Cancer in Your Community: Strategies to Reduce Cancer and Chronic Disease in the Arkansas Delta

摘要 在阿肯色州三角洲农村地区，肺癌、乳腺癌和结肠直肠癌筛查的可及性较低 这一地区的癌症死亡率过高，预期寿命较低。减少癌症 健康差距，阿肯色州癌症联盟的社区领导的健康公平小组将 调查多部门联合进程如何能够导致可持续的干预措施， 减少交通不公平，增加对圣弗朗西斯癌症筛查的需求 县位于阿肯色州三角洲农村地区的弗朗西斯县， 最不健康的县在阿肯色州和整体癌症死亡率超过全国平均水平。 阿肯色州癌症联盟是唯一一个旨在减轻癌症负担的全州性联盟。 阿肯色州的一个癌症研究所，在执行多层次的社会结构干预方面处于独特的地位 旨在实现交通公平。MAP-IT（动员、评估、计划、实施和 Track）和国家少数民族健康和健康差异研究框架研究所将 指导社区领导的地方联盟的混合方法需求评估， 制定和测试多层次的社会结构干预措施。我们的新方法寻求 1）改变县级交通系统，减少贫困、交通和时间 负担; 2）利用定期访问移动的乳腺癌和肺癌筛查单位; 3）工作 与合作伙伴一起改变政策，扩大粪便免疫化学检测筛查的范围 和结肠镜检查随访;以及4）与卫生系统合作，建立可持续的提醒 基础设施，增加了农村地区的筛查需求。这个项目可以有一个 对减少农村、服务不足、贫困和黑人/非洲人的癌症负担产生重大影响 美国人民

ABSTRACT Access to lung, breast, and colorectal cancer screening is low in the rural Arkansas Delta region, resulting in disproportionate cancer mortality and low life expectancy. To reduce cancer health disparities, the Arkansas Cancer Coalition’s Community-led Health Equity Team will investigate how a multisectoral coalition process can lead to sustainable interventions that reduce transportation inequities and increase demand for cancer screening in St. Francis County. St. Francis County, located in the rural Arkansas Delta region, is ranked among the least healthy counties in Arkansas and overall cancer mortality exceeds the national average. The Arkansas Cancer Coalition, the only statewide coalition that aims to reduce the burden of cancer in Arkansas, is uniquely positioned to execute a multilevel social-structural intervention that seeks to achieve transportation equity. MAP-IT (Mobilize, Assess, Plan, Implement and Track) and National Institute on Minority Health and Health Disparities Research Framework will guide the community-led local coalition’s mixed-methods needs assessment that will inform the development and testing of a multilevel socio-structural intervention. Our novel approach seeks to 1) change county-level transportation systems that reduce poverty, transportation, and time burdens; 2) leverage regular access to mobile breast and lung cancer screening units; 3) work with partners to change policies to expand the reach of fecal immunochemical test screening and colonoscopy follow-up; and 4) work with health systems to build a sustainable reminder infrastructure that increases screening demand in rural areas. This project could have a significant impact on reducing the cancer burden on rural, underserved, poor and Black/African American people.