December 18, 2020
Regular cancer screenings play an important part in your healthcare. Cancer can be easier to treat if it is diagnosed earlier, and screening can identify the disease long before symptoms arise. Yet some individuals and populations are less likely to undergo screenings, leaving them at increased risk for later-stage diagnoses and higher mortality rates.
Understanding and addressing those barriers is a key pillar of The University of Kansas Cancer Center’s National Cancer Institute (NCI) designation. Members of the cancer center seek to develop meaningful partnerships to help those who suffer from cancer disproportionately.
Angela Williams is a community health educator for the Masonic Cancer Alliance, the outreach network of The University of Kansas Cancer Center. In her role, Angela serves as a crucial link between the community and healthcare professionals, providing evidence-based cancer information tailored to suit the needs of African American and other underserved communities in the cancer center’s catchment area. In 2020, Angela was named a Regional Health Equity Champion during the Heartland Conference on Health Equity and Patient-Centered Care.
Below, Angela gives some insight into the life of a Community Health Educator.
What does your role as a Community Health Educator entail?
My role is to build and maintain community partnerships, facilitate community outreach and empower communities to change their attitudes toward screenings and early detection.
I primarily focus on colorectal cancer screening, in addition to breast, cervical and lung cancers, in our African American communities. In the United States, African Americans are 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups. Many colorectal cancers can be prevented through regular screening.
Engaging directly with these communities gives me better insight into the types of screening barriers they face and allows me to tailor my education efforts for maximum impact.
What are some ways you engage with the community?
I identify key community organizations that engage African American communities at large, such as government agencies, federally qualified health centers, faith-based organizations, independent living facilities for people over 55, clinical and non-clinical organizations and beauty salons in the urban core of Kansas City, Missouri and Kansas.
I then contact leadership and set up meetings to introduce myself and explain our goals and objectives. I provide PowerPoint presentations on colorectal cancer as well as conduct pre- and post- surveys of screening knowledge, attitudes and intentions. For those who consent, I follow up in three months to see if the individual who was referred received the screening. Follow-up conversations, based on their response, give me the opportunity to have a one-on-one conversation about colorectal cancer screening and meet people where they are about their health concerns. Through this process based upon the location and population of the presentations, I am often invited to participate in health fairs and provide a resource table that provides information on the importance of colorectal cancer screening, risk factors and symptoms. Since I have been a Community Health Educator for about 25 years, I also look to my large personal network, as well as friends and family, to share the importance of colorectal cancer screenings and encourage them to share this information with their family, friends and colleagues.
How has COVID-19 changed your approach?
I am being innovative in my approach to continue to build and maintain community partnerships, plan and conduct health-focused outreach, while empowering the community to influence behavior change as it pertains to cancer screening for early detection. I have been keeping the lines of communication open by providing a virtual interactive game on colorectal cancer screening and clinical trials as well hosting PowerPoint presentations via Zoom.
I have also created a resource Facebook page called Screen 2 Save Kansas City. This page was created to share information on COVID-19, colorectal cancer, breast, cervical, prostate and lung cancer screening and prevention information for early detection in communities of color, primarily African American populations over 45.
What are some common cancer screening misconceptions or barriers, and how do you address them?
Some people are afraid to go to the doctor because they don’t want to risk hearing bad news. Fear of a diagnosis can be a big deterrent. A diagnosis may also open a can of worms for an individual – maybe the results of their Fecal Immunochemical Test (FIT) test came back positive, and they need more tests. They may not have insurance to cover those costs.
A common misconception about screening is that if there is no family history of cancer, then screening isn’t necessary. However, family history is only one of many indicators in assessing the risk of getting cancer. The type of screening or test needed can also be confusing.
The fear of clinical trials as being “experimental” persists, too. The Tuskegee Airmen experimental study, in which hundreds of African American men went untreated for syphilis, has had a lasting effect on the community’s perceptions of clinical trials.
People often tell me that they don’t need a screening because they “feel fine,” or they don’t want to go looking for a problem. There’s a gap in understanding and/or lack of concern about the importance of screening for prevention purposes.
In my presentations and one-on-one meetings, I share personal stories of well-known African Americans who have passed away from colorectal cancer. I also share my own cancer experiences as a co-survivor and previvor. A previvor is someone who has a predisposition to cancer but hasn’t developed the disease. It gives the community the opportunity to identify with people who look like them. I try to make learning the information both interactive and informative.
When it comes to clinical trials, I explain that nearly all cancer treatments used today were studied and made available to patients through clinical trials. I also emphasize that participation in clinical trials is voluntary and participants can leave a study at any time. Some individuals believe that once they’re enrolled in a clinical trial, they are locked in. That’s a huge misconception. I discuss the possible benefits of clinical trial participation, especially from people of all backgrounds including gender, race, ethnic origin, age, weight, as well as possible risks.
Most importantly, I explain the process of informed consent in a clinical trial. Informed consent involves providing a participant with the necessary information to allow for an informed decision about participation in the clinical trial. Every person who contributes to research must have adequate knowledge and understanding before participating. I strive to empower communities through a collaborative knowledge base focusing on education, resources and prevention, while helping them make informed decisions.
It is better to give people tools to choose from rather than choose for them!
What is your favorite part about being a Community Health Educator?
I love to meet new people in their own environments and have honest conversations to better understand the barriers they face. This is especially important in the African American community. It’s important for me to understand where each individual is coming from and what resources I can provide to assist in how I can get them where they need to be.
Angela’s efforts are funded via an administrative grant supplement from the NCI to expand community outreach efforts and address cancer health disparities.