A model for cancer assessments that generate effective local action targeting cancer disparities: Role of the quality of cancer care continuum

Background: Southern Virginia has significant cancer health disparities compared to the rest of the Commonwealth. To improve cancer outcomes, quality service along the cancer care continuum is essential. Cultural, environmental, social, and personal influences on health behavior must be understood to decrease cancer risk through healthy choices and promote timely detection and treatment. We conducted a comprehensive assessment of cancer-related resources, health behaviors and attitudes in four Southern Virginia health districts to reduce cancer disparities. Methods: The model needs assessment was conducted at the community level by local health educators with direction from a university-based team, overseen by a state-wide advisory committee. Standard processes and data collection tools were employed across health districts for key informant interviews (n=29), community focus groups (n=20 general population groups; n=19 cancer survivor groups), and provider surveys (n=110). Secondary data analyses of Behavioral Risk Factor Surveillance System (BRFSS) and Virginia Cancer Registry data were also completed. Results: The needs assessment highlights opportunities for population-level impact at key steps in the Quality of Cancer Care Continuum around which groups and organizations can develop locally-relevant intervention strategies (e.g., barriers to health choices, early detection, and timely access to care). Findings resulted in local, collaborative, multi-factorial interventions addressing multiple levels of change for disparity reduction. Conclusion: Assessment of community cancer-related needs with an organizational framework of the Quality of Cancer Care Continuum (with addition of primary prevention) is effective in providing local-level community groups direction for culturally appropriate, effective action to remove barriers to care and improve health.