Northern Appalachia Cancer Network
Northern Appalachia Cancer Network
The Northern Appalachia Cancer Network (NACN) is a community/academic partnership that seeks to measurably reduce the cancer burden among rural residents of Pennsylvania and New York through community-based participatory education, training, and engaged cancer research.
About the Appalachian Region
The Appalachian region of Pennsylvania and New York is mostly rural, including 52 of the 67 counties in Pennsylvania and 14 counties in the southern tier of New York. NACN, as a part of the Appalachia Community Cancer Network (ACCN), is funded by the National Cancer Institute's Center to Reduce Cancer Health Disparities to reduce these inequalities among residents of rural Kentucky, Ohio, Pennsylvania, Virginia and West Virginia.
ACCN is the leading community-based cancer research program focused upon the Appalachia population in the United States.
What We Do
Penn State's participation in NACN is based in the College of Medicine's Department of Public Health Sciences. NACN affiliates include community-based cancer coalitions plus clinical and organizational partners. By bringing academicians, health care providers and community members together to develop, test and evaluate community-based interventions, NACN hopes to improve access to - and utilization of - beneficial cancer interventions and treatments in communities to address and reduce these disparities.
Through our work with community and clinical partners, we see the vital importance of a coordinated effort to remove barriers and improve access to services throughout the continuum of cancer care including early detection, diagnosis and treatment and follow-up care.
Penn State Cancer Institute is part of several projects in Appalachia, some of which are described here.
- Faith-Based Initiatives
- Patient Navigation Training
- Understanding Cancer
- Tip Sheets for Community Leaders
In January 2012, Appalachia Community Cancer Network partnered with churches in Appalachian regions of Ohio, Pennsylvania, Kentucky, Virginia and West Virginia to implement The Faith-Based Initiative to Promote Health in Appalachia.
This was a group randomized trial that compared a multi-level diet and physical activity intervention program ("Walk by Faith") to a control group receiving an educational program focused on cancer awareness and screening called "Ribbons of Faith." A total of 663 participants were enrolled from 28 churches across the five states.
Thirteen of the churches participated in Walk by Faith, a program focused on weight loss and increasing physical activity, and 15 received the Ribbons of Faith program focused on cancer screening.
Along with ACCN staff, local community experts and church volunteers from within the Walk by Faith and Ribbons of Faith churches led the program activities for the first year of the program. Once the 12 sessions were completed, participants attended a celebration event held in each church to recognize volunteers and participants, and to share success stories. After the series of education sessions and celebration events were completed, a follow-up set of measurements and surveys were conducted.
The programs were then passed along to church volunteers to continue within their church congregations for another one to two years to see if the programs could be conducted without additional assistance. The study was completed by November 2015. Preliminary analysis of final data showed the Walk By Faith program facilitated weight loss, especially among male participants. All Walk By Faith participants improved fruit and vegetable intake.Toolkit dissemination: Based on study results, toolkits were developed with the best elements of the Walk by Faith and Ribbons of Faith. The Walk by Faith toolkit was tested with Ribbons of Faith study participants. The toolkits are being further tested for the utility of self-administration. Toolkits, pedometers, educational materials, events and games are being offered to churches in northern Dauphin and Perry counties with supplemental funding from the Penn State Health Community Relations Community Health Project Start-up Grant.
Patient navigation is a patient-centered, community-based strategy that has been successful in addressing challenges and barriers to cancer screening, diagnostic care and treatment and survivorship. Appalachia is a culturally rich, diverse region struggling with cancer health disparities related to access to quality healthcare, culture, lower socioeconomic status and educational levels, and unhealthy lifestyle behaviors that affect a large portion of the population.
Patient Navigation Training for Appalachian Populations was developed to address the need for training among those who assist Appalachians to overcome challenges and barriers to care in order to improve successful outcomes.
The training was funded by the Appalachian Regional Commission and the Centers for Disease Control, in partnership with the Center for Prevention Research at the University of Kentucky, to bring culturally effective, community-informed patient navigation to Appalachian settings.
The goal of the training is to offer a competency-directed patient navigation curriculum to nurses, social workers, lay helpers and community health workers in a way that is respectful of the Appalachian culture and healthcare community.
The program, still in its formative stage, integrates evidence-based process and outcome evaluation along with community input and feedback as part of its development and continuous-improvement process. NACN coordinated review and training sessions with community and clinical partners.
Small-group training sessions are developed using multiple methods such as case studies, interactive presentations, multimedia, small-group activities and group discussions. Topics include origins and basics of navigation, outreach strategies, creating culturally effective navigation, identifying and addressing barriers to care, developing effective referrals, health literacy, addressing financial issues, and survivorship (focused primarily on breast, cervical and colorectal cancer).
Understanding Cancer is a five-chapter resource that includes not only text, but a glossary of terms, pre- and post-survey assessments, lists of resources, PowerPoint slides and a CD with all of the materials.
It is a collaborative work of the Appalachia Community Cancer Network. The modules have been carefully and exclusively adapted from NCI resources and tailored for use in the rural Appalachian culture in an easy-to-read cancer format.
All of the materials were pilot-tested with the ACCN Community Advisory Committee and regional Advisory Boards in Kentucky, Ohio, Pennsylvania, Virginia and West Virginia.
This community-based project was designed to help partners use the modules creatively and effectively in different community settings.
The Tip Sheets for Community Leaders handout series was developed by the Appalachia Community Cancer Network to provide a resource to support community-based cancer coalitions and aid in the implementation of successful community programs in Appalachia.
The documents focus on several main topics.
- Building Leadership
- Leading Effective Meetings
- Dealing Effectively with Conflict
- Managing Projects
- Maintaining and Energizing Members
- Recruiting and Maintaining Volunteers
- Planning and Implementation
- Writing Goals and Objectives
- Developing Logic Models
- Obtaining External Funding
- Planning and Promoting Events
- Initiating Advocacy Efforts