ENVIRONMENTAL CARCINOGENS

Goal 4:  Reduce incidence & mortality of cancers related to environmental carcinogens.

Objective 4.1:  Increase the knowledge base on environmental carcinogens in Kentucky’s environment.

Objective 4.2:  Foster research & education on Kentucky-specific environmental causes of cancer.

Strategies:
  1. Support research on the etiology of environmental cancers.
  2. Encourage Kentucky researchers to apply for federal & nonprofit funding for research projects on environmental carcinogens.
  3. Monitor cancer incidence & potential environmental exposures.
  4. Increase public education & awareness of environmental carcinogens.

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ENVIRONMENTAL TOBACCO SMOKE (ETS)

Objective 1.3:  Reduce or eliminate environmental tobacco smoke (ETS) exposure. 

Strategies:
  1. Encourage, educate & assist in implementation of tobacco-free policies in work places, day care facilities, schools & other public locations.
  2. Mandate that schools be tobacco free campus-wide for faculty, staff & students (including all school-sponsored events).
  3. Enforce existing laws relating to smoke-free environments.

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EXERCISE

Goal 2:  Reduce incidence & mortality from colon cancer & other cancers related to inadequate nutrition & lack of physical activity.

Objective 2.2:  Increase the percentage of Kentuckians who exercise moderately on a daily basis.

Strategies:

  1. Increase awareness among Kentuckians of the health benefits of physical activity & ways to incorporate it into daily activities. 
  2. Incorporate accessible physical activities within urban & rural community developments (i.e. “walkability” of a community). 
  3. Incorporate physical activity education into the school curriculum at all grade levels.

 

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FINANCIAL

Objective 5.1:  Increase the proportion of women who engage in breast cancer screening behaviors, according to appropriate guidelines, with special attention to “high risk” populations.

Strategies:

  1. Establish an integrated, ongoing public information program to foster a high degree of knowledge among women of all ages about breast cancer risks & benefits of early detection.
  2. Promote & expand community level programs, such as breast cancer coalitions, to increase education about the risk of breast cancer & the need for screening (and re-screening) at appropriate intervals.
  3. Encourage health care providers to routinely counsel women in their care to undergo breast cancer screening.
  4. Integrate reminder systems into physicians’ practices.
  5. Increase the use of available financial resources for routine screening for uninsured & underinsured women.
  6. Encourage in-state self-insured companies & in-state branches of companies located outside Kentucky to provide screening mammography coverage in accordance with evidence based screening guidelines.
  7. Ensure that age-eligible women in counties without mammography facilities have adequate access to breast cancer screening through facilities in adjoining counties and/or mobile mammography units.
  8. Encourage hospitals & other health service organizations to offer free or low-cost breast cancer screening.
  9. Develop & implement interventions targeting at-risk populations.

Objective 9.1:  Decrease the disparity in access to state-of-the-art treatment services based on financial and/or insurance status.

Strategies:

  1. Educate community regarding how & where to access care if uninsured & ineligible.
  2. Encourage in-state self-insured companies & in-state branches of companies located outside Kentucky to provide cancer treatment coverage in accordance with current evidence based treatment guidelines.
  3. Promote & enroll people who are currently eligible for health care services through Medicaid, and expand the eligibility.
  4. Promote insurance coverage of treatment under clinical trials.
  5. Work with policy makers to include diagnostic services in health care plans.

Objective 9.3:  Increase patient participation in clinical trials.

Strategies:

  1. Encourage physicians to inform & educate cancer patients about the availability & benefits of clinical trails & to offer participation in clinical trials as a choice.
  2. Increase patient education on the purpose & benefits of clinical trials.
  3. Reduce financial & geographic barriers to participation in clinical trials.

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FRUIT

Objective 2.1:  Increase the percentage of Kentuckians who eat five or more servings of fruits & vegetables daily.

Strategies:

  1. Increase awareness of the nutrition goals & health benefits of proper nutrition through the media & other communication channels.
  2. Encourage consumer education by food retailers.
  3. Increase the capacity of health care providers to provide nutrition advice, counseling & referrals.
  4. Encourage availability of healthy food choices at fast-food concessions in worksites, congregate eating sites & other locations.
  5. Support efforts to eliminate unhealthy food selections in schools, including vending machines.
  6. Incorporate nutrition education into the school curriculum at all grade levels.

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GEOGRAPHY

Objective 9.2:  Decrease the disparity in access to state-of-the-art treatment services based on geography.

