Session

Lessons Learned from International Settings Related to Cancer Care Delivery Across the Cancer Continuum

Nora Nock, PhD, PE, FSBM, Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH and Krista Brown, PhD, MBA, MPH, Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center - College of Public Health, 984395 Nebraska Medical Center, Omaha, NE 68198-4395

APHA 2025 Annual Meeting and Expo

Abstract

Association between cancer stage and mental quality of life among participants in a peer-to-peer support program for women with cancer in Viet Nam

Kira Vom Eigen, MPH1, Carolyn Taylor, BFA2, Rachel Monahan, BA3, Thanh Huong T. Tran, MD, PhD4, Mai Do, MD, MPH5 and PhuongThao Le, PhD, MPH6
(1)New York University, New York, NY, (2)Global Focus on Cancer, South Salem, NY, (3)New York, NY, (4)Hanoi Medical University, Hanoi, Viet Nam, (5)K National Cancer Hospital, Hanoi, Viet Nam, (6)Watertown, MA

APHA 2025 Annual Meeting and Expo

Cancer can have a devastating impact on individuals’ mental quality of life, yet infrastructure for psychological care does not exist in many low- and middle-income countries. The Stronger Together: Evaluation of a Peer-to-Peer Support Program (STEPPS) pilot study was the first peer-to-peer support intervention to be implemented across Viet Nam and addressed a critical gap in care. The current study examined whether the beneficial relationship between peer support and mental quality of life varies for patients with different cancer stages.

The STEPPS study was a two-arm, parallel, non-randomized trial study design. A total of 186 breast and gynecological cancer patients in Viet Nam were enrolled. The mental quality of life outcome was assessed using the Short Form Health Survey -12 item (SF-12) mental component score (MCS), reported at baseline, 2 – months, 4 – months, and 6 – months. Treatment groups were stratified by cancer stage to assess within group changes.

Among mentees (peer support group), mental component scores significantly improved. There were no significant differences in mental quality of life between stage I, II, and II cancer patients at baseline. For the usual care group, there were no significant differences in mean MCS observed between baseline and follow-up timepoints for any cancer stage. For mentees, there was a significant increase in mean MCS between baseline and 6 – months and 4 – months for all cancer stages. The STEPPS peer support program improved mental quality of life for cancer patients, and this beneficial relationship extended across cancer stages.

Administer health education strategies, interventions and programs Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Program planning Public health or related research Social and behavioral sciences

Abstract

Collaborative Model for Local Cancer Organizations and District Health Departments to Increase Cervical Cancer Screening in India

Shaylen Foley, MPH1, Ashleigh Flowers, MPH1, Meenu Anand, MBA, MPH2, Mridu Gupta3, Swati Saxena, PhD4, Tolsy Sharma3, Nina DaSilva Batista5 and Sara Comstock, MSSW6
(1)Raleigh, NC, (2)American Cancer Society, Atlanta, GA, (3)Cancer Awareness, Prevention and Early Detection Trust, Gurgaon, India, (4)American Cancer Society, New Delhi, India, (5)American Cancer Society, Raleigh, NC, (6)American Cancer Society, Norwalk, IA

APHA 2025 Annual Meeting and Expo

Background: Cervical cancer is the second leading cause of cancer deaths among women in India. It can be prevented and detected early through screening. While national guidelines exist, cervical screening availability at primary health centers (PHCs) is low. After a successful pilot in Gurugram district in 2022, Cancer Awareness, Prevention and Early Detection (CAPED) Trust, a local community organization (LCO), and the American Cancer Society are validating their LCO-District collaboration model in two additional districts with support from District Health Centers. Project activities include prioritizing cervical cancer screenings at PHCs, increasing capacity of nurses, and training Accredited Social Health Activists (ASHAs) to mobilize communities.

Methods: The mixed-methods evaluation uses key informant interviews, pre- and post-tests, and project tracking tools to assess the effect on DHC prioritization of cervical cancer prevention, changes in ASHA and PHC staff knowledge, beliefs, and confidence, and LCO’s successes and challenges implementing the collaboration model.

Results: To date, 8095 women have been screened, 1884 ASHA trained, and 234 nurses certified for screening in 79 PHCs across 3 districts. ASHAs increased knowledge by 19-percentage points and had positive changes in beliefs and confidence. Interviews highlighted the need to gain additional buy-in and support from levels above District Health Centers and normalize the topic of cancer in communities for sustaining screening outcomes. This presentation will cover the final quantitative and qualitative evaluation findings.

Conclusion: Local cancer organizations can strengthen government efforts to increase availability and demand for cervical cancer prevention services in India.

Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Public health or related education