Toronto’s first peer education program for black women improves cancer awareness and screening

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Public health researchers created a first-of-its-kind peer education project targeting black women to improve breast and cervical cancer awareness and screening for black women living in Toronto’s Malvern community.

“There is a lot of silence in the black community. People think that cancer is not a black issue and many survivors are shy to speak out,” said Dr. Onye Nnorom, who leads the Health Equity Research Collaborative (HERC), a group of Toronto-based researchers who are interested in health disparities and community-based solutions.

“The goal of this project is to reach out to women and break the silence by promoting prevention and screening,” said Nnorom, who is also Associate Program Director of the Dalla Lana School of Public Health’s Public Health and Preventive Medicine Residency Program.

The project is known as Ko-Pamoja, which means “learning together.” It is Toronto’s first partnership of community members and academics to design a breast and cervical cancer peer education program with an Afrocentric lens. This pilot project took place from fall 2015 to January 2016 and trained two community members to lead five educational sessions at TAIBU Community Health Centre, located in Malvern, Toronto.

The Canadian Cancer Registry does not collect information on race or ethnicity, but according to the American Cancer Society, African American women have a 41 per cent higher breast cancer death rate, and are nearly twice as likely to die from cervical cancer as white women. Canadian research indicates that immigrant women, including black women, are less likely to get their mammograms or pap tests and often go to the doctor later on, when a cancer has progressed and it is harder to treat.

This was the case for Leila Springer, a breast cancer survivor and Ko-Pamoja collaborator who was diagnosed with an aggressive form of the disease in 1999.

“My entire life changed after the diagnosis. I realized that life is short. Now I talk about the importance of a mammogram,” said Springer who, following her treatment, received regular mammograms and avoided a second cancer diagnosis.

“Had I not done a [second] mammogram, my outcome could have been very different,” said Springer, founder of the Olive Branch of Hope, an organization that provides support for women who have been diagnosed with cancer.

Upon program evaluation, Dr. Nnorom and the research team, including Dr. Aisha Lofters, a family physician at St. Michael’s Hospital, and Nakia Lee-Foon, a PhD student in Social and Behavioural Health Sciences at the Dalla Lana School of Public Health, found that there was a general increase in awareness of risk factors for breast cancer and cervical cancer and benefits of screening and early detection. Most participants reported they planned to get screened post-education.

“We need more community-focused research and education for black women to improve cancer screening and outcomes,” said Nnorom, who is the primary care lead of the Central East Regional Cancer Program.

“In fact, we need more culturally-specific cancer prevention programs and research to address the needs of the diverse communities in Ontario.”

Ko-Pamoja was funded by a community research grant from Women’s College Hospital.

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