Introduction:

BreastScreen Victoria (BSV) provides free breast screens to eligible people, targeting women aged 50-74 to find breast cancer early, reducing morbidity and mortality. Nearly 5,000 eligible clients living in Latrobe City Local Government Area (LGA) are not up to date with the recommended biennial breast screen.

In 2019, Gippsland Primary Health Network (GPHN) partnered with BSV to increase breast screening participation in Latrobe City LGA as part of the Latrobe Health Innovation Zone Project.

Practice change:

BSV partnered with community pharmacies in Latrobe City LGA to increase the capacity of pharmacy staff to raise awareness of the importance of breast screening, and encourage community to screen via an active eight-week in-store campaign.

BSV utilised findings from previous trials to develop and implement an effective, evidence-based program specific to Latrobe City.

A key element of the campaign included pharmacy staff initiating conversations with eligible customers providing BSVs key messages and screening advice.

Aim:

The pharmacy-based campaign aimed to increase awareness and breast screening participation in women aged 50-74 living in Latrobe City.

Pharmacy staff received training delivered by BSV, displayed health promotion collateral, initiated conversations with customers, and monitored and evaluated campaign activity.

Targeted population/stakeholders:

Women aged 50-74 were targeted, with a particular focus on low screening groups such as culturally and linguistically diverse and low SES communities.

BSV partnered with seven community pharmacies within Latrobe City where pharmacists and on-ground pharmacy staff were key to the implementation of the campaign.

Timeline:

January 2019: Pitch campaign to local pharmacies
March–April 2019: In-store training for pharmacy staff
March–June 2019: Implementation of eight-week pharmacy campaign
July 2019: Campaign conclusion and evaluation

Highlights:

- Innovative opportunity to initiate conversation about an important preventative health topic
- Successful partnership between BSV, GPHN and local pharmacies
- Demonstration of a successful pharmacy-based recruitment model

Sustainability:

- Training provided builds the local capacity to continue to promote breast screening by a trusted primary health care professional
- Cost-effective strategy to increase awareness and participation in screening
- Continued pharmacy support through engagement opportunities and provision of resources

Transferability:

The Latrobe City pharmacy campaign provides a successful model that could be replicated and scaled to a state-wide initiative.

Conclusions:

Interim results (five of seven pharmacies) demonstrate:

- 267 conversations initiated between pharmacy staff and the community
- 96.5% of pharmacists and pharmacy staff found the campaign to be effective in raising awareness of breast screening
- 89.6% of pharmacists and pharmacy staff intended to continue to promote breast screening with customers

Full findings will be available in July 2019.

Discussion:

- Demonstrated successful partnership between a cancer screening service, PHN and pharmacies
- Pharmacies are receptive and eager to deliver health promotion activities, if a successful model is provided

Lessons learned:

- Community pharmacies are an effective, yet underutilised resource to promote breast screening
- Campaigns can be easily implemented and localised, requiring minimal resources and high engagement impact
- Opportunity exists for BSV to partner with other PHNs to increase breast screening participation rates across Victoria

Introduction

The Community-led Cancer Screening Project (CLCSP), funded by the Victorian Department of Health and Human Services is a three-year project being run in partnership with the North Western Melbourne Primary Health Network (NWMPHN), and three other Primary Health Networks (PHNs) in Victoria.

The project aims to increase participation in bowel, cervical and breast cancer screening by building capacity within primary care and through facilitated targeted community-led interventions. The project focuses on under-screened communities including Culturally and Linguistically Diverse (CALD), Aboriginal and Torres Strait Islanders and people experiencing socio-economic disadvantage.
 
This abstract focuses on the community-led aspect of the project.

Practice change implemented

The project focuses on engaging and collaborating with communities to understand the barriers and enablers for cancer screening. The project is underpinned by the principles; local initiatives, equity, partnerships and sustainability. A community-led governance group that includes project partners, stakeholders and community members guide the work.

Aim and theory of change

A place-based approach is being used to address the structural and systemic issues that cause cancer screening differences between populations. Collaborating and co-designing initiatives with communities ensure that projects meet its needs.

