Kentucky Homeplace: Improving Colorectal Cancer Screening Rates Through Tailored, Community-Based Approaches
In the state of Kentucky, colorectal cancer is a serious concern. Compared to the national rates, Kentucky’s incidence and mortality rates for colorectal cancer were 14 percent and 18 percent higher, respectively, during 2002–2006.1 To help residents utilize life-saving colorectal cancer screening services, in 2006, Kentucky Homeplace (Homeplace) developed a colorectal cancer component for their community health worker program.2 Based out of the University of Kentucky, Center of Excellence in Rural Health, Homeplace works to improve the health of rural Kentuckians. Homeplace trains and employs community health workers to help Kentuckians in 38 rural counties to access and utilize medical, social, and environmental services.3,4 Homeplace also works with medical providers to obtain free or reduced-cost services, medications, and equipment for their clients.5
The Homeplace colorectal cancer program identifies individuals at-risk for colorectal cancer; then community health workers provide them with in-home education on cancer risks and preventive measures. Home visits are tailored to clients’ needs and lifestyles, and include topics such as smoking cessation and nutrition counseling as well as the importance of cancer screening. Homeplace recruits these community health workers from targeted communities and provides them with 40 hours of didactic training. Community health worker trainees also complete an 80-hour practicum that includes shadowing experienced community health workers.4
A 2012 evaluation of Homeplace’s community health worker colorectal cancer program found a 24 percent increase in the number of patients who reported that they asked their physicians about colorectal cancer screening after participating in the program (P=0.013). Participants also reported feeling less embarrassed during screening for colorectal cancer.4 In 2008, the National Rural Health Association awarded Homeplace with their Outstanding Rural Health Program award for Homeplace’s work with rural Kentucky communities.
1Chronic Disease Prevention Branch. (2010). The Kentucky Colorectal Cancer Screening Advisory Committee Annual Report: July 2009 through June 2010. Frankfort, KY: Kentucky Department for Public Health.
2Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. "March Is National Colorectal Cancer Awareness Month." CDC Features. Available at http://www.cdc.gov/features/colorectalawareness. Accessed August 16, 2013.
3Center of Excellence in Rural Health, University of Kentucky. "About Kentucky Homeplace." Kentucky Homeplace. Available at http://ruralhealth.med.uky.edu/about-kentucky-homeplace. Accessed August 16, 2013.
4 Feltner, F. J., Ely, G. E., Whitler, E. T., et al. (2012). "Effectiveness of Community Health Workers in Providing Outreach and Education for Colorectal Cancer Screening in Appalachian Kentucky." Social Work in Health Care, 51(5): 430–440.
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