Project
REACH
Program
Planning Guide
Background
Information:
Welcome to Project REACH
The
More the Merrier: Working with a Team
In
addition to support from Project REACH, there
is another way to stay motivated and inspired�recruit
others! Although it takes only one dedicated person
to head up a local cancer education program, you
don’t have to take on the challenge by yourself.
Talk to other employees in your school and ask
for help. You may be surprised how many people
are willing to become involved in such an important
initiative. The more people you have working on
and planning the program, the more support you
will feel.
Past
experiences have shown that the most successful
programs are ones in which a team of members worked
together to accomplish a common goal. The best
way to avoid being overwhelmed is to have people
help you through the process. Don’t think you
have to do it all alone! With additional help
from your peers, you will have a built-in support
system AND can distribute the workload.
Women
Who Need this Program: What Makes School Employees
Unique?
The
ultimate goal of any activity you plan should
be to educate women about the importance of breast
and cervical cancer early detection, and to link
them with resources. Project REACH is designed
to help school employees identify the barriers
stopping their colleagues and community members
from being screened and to help them overcome
those barriers.
There
are many reasons women do not obtain the appropriate
screening tests, but fear and unawareness are
probably the greatest hindrances. Women are afraid
that once they are screened, they will not like
hearing the test results. Other women do not know
where to get screenings, or think that the screening
will somehow harm them. Additional barriers that
prevent women from practicing early detection
are listed in Table 1.
Although
many women can relate to the barriers listed in
the table, educational employees are unique because
they face an additional set of “occupational barriers,”
specifically arising in the work environment.
For example, educational employees are known for
taking care of others, and neglecting their own
health in the process.
Additional
examples of occupational barriers for school employees
include: Privacy: Many school employees
do not have offices or private rooms to make or
receive personal calls to/from their health care
providers. In some cases, classrooms and offices
are in separate buildings on a campus and could
require multiple messengers, including students,
to relay a message to a school employee.
Insufficient
health care benefits or high deductibles:
For part-time school employees with insufficient
or no insurance benefits, early detection screening
tests and potential follow-up treatment could
cause financial difficulties.
School
schedule/allowable personal days: Many school
employees cite few personal days for “wellness”
visits with their health care provider, and may
be hesitant to use vacation days or sick days
for preventive visits to the doctor.
Time:
School employees often find themselves involved
in a variety of extracurricular activities after
school and on weekends. When combined with family
or personal obligations, there are limited opportunities
for planning or participating in preventive health
maintenance activities.
Lack
of a knowledgeable resource person on campus:
School nurses are often considered the health
information specialists on campus. However, an
increasing number of schools do not have a school
nurse or share one school nurse among multiple
schools or facilities. As a result, these schools
are often left without an identified and easily
accessible source of health information. In addition,
some school nurses may not be up to date on breast
and cervical cancer and early detection information,
or aware of the many early detection resources
in their community.
As
previously stated, many school employees face
barriers related to work, but groups within the
same school can face a different set of barriers.
For example, school staff who are minority, retired,
and Education Support Professionals are particularly
likely to have barriers that keep them from seeking
cancer screening tests. Elderly and minority women
may be at even greater risk for breast or cervical
cancer. Because of the additional barriers and
risk factors these women face we refer to them
as “Priority Populations.” (Please read Basic
Cancer Facts for more information on risk
factors). The following groups of women are examples
of Priority Populations and are not listed in
order of importance:
Minority Women: African American women
have higher rates of cancer (incidence) as well
as higher rates of death from cancer. Besides
potential differences in cancer incidence and
death, it is important to include all minorities
in your programs to address cultural values and
belief systems that can affect attitudes about
cancer screening or seeking medical care.
Older
Women: Risk for developing breast and cervical
cancer increases with age. Mammograms are the
most effective method for detecting breast cancer
at a treatable stage, and older women must be
encouraged to receive mammograms every year starting
at age 40 as well as an annual Pap test starting
at age 18. Additionally, retired women face barriers
that result from being “out of the loop.” Because
they are no longer in the school setting on a
daily basis, they lack mailboxes and access to
bulletin boards, which are often avenues for the
dissemination of health information. Insufficient
health insurance also plays a role in seeking
out screening tests.
Women
with Lower Incomes or Insufficient Insurance:
Women with lower incomes or insufficient insurance
may have financial difficulty obtaining mammograms
and Pap tests. Education Support Professionals,
part-time school personnel, and others who have
no or insufficient insurance may not be able to
afford annual screening exams. These women may
be eligible for low or no-cost screenings through
your state or local health department. And much
like retired women, Educational Support Professionals
may also have no privacy or support for sharing
or receiving health information in the school
setting.
For
these reasons, members of Priority Populations
should be considered an important audience for
your local cancer education program.
Understanding
Breast and Cervical Cancer
Before
you begin to think about planning an education
program, it is important to have a basic
understanding of the disease, risk factors,
and early detection issues. The information was
taken from the National
Cancer Institute (NCI) and American
Cancer Society.
Recent
health studies have addressed the effectiveness
of mammograms and breast self-examination in detecting
breast cancer. NEA HIN supports the National
Cancer Institute (NCI) of the Centers
for Disease Control and Prevention (CDC) in
recommending that:
- Women
in their 40s should be screened every one to
two years with mammography. - Women
aged 50 and older should be screened every one
to two years. - Women
who are at higher than average risk of breast
cancer should seek expert medical advice about
whether they should begin screening before age
40 and the frequency of screening.
NEA
HIN also follows the American
Cancer Society (ACS) screening guidelines
as follows:
- Breast
self-exam monthly for women aged 20 and over
- Clinical
breast exam (an exam performed by your doctor)
for women aged 20-40, every 3 years; over 40,
every year. This exam should be done close to
the time of the scheduled mammogram. Ideally,
the clinical breast exam should be done before
the scheduled mammogram.