Targeted population and stakeholders

Filipino community and people of low socio-economic status in Brimbank and the Aboriginal and Torres Strait Islander community in Wyndham local government areas.
To successfully engage with the communities, community members have been recruited to help govern, lead and implement activities and assist with evaluation. They have been pivotal in engaging community organisations to be involved.

Timeline

The Community-led Cancer Screening Project is being delivered from July 2017 – June 2020.

Highlights

• Establishment of governance group involving community members
• Filipino community member assisting in fostering engagement, providing access to several community groups such as a Filipino playgroup
• 40 women participated in an Aboriginal and Torres Strait Islander Women’s Health Day where three community members shared their breast screening experience
• Cervical Screening Information pilot has delivered 90 community members ‘Period Packs’ containing Cervical Screening information via a local food bank.

Sustainability

Initiatives are being collaboratively designed and implemented by community members and stakeholders including local community health centre, Neighbourhood House, and a university. Initiatives are being supported by the Program Coordinator to build the capacity of community to continue beyond the project.

Transferability

The community-led place-based methodology has been shown to be transferable to other health initiatives and can be applied to other regions.

Conclusions

To date, 111 community members have been involved in consultations. A further 133 community members have been involved in pilot projects aimed at increasing cancer screening. Further data will be available in November.

Discussions

Involvement of community members have been crucial to build and establish connections in communities to ensure that its needs are being recognised and addressed.

Lessons learned

• Emphasise importance of community members in bridging the gap between communities and facilitators
• Trust and respect are vital in community and stakeholder relationships
• Regular communication is key in community-led projects to maintain momentum and ensure ongoing community input.

Introduction
Breast, bowel and cervical cancer screening participation rates are lower for sub-population groups in Latrobe City, Gippsland compared to Victorian rates. The aim of this qualitative research was to directly engage with the community to explore their knowledge, attitudes, behaviours and barriers to the three National Screening Programs, as part of the Gippsland Primary Health Network’s Latrobe Health Innovation Zone Initiative.
Theory/Methods
Fourteen group discussions with 80 participants from the local community, segmented by age, sex, and screening participation were conducted. Participants were not up to date in at least one of the cancer screening programs. All sessions were recorded and transcribed, and the data was thematically analysed.
Results
While results differed for each of the three cancer screening programs, overarching themes included: the concept of cancer screening was not well understood, with the construct of population screening being somewhat antithetical to people’s approach to their personal health; low priority for preventive health behaviours; issues related to local general practitioners, and; screening was described as unpleasant, embarrassing and/or inconvenient. A key determinant of participation in cancer screening was exposure to prompts to action, and it was evident that participants often required multiple prompts before they took action.
Discussions
Factors that affect screening participation included a combination of: perceptions of susceptibility to each of the cancers; awareness and experience of each of the screening tests; personal health attitudes and beliefs; and being reminded to screen.
Conclusions (comprising key findings)
There are opportunities to influence behaviours across all three screening programs by addressing health attitudes and beliefs that affect how people balance their decisions with respect to the barriers and benefits of screening. Addressing barriers and perceptions of susceptibility will require different messages for each of the cancers.
Lessons learned
Engaging with the community highlighted opportunities to address low breast, bowel and cervical cancer screening participation in the region including: developing attitudes to health that place disease prevention as a high priority; improving understanding of the benefit of screening in terms of early detection and treatment, and; the development of messages for each of the screening programs.
Limitations
Participants were recruited through a professional research recruitment agency who have previously expressed their interest in participating in market and social research thus there may be a degree of sampling bias in the research. As with all quantitative research, these findings cannot be extended to wider populations and future research should validate the findings.
Suggestions for future research
Further research would be recommended to inform the development of social marketing campaign messages that more effectively prompt and remind people about the screening programs, with an aim of communications being to normalise participation through stimulating conversations about cancer screening. Further consideration needs to be given to the effectiveness of existing communication programs, including invitation and reminder letters, general practice reminder systems, the role, barriers and challenges of the general practitioner, the practice nurse and others in promotion and delivery of cancer screening programs.