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Improving cancer care for African Nova Scotians

Learning that you ocouple-stock photor someone close to you has cancer is life-changing, and because culture and life experience defines who we are, it is not surprising that our needs within the formal health system will vary accordingly.

Twelve years ago Cancer Care Nova Scotia (CCNS) believed there was a gap in how the cancer system responded to the needs of diverse communities. Beginning with the African Nova Scotian (ANS) community, CCNS commissioned two ANS consultants to conduct a needs assessment.

The 2001 needs assessment recommended:
• Developing culturally-specific patient education materials;
• Enhancing cultural competency of health professionals;
• Recruiting health professionals from ANS communities;
• Conducting research specific to people of African descent;
• Formally recognizing supportive services available in the ANS
Community; and
• Developing community-based outreach programs led by individuals of African descent across the cancer care continuum, from prevention and treatment to palliative care.

With this increased knowledge, CCNS worked with health professionals and administrators throughout the province to address these recommendations. In 2012, CCNS conducted a series of focus groups in five ANS communities (Yarmouth, Tracadie, Whitney Pier, North and East Preston and metro Halifax) to find out if the organization’s efforts had resulted in an improved experience for African Nova Scotians.

The findings from the 2012 report indicate progress in the following areas:
• access to education, information and resources in their own communities;
• knowledge of the role of Cancer Patient Navigation;
• cultural competency of health professionals working within the cancer care system; and
• feeling more empowered in their interactions with health professionals and the health care system.

One focus group participant recalled entering the cancer centre with her husband who had cancer, and said, “They (staff) were so compassionate and so kind and so caring, they just put you at ease the best they could. I thought I was just so fortunate to be blessed to have them, all of them.”

Although the African Nova Scotian experience with the cancer system has greatly improved, the work is not yet complete, as some African Nova Scotians continue to:
• experience systemic racism, particularly within primary health care settings;
• encounter delays in accessing cancer specialist services;
• hold misconceptions regarding cancer and its treatment;
• face challenges in communicating with health professionals;
• struggle in making informed decisions about their care; and
• face barriers with respect to transportation, medication costs, other financial issues and geographic isolation.

One focus group participant commented, “… They (health professionals) don’t recognize the cultural differences. And so you almost feel like they’re never going to understand, (that) they won’t understand our responses, they won’t understand how it affects us...”

Another participant said, “When I was diagnosed, it would be nice to see an African Nova Scotian face there [among health professionals]. You don’t see them.”

CCNS appreciates the contribution of all who took time to share their experience through focus groups. Their contribution provides CCNS and others with information that will help us re-focus our efforts as we continue our work to improve the African Nova Scotian experience with the province’s cancer system.

This work includes:
• Integrating cultural competency within cancer continuing education programs:
• Applying “The Cultural Competence Assessment Tool for Clinical Guidelines Development";
• Raising awareness of cancer risk factors and screening recommendations specific to African Nova Scotians; and
• Enhancing connections between Cancer Patient Navigators and African Nova Scotian communities.

Over the coming months, CCNS will also be meeting with a variety of stakeholders to explore how to address the broader health system and research issues raised in this report.

View the full report.