Strategies:

  1. Expand educational programming, distance learning & teleconference capabilities to cover rural areas through out the state.
  2. Encourage health care providers in remote areas to work collectively to increase access to screening facilities & arrange for treatment specialists to establish office hours in their areas.
  3. Increase free or low-cost transportation & housing options for persons in remote areas, who have to travel for treatment services.
  4. Invest in local health facilities & other community-based resources.
  5. Increase the number of certified nurses, social workers, translators & other healthcare professionals & funding for retaining professionals in underserved areas.

Objective 9.3:  Increase patient participation in clinical trials.

Strategies:

  1. Encourage physicians to inform & educate cancer patients about the availability & benefits of clinical trails & to offer participation in clinical trials as a choice.
  2. Increase patient education on the purpose & benefits of clinical trials.
  3. Reduce financial & geographic barriers to participation in clinical trials.

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HEALTH CARE PROVIDERS

Providing Tobacco Cessation Counseling/Referrals

Objective 1.1:  Increase the proportion of tobacco users in Kentucky who   successfully quit.

Strategies:
  1. Make cessation resources & programs widely available in communities, including programs tailored to youth to support users who want to quit.
  2. Increase the capacity of physicians & other health care providers to provide cessation advice & counseling.

Providing Nutrition Counseling/Referrals

Objective 2.1:  Increase the percentage of Kentuckians who eat five or more servings of fruits & vegetables daily.

Strategies:

  1. Increase awareness of the nutrition goals & health benefits of proper nutrition through the media & other communication channels.
  2. Encourage consumer education by food retailers.
  3. Increase the capacity of health care providers to provide nutrition advice, counseling & referrals.
  4. Encourage availability of healthy food choices at fast-food concessions in worksites, congregate eating sites & other locations.
  5. Support efforts to eliminate unhealthy food selections in schools, including vending machines.
  6. Incorporate nutrition education into the school curriculum at all grade levels.
Recommending Appropriate Screenings

Objective 5.1:  Increase the proportion of women who engage in breast cancer screening behaviors, according to appropriate guidelines, with special attention to “high risk” populations.

Strategies:
  1. Establish an integrated, ongoing public information program to foster a high degree of knowledge among women of all ages about breast cancer risks & benefits of early detection.
  2. Promote & expand community level programs, such as breast cancer coalitions, to increase education about the risk of breast cancer & the need for screening (and re-screening) at appropriate intervals.
  3. Encourage health care providers to routinely counsel women in their care to undergo breast cancer screening.
  4. Integrate reminder systems into physicians’ practices.
  5. Increase the use of available financial resources for routine screening for uninsured & underinsured women.
  6. Encourage in-state self-insured companies & in-state branches of companies located outside Kentucky to provide screening mammography coverage in accordance with evidence based screening guidelines.
  7. Ensure that age-eligible women in counties without mammography facilities have adequate access to breast cancer screening through facilities in adjoining counties and/or mobile mammography units.
  8. Encourage hospitals & other health service organizations to offer free or low-cost breast cancer screening.
  9. Develop & implement interventions targeting at-risk populations.

Objective 6.1:  Increase screening according to appropriate guidelines with special attention to “high risk” populations. 

Strategies:

  1. Establish an integrated, ongoing public information program to foster a high degree of knowledge among women about cervical cancer risks & early detection.
  2. Develop & monitor programs that specifically target older women with the message about screening.
  3. Increase the number of health providers who perform or refer women for regular pap tests & pelvic exams.
  4. Reduce access barriers to screening.
  5. Develop & implement standards of care for patient reporting, tracking & follow-up.

Objective 7.1:  Increase screening according to appropriate guidelines with special attention to “high risk” populations. 

Strategies:

  1. Increase access to recommended colorectal cancer screenings for Kentuckians, ages 50 & older.
  2. Encourage health care providers to offer or refer patients for routine screening.
  3. Establish an educational campaign on colorectal cancer risk factors & screening.

Increasing Access to Care

Objective 9.2:  Decrease the disparity in access to state-of-the-art treatment services based on geography.

Strategies:
  1. Expand educational programming, distance learning & teleconference capabilities to cover rural areas through out the state.
  2. Encourage health care providers in remote areas to work collectively to increase access to screening facilities & arrange for treatment specialists to establish office hours in their areas.
  3. Increase free or low-cost transportation & housing options for persons in remote areas, who have to travel for treatment services.
  4. Invest in local health facilities & other community-based resources.
  5. Increase the number of certified nurses, social workers, translators & other healthcare professionals & funding for retaining professionals in underserved areas.

