rural, Francophone/Anglophone
  multicultural and Aboriginal communities
• 14 are members of a visible minority
• Distribution of Francophone population ()
  varies
• - Prescott Russell 70
• - Stormont Dundas Glengarry 23
• - Ottawa 20

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Context

• Guided/supported by provincial, regional and
  local policies
• CCO OBSP is a bilingual program (French and
  English). Materials may also be available in
  other languages based on need and resource
  availabilities. This also applies to other CCO
  programs, eg. colorectal and cervical cancer
  screening, cancer services, etc.
• Public Health Acknowledges that the health of
  individual and communities is significantly
  influenced by complex interaction between various
  factors (Determinants of Health) which includes
  gender, culture and language
• TOH Respect for the individual (core value)
  drawing on our linguistic and cultural diversity
  as a strength on how we deliver our program
• Official Languages Advisory Committee
  Provides advice to the CEO/President of TOH on
  issues related to official languages

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Context

• Official Languages French and English
• Clients/Patients services, available in both
  languages
• Clients/patients information, available in both
  languages eg. brochures, posters, registration
  forms, recall and result letters, etc.
• Health Care Providers material, available in both
  languages eg. result letters, etc.
• Public Service Announcement, radio, TV, written
  media

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Breast and Cervical Cancer Screening for Arabic
and Somali women

• Objective
• Develop an approach and tools to reach under
  served Arabic and Somali women to increase their
  awareness of breast and cervical cancer screening
  and to facilitate access to screening

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Phase I Connecting with the Community, Forming
Work Group and Work Plan

• Meeting with South East Ottawa Community Health
  Centre (SEOCHC)
• Community profile
• Cultural barriers
• Potential partners
• Formation of working group SEOCHC, OBSP, OPH,
  Somali Centre for Family Services
• Development of work plan centred on multicultural
  poster to be used in buses and family physicians
  offices
• Collaborative partners
• Design firm
• OC Transpo
• Pinecrest-Queensway Health Community Service
• Carlington Community and Health Services
• Appletree Medical Centres

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Phase II Implementation

• Posters (11 x 35) 9 women known in their
  communities from various ages and ethnic
  background were recruited to appear on
  multicultural poster. 850 posters ran on Ottawa
  city buses for 6 months
• Information packages were prepared and
  distributed through a Multilingual Health
  Information Line (MHIL) at Ottawa Public Health
• Posters (11 x 17) were posted in different
  locations, eg. physicians offices, ESL classes,
  mosques, grocery stores, etc.
• Supporting activities
• Health Promotion materials, eg. Fact Sheets, Tell
  a Friend
• Adaptation of OBSP registration and Authorization
  to Release Information forms
• Presentation request and evaluation forms used by
  trained volunteers
• Letters to 123 health care providers and 80
  community organizations
• Presentations about the project to key
  organizations
• Translation of breast and cervical cancer
  screening presentation
• Recruitment of 6 peer educators
• Training workshop
• Interviews with local radio and TV stations, News
  Release

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Phase III Evaluation

• Number of women accessing pap tests through
  Appletree Medical Centres
• Number of women participating in breast cancer
  screening
• Presentations to groups
• Displays at Community Events, eg. Muslim Summer
  Festival
• Information packages distributed
• Radio and TV interviews
• Training workshop
• Letters to family physicians and community groups
• Posters distributed
• One to one personal feedback

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Next Steps

• Colorectal Cancer Screening
• Target population to include men
• Training of male peer educators
• Literature review on health promotion strategies
  to reach man

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Other Initiatives / Activities

• Chinese and Vietnamese outreach initiative
• Presentations on cancer screening to ESL classes
  with interpreters
• Group screens for breast screening with cultural
  interpreters
• Multicultural Advisory Committee Ottawa Public
  Health
• Partnerships Ottawa Public Health, Community
  Health Centres, hospitals, Canadian Cancer
  Society, fundraisers, Community Centre for
  Aboriginal Health
• Adaptation of forms, video, brochures
• Aboriginal initiatives breast, tobacco cessation

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Lessons Learned

• Multicultural group must drive the project
  (methods, messages, timing, activities,
  workgroups)
• Partnerships allow sharing of resources and
  expertise
• Multi approaches work best with a repetition of a
  central message
• Sustainability to be addressed throughout project
• Revisit strategy frequently
• Adaptability/flexibility to opportunities and
  feedback
• Adapting/creating material rather than
  translating
• Focus testing
• Back to back translation

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Resource

• Canadian Cancer Society
• http//www.cancer.ca/Canada-wide/About20cancer.as
  px?sc_langen\ontario/publications
• Cancer Care Ontario
• www.cancercare.on.ca/prevention/screening
• ? cervical screening
• ? colorectal cancer screening