Problem Addressed: Cancer

Healthy People 2010 Objective: 3

Web Address: http://www.scdhec.net

SNAPSHOT

The South Carolina Department of Health and Environmental Control’s (SCDHEC) Office of Minority Health (OMH), under contract with the U.S. Department of Health and Human Services Office of Minority Health (DHHS OMH), developed and implemented Real Men Checkin’ It Out, a community-driven, culturally appropriate education and communication initiative addressing prostate cancer in the African-American community. Real Men Checkin’ It Out provides prostate cancer screening, follow-up and educational sessions, technical assistance, training services, one-to-one screening, one-to-one follow-up, and culturally appropriate social marketing outreach initiatives.

THE MODEL

Blueprint: There has been limited attention directed toward men’s health issues in the area of primary prevention. Within the last decade, prostate cancer emerged as a major health problem and a critical health issue in South Carolina. The prostate cancer mortality rate in South Carolina is one of the highest in the nation. African-American men are particularly at risk for the disease, with black males being two times more likely to die from this cancer than their white counterparts.

Real Men Checkin’ It Out is a two-phase demonstration project. Phase I focused on community prostate cancer education and awareness through various community-based grantees in one county. The current Phase II of the project expands activities to include prostate cancer screening through specific partnership grants with Historically Black Colleges and Universities (HBCUs) in three counties.

The project activities target at risk African-American/black men ages 40-70. The project also focuses on African-American/black men (21-39) who are less at risk; African-American/black females (ages 21 and over); and young adults (ages 17-20) as secondary target groups for reaching and providing information and education to the priority targeted African-American/black males.

The goal of Real Men Checkin’ It Out is to educate African-American men about prostate cancer and to ensure the provision of appropriate screening and follow-up services by engaging the state’s HBCUs located in Orangeburg, Bamberg, and Richland Counties¾two of which are rural counties. The emphasis for the current initiative (Phase II) is screening. Benedict College, Claflin University, and Palmetto Health in collaboration with Allen University, and Omicron Phi Chapter, Columbia South Carolina of the Omega Psi Phi Fraternity, Inc., implemented the project activities.

The staffing required for Real Men Checkin’ It Out includes a South Carolina OMH director who provides oversight and direction for the project, a health disparities consultant who serves as the program coordinator, an epidemiologist who provides guidance with data and evaluation, a media consultant who assists with an awareness campaign, and an administrative assistant who provides administrative support.

OMH provides administrative and programmatic staff support to assist with the coordination of project activities with the grant recipients (partners). Each partnership/grantee has a non-paid project coordinator. Individuals from the grantees and other organizations, which include nurses, administrators, counselors and instructors, etc., provide other in-kind or donated services. Volunteer staff is from the faith community, media, and civic and fraternal organizations who provide support to implement the outlined project activities.

Making a Difference: The plan incorporates three separate categories/stages of evaluation to address the process of implementation, provision of technical assistance/support, and outcome assessment. The process evaluation seeks to address:

· the types of activities that will be carried out by the prostate cancer initiative and by whom,

· the timely manner in which activities were initiated/performed (contractor),

· the barriers that were encountered and how were they overcome,

· to what extent the actual cost of project implementation is in line with initial budget expectations.

The process evaluation tools include: Real Men Checkin’ It Out Time-Line, Program Activity Check List, and Budget Proposal vs. Actual Budget.

The performance evaluation provides feedback on OMH’s execution of its role as contractor for the initiative. The evaluation seeks to address: to what extent did OMH provide technical assistance/support, the effectiveness and efficiency of services/trainings provided by the contractor, and to what extent were resources identified to sustain activities beyond the project period. The evaluation tools for the performance evaluation include: Grantees Focus Group, Real Men Training Evaluation, and Resource Guide.

The outcome evaluation provides data on the community response to the initiative and the effectiveness of the education and screening components. The evaluation addresses the receptiveness of the community toward the initiative, to what extent community members were willing to be screened, was the initiative viewed as a successful venture by the community and program implementers, and obstacles/challenges in implementing the program and/or gaining community buy-in. The outcome evaluation tools include: Education Seminar Evaluation, Log Sheet for PSA Screening, Community-Based Organizations (CBOs) Evaluation of Initiative, and Grantees Focus Group.

Beginnings: In 1998, the South Carolina Department of Health and Environmental Control’s Office of Minority Health, under contract with the U.S. Department of Health and Human Services Office of Minority Health, developed and implemented Real Men Checkin’ It Out, a community-driven, culturally appropriate education and communication initiative addressing prostate cancer in the African-American community. The program recently received additional funding to continue its efforts and to expand the Real Men Checkin’ It Out prostate cancer education community initiative.

Within the last five years, several organizations in South Carolina have given attention to prostate cancer, focusing on both education and screening. While these efforts have played an important role in addressing this disease and identifying the lack of education and screening as critical gaps in early intervention, they have not taken into consideration the need to seek community involvement in the development and implementation of acceptable educational programs for the target population. A culturally appropriate, public-health-based educational outreach approach was needed to enhance current efforts.

Challenges and Solutions: Initial funding supported a one-year demonstration project, and additional funding was received in 2001. Between the two-year break in the funding cycle, the community, including churches and fraternal organizations, either funded or voluntarily carried out the project activities. If additional funding becomes available, SCDHEC-OMH will apply to continue this prostate cancer initiative. SCDHEC-OMH will also assist in identifying other funding opportunities for the current grantees as well as other organizations to sustain and implement the existing prostate cancer project.

The most difficult challenges for the program have been timely submission of initial Requests for Proposals, identifying physicians to participate, and recruitment of men for screening.

PROGRAM CONTACT INFORMATION

Rita Jefferson

Real Men Checkin’ It Out

South Carolina Office of Minority Health

2600 Bull Street

Columbia, SC 29201

Phone: (803) 898-2490

Fax: (803) 898-3810