Providing Information/Referral on Clinical Trials

Objective 9.3:  Increase patient participation in clinical trials.

Strategies:

  1. Encourage physicians to inform & educate cancer patients about the availability & benefits of clinical trails & to offer participation in clinical trials as a choice.
  2. Increase patient education on the purpose & benefits of clinical trials.
  3. Reduce financial & geographic barriers to participation in clinical trials.

 

Providing State-of-the-Art Treatment Services

Goal 10:  Increase health professionals’ capacity to provide state-of-the-art cancer treatment services.

Objective 10.1:  Increase the number of health care providers who follow practice guidelines of national professional organizations (i.e. NCCN)

 

Strategies:

  1. Increase health professionals’ awareness & use of the National Cancer Institute’s PDQ & continuing medical education.
  2. Integrate professionally accepted practice guidelines into health professional school curricula.
  3. Increase physician-to-patient education as to the appropriate professional treatment guidelines for their situation.
  4. Enhance relationships between medical specialists & academic medical facilities & researchers.

          Being Trained in Cultural Competency

Objective 11.3:  Integrate patient-provider cultural & communication training into healthcare & allied health education & training programs.

Strategies:

  1. Advocate Kentucky medical schools to add culturally competency courses to their curriculum.

Develop Multidisciplinary Teams

Objective 12.2:  Increase quality of life resources available to patients & their families, with special attention to end of life resources.

Strategies:
  1. Increase availability of support groups/systems, information & counseling services.
  2. Develop & support multidisciplinary palliative care teams specifically committed to symptom management that begins at diagnosis (inpatient & outpatient). 
  3. Encourage the development and/or use of cancer resource centers as a clearinghouse for cancer information. Educate health care providers in the use of these facilities.

Providing Referrals to Community Support Services

Objective 12.4:  Increase health professionals’ provision of care that is sensitive to quality of life issues from diagnosis onward.

Strategies:
  1. Refer all patients to existing community support services in a supportive & timely manner.
  2. Increase referrals to hospice in a timely manner.
  3. Inform physicians & nurses about the provision of the ADA so that they may be able to assist cancer patients in obtaining entitlements under the statute.
  4. Educate providers regarding resources & referrals on all legal & ethical end of life care options & how best to discuss them with their patients.
  5. Educate providers on effective pain management procedures.
  6. Increase equitability of prescriptive practices amongst all Kentucky cancer survivors.

Providing Referrals to Legal/Ethical Options

Objective 12.4:  Increase health professionals’ provision of care that is sensitive to quality of life issues from diagnosis onward.

Strategies:
  1. Refer all patients to existing community support services in a supportive & timely manner.
  2. Increase referrals to hospice in a timely manner.
  3. Inform physicians & nurses about the provision of the ADA so that they may be able to assist cancer patients in obtaining entitlements under the statute.
  4. Educate providers regarding resources & referrals on all legal & ethical end of life care options & how best to discuss them with their patients.
  5. Educate providers on effective pain management procedures.
  6. Increase equitability of prescriptive practices amongst all Kentucky cancer survivors.

Administering Effective Pain Management Procedures

Objective 12.4:  Increase health professionals’ provision of care that is sensitive to quality of life issues from diagnosis onward.

Strategies:
  1. Refer all patients to existing community support services in a supportive & timely manner.
  2. Increase referrals to hospice in a timely manner.
  3. Inform physicians & nurses about the provision of the ADA so that they may be able to assist cancer patients in obtaining entitlements under the statute.
  4. Educate providers regarding resources & referrals on all legal & ethical end of life care options & how best to discuss them with their patients.
  5. Educate providers on effective pain management procedures.
  6. Increase equitability of prescriptive practices amongst all Kentucky cancer survivors.

Survivorship

Objective 12.5:  Increase awareness of concept of cancer as a chronic disease.

Strategies:
  1. Include updated definitions of survivorship in cancer treatment messages.
  2. Conduct trainings for health professionals, community health workers & patient navigators on evolving concept of cancer survivorship.
  3. Promote & disseminate printed survivorship information, for both providers & patients, to medical facilities across Kentucky.
  4. Promote & disseminate information on effective pain management, from diagnosis onward.

 

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