Innovations conference 2014 robyn sharman lets yarn with aboriginal health workers and community about cancer

“Let’s Yarn with the Aboriginal community of

Albury/Wodonga about cancer prevention,

early diagnosis and better outcomes”

Robyn Sharman & Valda Murray

Cross Border Collaboration

BORDER CANCER NETWORK

RIVERINA CANCER NETWORK

Source: ABS CDATA2001, Greater Southern Area Health Service, Population Health, May 2006

Greater Southern Area Health ServiceCancer Networks

SOUTHERN CANCER NETWORK

WEST WYALONG

BOMBALA

EDEN

PAMBULA

MERIMBULA

BEGA

NAROOMA

BODALLA

TUROSS HEAD

MORUYA

BATEMANS BAY

JUNEE

GUNDAGAI

BATLOW

TUMUT

COOTAMUNDRA

COOLAMON

TEMORA

LEETON

NARRANDERA

GOULBURN

TUMBARUMBA

HOLBROOK

BRAIDWOOD

QUEANBEYAN

BUNGENDORE

BOOROWA

HARDEN

YOUNG

WAGGA WAGGALOCKHART

HENTYBARHAM

URANA

FINLEY

JERILDERIE

DENILIQUIN

BERRIGAN

TOCUMWAL

ALBURY

HOWLONGCOROWA

DELEGATE

COOMA

GRIFFITH

YASS

CROOKWELL

JINDABYNE

HAY

HILLSTON

Hume Regional Integrated Cancer

Service (Hume RICS)

Cancer incidence for Indigenous

Australians

Cancer is

a chronic

disease2nd largest

cause of

death in

Indigenous

Australians

Incidence rate

of cancer is

higher for

Indigenous

people

Most cancers

in Indigenous

people with a

high incidence,

are

preventable

Indigenous

Australians

have poorer

outcomes after

a cancer

diagnosis

“Lets Yarn” with the Aboriginal

Community in Albury/Wodonga

June 2012 – May 2014

Led by Lung Foundation Australia

in collaboration with Hume RICS

June 2012 - May 2014

Project aims

To raise awareness and understanding of

lung cancer in the Aboriginal community

• To provide education about cancer & treatments

• To develop the “Key Messages” ……risks, symptoms & actions

• To provide information about local cancer services

• To develop Aboriginal specific cancer resources

• To provide information on how to access supportive care

Advisory Steering Group

“Furthering Aboriginal Health & Cancer Services”

Chaired by an Aboriginal Health Worker

o 8 AHW – employed by various Aboriginal services across Albury Wodonga

o 2 Aboriginal community members

o 7 members from local cancer/health support services

Community Engagement

• Feel the passion

• Identify a key person

• Be persistent – keep trying

• Integrity and honesty

Developed “Key Messages”

RisksSmoking

Passive smoking

Asbestos exposure

Symptoms

Persistent cough

Coughing up blood

Feeling tired

Change in voice

Unexplained weight loss

Shortness of breath

ActionsGo to the Doctor

Ask advice from the

Aboriginal Health Worker

Resources Developed

Archie Roach

Surviving Lung

Cancer

Merles story

Surviving Lung Cancer

‘

Key messages

Symptoms & risks

Available on You tube, Lung Foundation or Hume RICS websites

Aboriginal cancer awareness pin

Lung cancer: signs and symptoms

Education Sessions

“Walk thru” treatment sites

• Radiation Oncology -

• Day Chemotherapy Unit

• Palliative Care Unit

• Palliative care (PEPA) training

Evaluation:

Learning

more about

cancer myths

was great

Bring on more

education

about cancer

and supportive

care

Education was

needed to

empower the

workers to get the

information out

Sessions on

palliative

care would

be great

Good to

understand how

the treatment is

given and to

meet staff

Aboriginal Health Worker feedback

“

Lets Yarn” Lung Cancer project

completed May 2014

However, the work with the AHWs

continues in the Hume RICS region

Working with Aboriginal Health

Workers

June 2013 - December 2014 :

“Yarning along the Murray” funded by Cancer Institute NSW

Aim: To increase the knowledge about cancer for Aboriginal Health

Workers

“Yarning along the Murray”

Aboriginal Project Officer appointed 0.6 FTE

Project Coordinator 0.2 FTE

Guided by the established steering group

Topics

• Breast screening and assessment

• Radiation

• Chemotherapy

• Palliative care

Cancer & treatment theory

sessions

Breast screening

Cancer treatment ..

Radiation &

chemotherapy

An understanding of

palliative care

Aboriginal Health Workers

What is cancer?

Palliative Care Sessions

4 PEPA sessions (palliative care theory) conducted

80 participants attended from regional /rural areas of NSW

Placements

Radiation :

Planning session

Discussion with oncologist

Treatment session

Side effects with nurse

Chemotherapy :

Pt education with nurse

Explanation of treatment regimes

Meeting with pts and listening to their stories

Placements cont……….

Breast screening and assessment

Attending mammograms to develop an understanding of process

Attendance at assessment days … involved investigation of

suspicious findings … biopsies, ultrasounds & sessions with

nurse

Palliative care

Conducted at Mercy Health, Albury over 2 days

Developed an understanding of services /supports available

Attended education sessions on palliative care

Attended community visits with nurses

Placement Challenges

• AHW scheduled for placements but failed to attend

• Pre and post evaluations difficult to collect

• Staff at units often too busy to support placements

Addressing the Challenges Pre placement evaluations sent electronically & returned before

placement commences

Undertaking theory sessions prior to placement

Provide a mentor to support, orientate & assist workers during placement

Collect placement evaluations immediately following placement

Ensure each AHW is committed to the placement

Partnership with TAFE NSW (AHW Cert 1V course)

Evaluations

Pre placement evaluations – to determine AHW understanding of

placement site

Post evaluation survey to determine if program has met the aims

Feedback

Treatment staff - “not only was I able to help with their understanding of the

R/T process, but I had many of my own questions answered about their

culture” & chemotherapy nurse “having a mentor worked much better as

we do not have the time to give to the workers “

AHWs – All participants felt the placements were very rewarding and

increased their knowledge, but noted some staff at sites required cultural

awareness training.

Cultural Awareness Training Provided to private oncology practices in Albury/Wodonga

WHY private practices ????

Training not mandated for private practices

Practice questionaires not asking the question

AHW identified lack of cultural awareness during placements

Conducted over 3 subsequent sessions

20 staff attended (radiation therapists, reception, nursing)

Feedback

“I honestly had very little understanding of our nation’s

Indigenous history. This has truly opened my eyes & given

me an appreciation for what they have and are still trying to

overcome”

New Resource

Educational DVD for Aboriginal patients and community

Sustainability

Aboriginal Health Workers have developed :

The skills/knowledge/confidence to discuss treatment and care

The skills to conduct training and assessment

Understanding of the principles of palliative care

Knowledge of cancer treatments

The Strengthened networks with cancer services for improved

collaboration

In progress

Placements are still progressing

Partnership established with TAFE NSW (Cert 1V AHW course)

Metro Visit - 12 AHW will visit major metro facilities

Steering group continues to be active and supportive

Development of a service directory for Aboriginal and mainstream

health professionals

Partnerships

Aboriginal Health Service

Mungabareena Aboriginal Corporation

Viney Morgan Aboriginal Medical

Service

Murrumbidgee Local Health District

Gateway Community Health

Thank You

Robyn Sharman and Valda Murray