Engaging community in cancer control solutions: An Appalachian experience

This presentation describes a project funded by the Centers for Disease Control and Prevention and the Appalachian Regional Commission to reduce cancer burden in Appalachian communities and engage communities with Community Cancer Control Coalitions and state Cancer Control Plans. Appalachia is a federally defined geographic area in parts of 13 states along the Appalachian Mountains, where poverty, lower educational levels and health disparities persist into the 21st century. Lung, skin and colorectal cancer exceed national and state levels. Parts of the region have higher rates of cervical cancer; and breast cancer, while not exceeding national rates, is discovered at a later stage. Appalachian culture is characterized by deep family ties, identification with mountain culture and geography, religiosity, and self-reliance. Locally acceptable engagement strategies to reduce the cancer burden were discovered in this project. Community-based participatory strategies were used by community leaders and academics to engage communities in cancer control, including the development of Community Roundtables, Community Forums and Storytelling to learn community perspectives on cancer in communities. Sub-awards to communities for local projects, training sessions, and partnerships with community organizations were used to implement the project. Roundtables, consisting of presentation of data around cancer concerns and community needs and resources; forums, where cancer advocacy plans were developed; and storytelling to “tell the community cancer story” were developed and used in seven states. Facilitators and barriers to Appalachian community participation in cancer control efforts were discovered including personal motivation, effective use of meeting time, long term commitment, and others.