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Mobilizing newcomers and immigrants to cancer screening programs

Mobilizing Newcomersand Immigrants to Cancer Screening Programs

Funded by Public Health Agency of Canada (PHAC)

The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada (PHAC).

Adriana Diaz, Project Coordinator, South West Regional Cancer Program

Why do this project
Why Do This Project?

Newcomer/Immigrant populations

  • Less likely to participate in cancer screening

  • Have later-stage cancer diagnosis (sometimes present at stage of entry

    And as a result

  • More likely to experience unfavorable outcomes from the disease

Project goal
Project Goal

  • Develop, deliver and evaluate evidence-based cancer prevention and screening service delivery model

  • Targeted to newcomer and immigrant under/never screened populations in London, Ontario

  • Disseminate across Canada

Project deliverables
Project Deliverables

  • Reduce barriers that limit access to cancer prevention/screening information and cancer screening programs

  • Increase awareness about cancer prevention and screening

Project deliverables1
Project Deliverables

  • Improve cultural safety of immigrant and newcomer cancer care experience

  • Promote participation of immigrants and newcomers in cancer screening and early detection

Project structure
Project Structure



Advisory Committee Members





Project Coordinator


Focus Group Facilitators

Evaluator Consultant



Arabic PHE (2)

Spanish PHE (2)

Nepalese PHE (2)

Peer health educator phe model
Peer Health Educator (PHE) Model

  • PHEs “represent the intersection between risk and resilience, between institution and community, and between research and practice” (Landers & Stover, 2011, p.2198)

  • The Institute of Medicine (2002) recommended that PHEs be included on multidisciplinary health care teams to address issues in serving racial and ethnic populations that face chronic barriers in accessing the health care system

Peer health educator phe model1
Peer Health Educator (PHE) Model

  • Roles:

    • preventative and health education

    • interactions with other Health Human Resource (HHR)

    • Research and health system access and navigation

  • PHEs have strong ties, based on trust, respect, and mutual understanding, with the communities they serve

  • PHEs understand the needs of their communities, mainly because they have lived and experienced those needs

  • Community evidence based barrier
    Community Evidence-Based Barrier


    “There are many brochures but they do not answer my questions. In our Latino culture we are more personal. I would like the information in person where I could ask in my own language. We do not want to read those and then look on websites or call that number”

    Spanish Participant

    Community evidence based barrier1
    Community Evidence-Based Barrier


    “If I have an abnormal pap test or if I have cervical cancer, my husband should leave me…I would be disowned by my husband. I will not go… I have 4 kids”

    Arabic participant

    “Why does the doctor ask if I have relatives with cancer? Is it because it is contagious? Could I infect others?”

    Nepalese participant

    Community evidence based barrier2
    Community Evidence-based Barrier


    “My mom had a medical appointment, so I had to go with her to be an interpreter. When we were in, I asked for a breast screening test – a mammogram – for my mom…

    …the answer was you need to book another appointment to talk about it. I do not have time and get permission…it is not easy… it is another barrier.”

    Spanish participant

    Mobilizing newcomers and immigrants to cancer screening programs1
    Mobilizing Newcomers and Immigrants to Cancer Screening Programs

    Cultural differences among target populations necessitates

    Customized presentations


    • Delivered by PHEs in their language

    • Child care offered and refreshments

    • Culturally-relevant/community locations


    • Reducing cancer risk (healthy living)

    • Breast, cervical and colorectal cancer screening programs


    • Video – sharing personal experience in cancer screening

    • “How to reduce your risk” form

    • Booking mammogram and pap test appointments and arranging – “community appointments”

    Learning points
    Learning Points

    • Peer Health Educators

      • Approach communities in a culturally sensitive manner

      • Build trust in communities

      • Deliver information in own language

      • Deliver information with understanding of culture, traditions and behaviors

      • Find the right location

    Learning points1
    Learning Points

    • Use healthy living examples to help overcome fear and anxiety of cancer

    • Immigrant communities participate in cancer screening programs when the purpose, access to programs, and procedures are understood

    Health care providers cultural competency workshops
    Health Care Providers – Cultural Competency Workshops

    • ABCDE Model for CulturalCompetency

      • Acknowledgements to SickKids

        Hospital in Toronto

  • Grand Rounds LRCP (1) and Evening Workshops (2)

    • Dr. BhoomaBhayana, Schulich School of Medicine and Dentistry

    • Dr. Jan Owen, Primary Care Lead, Southwest Regional Cancer Program

    • Dr. Adriana Diaz, Project Coordinator