Kentucky’s Cancer Action Plan serves as a blueprint for cancer prevention and control throughout Kentucky. The purpose is to provide statewide coordination of public and private cancer control efforts that are ongoing or needed within our state. It is intended for use by individuals and organizations in all areas of cancer control statewide.

Kentucky’s Plan addresses cancer issues along the continuum of care, from prevention and early detection through treatment and quality of life. It also addresses cross-cutting issues including data, health disparities and advocacy. The Plan comprises 12 goals and 28 objectives aimed at reducing the burden of cancer and improving the lives of Kentuckians. Strategies for achieving these goals and objectives are quite varied and address public and professional education, individual behavior change, access to clinical and support services, systems improvement, and policy.

By using Kentucky’s Cancer Action Plan as a blueprint, organizations and communities will become part of a statewide effort to battle cancer in a comprehensive and unified manner.

The Kentucky Cancer Consortium:

The Kentucky Cancer Consortium (KCC) oversees a coordinated and integrated process for implementing the Cancer Action Plan. The Consortium is a network of organizations and individuals that provide leadership for the development and coordination of effective state and local programs addressing cancer prevention and control. The Kentucky Cancer Consortium encourages cooperative, comprehensive, and complementary planning among the public, private, and volunteer sectors involved in cancer control efforts in Kentucky.

WEBSITE LINK: http://www.kycancerc.org//ActionPlan.htm

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.

Objective 1.2:  Reduce youth initiation of tobacco use.

Strategies:

1. Integrate evidence & research based tobacco use prevention into the school curriculum at all grade levels.
2. Include tobacco use prevention in the curriculum of colleges of education at Kentucky universities; encourage those pursing careers in teaching to become smoke free themselves.
3. Distribute prevention messages through existing youth-oriented community-based channels, such as youth sports, Scouts, 4-H Clubs, youth recreational organizations, YMCA/YWCA, & church groups.
4. Raise youth awareness through the media.
5. Support the increase or establishment of an excise tax for all tobacco products.
6. Eliminate promotion of tobacco products.

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.

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.

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.

Objective 3.1:  Increase the proportion of people of all ages who limit sun exposure, use sunscreen & protective clothing when exposed to sunlight & avoid artificial sources of ultraviolet light (i.e. sun lamps, tanning booths & other devices).

Strategies:

1. Integrate sun safety & skin cancer prevention into the school curriculum at all grade levels.
2. Educate & encourage schools & day care facilities to protect children from sun exposure.
3. Encourage designers of playgrounds & outdoor recreational facilities to provide adequate shade (i.e. sunscreen kiosk).
4. Educate & encourage farmers, construction workers & others in outdoor occupations to practice sun protection.
5. Increase public awareness of sun safety & the hazards of artificial light sources.

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

(back to Action Plan)

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 5.2:  Assure quality (including compliance with guidelines) & effectiveness of screening methods.

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 6.2: Assure quality & effectiveness of Pap tests in laboratories serving Kentucky women.

Strategies:

1. Monitor laboratories in reading Kentucky pap tests for compliance with rules & regulations of CLIA (Clinical Laboratory Improvement Amendments of 1988).
2. 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.

Objective 7.2:  Assure quality & effectiveness of screening methods.

Strategies:

1. Support research to identify & promote effective screening methods.

Objective 8.1:  Increase screening according to appropriate guidelines with special attention to “high risk” populations, such as African Americans.

Strategies:

1. Develop targeted education & outreach programs for African American men that focus on prevention, early detection & information on best practices for prostate cancer treatment.
2. Provide access to current information on best practices for prostate cancer treatment.
3. Encourage men to talk to their health care providers about early detection of prostate cancer.

Objective 8.2:  Assure quality & effectiveness of screening methods.

Strategies:

1. Support research on the cause, detection & treatment of prostate cancer.

(back to Action Plan)

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 9.2:  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.

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.

Objective 11.1:  Expand community capacity for providing patient access to cancer treatment information.

Strategies:

1. Work with community organizations to increase their awareness of cancer information resources.
2. Promote existing community & cancer information resources.
3. Improve & promote resource guides for cancer patients & their families.
4. Educate home health workers & others having contact with patients on providing information & referrals.
5. Expand network of patient navigators, including volunteers & trained social workers.

Objective 11.2:  Increase available culturally diverse & low-literacy cancer treatment information resources.

Strategies:

1. Identify special populations & work with opinion leaders in these cultures to disseminate appropriate treatment messages.
2. Promote & disseminate cancer treatment information, especially for special populations & low literacy groups.
3. Increase distribution channels in special populations communities.
4. Promote use of Spanish language cancer information services.

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

Strategies:

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

(back to Action Plan)

Objective 12.1:  Identify quality of life programs proven to be effective (i.e. best practices).

Strategies:

1. Establish quantifiable criteria to determine which programs are among the best practices for addressing cancer survivor needs.
2. Identify best practices based on agreed upon criteria & rank order programs accordingly.
3. Identify gaps in survivorship research & provide funding to test new models & approaches.

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.

Objective 12.3:  Increase utilization of available services that enhance quality of life for cancer patients from diagnosis onward.

Strategies:

1. Increase awareness of available services that enhance quality of life for cancer patients from diagnosis onward.
2. Work at the community level to increase access to cancer support services, through low cost transportation & placement of services in rural medical facilities.
3. Develop patient navigation or case management programs that improve quality of life.
4. Increase human resources/workplace education regarding patient rights.
5. Advocate for more appropriate reimbursement of medically necessary psychosocial & palliative care.
6. Ensure adequate services & equitable quality of life for culture specific groups by focusing outreach efforts where people are, with an emphasis on utilizing outreach in faith based groups, community centers, workplaces, etc.

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.

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.

 

(back to Action Plan)

_________________________________________________________________________