4CNC Planning Summit: Many Voices, One Vision. December 13, 2005. Chapel Hill, NC


Summary of Planning Summit

Sixty individuals representing over 30 partner organizations met on December 13, 2005 to launch 4CNC's effort to accelerate the adoption of evidence-based interventions in cancer prevention and control in NC. View Cathy Melvin's introductory remarks (pdf). Participants at the 4CNC Planning Summit: Many Voices, One Vision addressed 4CNC's two primary areas of focus: tobacco use prevention and control and colorectal cancer prevention and early detection. After a plenary session focused on the need to accelerate the adoption of evidence-based interventions to "get more of what works to more people in more places", participants met in two sessions to map out specific strategies for tobacco use prevention and control and colorectal cancer prevention and early detection.

The Tobacco Use Prevention and Control session formed two working groups, one addressing secondhand smoke exposure and one addressing tobacco cessation in communities.

  1. The Secondhand Smoke Exposure working group chose to focus on developing policy initiatives on reducing secondhand smoke exposure in North Carolina including community-by-community adoption of smoking bans and reversing preemption.

  3. The Tobacco Cessation working group chose to focus on developing links in key communities between healthcare systems with solutions and communities with needs and problems around cessation. 4CNC would explore how to work with other resource organizations such as Quit Now NC! and a range of potential audiences such as municipalities, schools, faith based and Native American organizations.

The Colorectal Cancer Prevention and Early Detection session divided into three working groups addressing individual, practice, and policy changes.

  1. The individual changes working group focused on reducing structural barriers to improve fecal occult blood test (FOBT) screening rates, especially for those without a regular primary care clinician or those whose clinician has not initiated colorectal cancer screening. A proposed FOBT safety net intervention would distribute materials at non-clinical venues partnered with health care entities responsible for developing reminders, providing results to participants, and making recommendations for further evaluation, as appropriate.

  3. The practice change working group is focusing on implementing a patient reminder toolkit to increase colorectal cancer screening rates. The project would increase patient awareness, prompting health care providers to perform colorectal cancer screening based on the patient's inquiries. The area of impact could be statewide after an initial test of effectiveness ensuring the interventions can be adapted to any clinical setting.

  5. The policy issues working group is primarily focused on two areas: improving access and reducing disparities. Interventions hinge on reducing structural barriers, reducing financial barriers, enhancing surveillance, and enhancing quality of services.
    • Reducing structural barriers: assess system-wide capacity for screening (e.g., endoscopy facilities) to determine whether facility capacity is sufficient to meet increased demand for screening services
    • Reducing financial barriers: assess insurance coverage, cost and quality for colorectal screening; assess coverage and other cost-reduction options for uninsured populations – BCCCP-like program (e.g., Maryland)
    • Enhanced surveillance: survey current clinician practice behavior regarding CRC screening; analyze existing data on individual behaviors associated with CRC screening such as that contained in the Behavioral Risk Factor Surveillance System (BRFSS)