Engaging communities across Kentucky

In most other states, CDC-funded comprehensive cancer control programs, such as KCC, are managed by the state department of health. But in Kentucky, Markey receives that funding on behalf of the state and, through the CIO, organizes and manages the consortium for the Commonwealth.

“The consortium, which has been in place since 2002, brings together more than 80 partners statewide, such as the Kentucky Department for Public Health, American Cancer Society, health systems, University of Louisville, and other institutions,” Hull said.

These KCC members drive the consortium’s activities and collectively create and maintain Kentucky’s Cancer Action Plan. Addressing the unique needs of Kentucky residents, this plan provides strategies and goals regarding cancer prevention and detection, treatment and quality of life. KCC also shares resources and convenes members in workgroups to coordinate collective actions that focus on identified needs.

Within the state’s current five-year Cancer Action Plan, which extends through 2022, KCC focuses on three priority areas: tobacco treatment/lung cancer, colorectal cancer screening and cancer survivorship. These priorities were chosen based on member input and data from the Kentucky Cancer Registry on the burden of cancer and the impact of prevention and early detection strategies across the state.

“It’s not just community outreach; it’s community engagement. Our community engagement takes many forms, including outreach, policy, education and facilitating research.”

Pamela Hull, Associate Director of
Population Science and Community Impact

KCC is actively preparing the next version of the Cancer Action Plan, which will be in place from 2022 through 2027 and directly informs the strategic plans of individual member organizations, including Markey. The new plan is being guided by the 2021 Kentucky Cancer Needs Assessment and a community-engaged prioritization process conducted by the CIO and a steering committee of statewide partners, with a focus on social determinants of health and health equity. The comprehensive needs assessment and community input highlighted key areas of need and opportunities to reduce the cancer burden and disparities in Kentucky communities.

In addition to preparing the next Cancer Action Plan, the KCC has been working diligently on other initiatives during 2021:

• The Consortium is addressing a common problem among Kentucky patients: receiving bills for preventive medical services that should be free under federal law, such as cancer screening. A workgroup from KCC presented to the Kentucky Health Insurance Advisory Council about this challenge and recruited insurance representatives to join the effort in devising Kentucky-focused solutions.
• In collaboration with the Harvard Center for Health Law and Policy Innovation, KCC convened partners in a series of health equity-focused webinars. Topics included the role of radon in cancer risk reduction and access to medically supportive food and nutrition for cancer prevention and cancer survivorship.
• KCC co-hosted a symposium with the Markey Cancer Center Affiliate Network focused on how patient navigators across the state can meet the needs of Kentucky cancer survivors.

Since 1982, KCP has served as Kentucky’s statewide cancer prevention and control program, co-led by the Markey Cancer Center and the University of Louisville Brown Cancer Center. KCP collaborates with a variety of organizations to implement and evaluate evidence-based cancer prevention and control programs in communities throughout Kentucky.

“KCP is an important, long-standing program,” Hull said. “It was created by visionary representatives in the Kentucky State Legislature back when the fight against cancer was starting to gain momentum.”

Embedded within Kentucky’s 15 area development districts is a KCP regional cancer control specialist who lives and works in each district. The specialists affiliated with Markey cover the eastern part of Kentucky, while the University of Louisville specialists oversee the western part. They all work to deliver a menu of cancer control programs customized for their regions.

“KCP’s regional cancer control specialists are integrated and engrained in the local fabric of these communities,” Hull said. “They have a close, on-the-ground perspective in the local communities, which is important because cancer prevention is not one-size-fits-all for all of our different regions across the state.”

Throughout the year, KCP regional cancer control specialists:

• Conduct outreach with residents and health care providers to promote cancer risk reduction and screening programs.
• Connect residents to programs that help them navigate the health care system to get screenings or the appropriate care.
• Connect patients, survivors and caregivers with helpful resources.
• Deliver programs in schools on tobacco and vaping prevention.

With a pulse point in each district, KCP was able to quickly assess community needs at the onset of the COVID-19 pandemic and pivot from in-person program delivery. Regional cancer control specialists worked locally and resourcefully to ensure continued access to services and programs.

Each regional cancer control specialist also maintains a District Cancer Council (DCC), in which they gather partner organizations and institutions in their region to network, share resources, coordinate programs and understand local cancer control needs. These councils adapted to convening virtually in 2021, which enabled partners to share challenges and successes and maintain DCC networks and relationships.

KCP received funding from Markey this year to create a new position within the CIO: a community health worker. This role will focus on expanding and strengthening the program’s partnerships
in Black communities, particularly in the greater Lexington area. The aim is to improve health equity and reduce barriers to cancer care and screening among this population.

In addition to the Community Impact Offce’s KCC and KCP efforts and accomplishments this year, the Office expanded its staff to help amplify its work with partners across the state. The new Data, Dissemination and Evaluation Team is led by a new CIO director of operations and evaluation. A quality improvement research director liaises directly with the Markey affiliate and research networks to facilitate research on improving how cancer prevention, screening and care guidelines are implemented across the state. The team also includes a data visualization specialist who collated multiple sources of data for the 2021 Kentucky Cancer Needs Assessment, as well as a health communications manager who focuses on how to effectively disseminate evidence-based research and cancer-related information to the community.

“This new talent will help us enhance the ability for Markey’s research and outreach to respond to community needs, connect researchers and community partners across the state, and better communicate to the public why and how research is important in the fight against cancer,” Hull said.

The CIO is also prioritizing diversity, equity and inclusion (DEI) efforts through its programs, with the leadership of Lovoria Williams, PhD, FNP-C, FAANP, FAAN, associate director for cancer health equity at Markey.

“The KCC and KCP are our boots on the ground, and my job is to make sure those boots are going everywhere and reaching everyone, including minorities, and ensuring they’re equipped to do that,” Williams said.

Williams, who wears many hats within and outside the CIO, including associate professor in the College of Nursing, meets regularly and holds trainings on cancer health inequities with KCP staff and KCC partners to empower them to address these issues in their areas. She also leads the CIO’s collaborations with the Markey Clinical Trials Office to develop strategies to improve the participation of minorities in clinical trials.

In addition to her role with the CIO, Williams leads Markey’s DEI Committee, through which she and other members across the cancer center’s various units meet monthly to discuss and enact strategic plans to improve DEI throughout Markey. One plan that has already been implemented is Markey’s partnership with the American Cancer Society to create the Markey STRONG research program for undergraduates of color who are interested in cancer research.

“DEI is a new conversation around UK and Markey, and my role is to provide support and make sure we’re developing cultural humility, understanding health inequities, and uncovering the source of health inequities and the strategies to address them,” Williams said.