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社区抗癌:一项定性研究,评估社区参与倡议在提高边缘化社区癌症意识方面的有效性。

Communities against cancer: a qualitative study assessing the effectiveness of a community engagement initiative in improving cancer awareness for marginalised communities.

作者信息

Wright David, Foster Rebecca, Miles Phoebe, Duffield Nicola, Rickard Sally, Frankland Jane, Calman Lynn, Foster Claire

机构信息

The Centre for Psychosocial Research in Cancer, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, University Road, Building 67/4061, Southampton, Hampshire, SO17 1BJ, UK.

Wessex Cancer Alliance, Oakley Road, Southampton, Hampshire, SO16 4GX, UK.

出版信息

BMC Public Health. 2025 May 31;25(1):2011. doi: 10.1186/s12889-025-23179-0.

Abstract

BACKGROUND

Marginalised communities (including minoritised ethnic groups and people with lower socioeconomic status) often present with a late cancer stage at diagnosis, affecting survival. This is due to many factors including cultural barriers, mistrust of health services and low levels of cancer awareness. Communities Against Cancer (CAC) aimed to promote cancer awareness and healthy lifestyles and help-seeking behaviours for marginalised communities through a grant-scheme that provided funding for community-led projects, which ran from 1st January 2021 - 31st December 2022. This paper reports findings from a study that assessed whether CAC met its aims and the characteristics of successfully delivered projects.

METHODS

A qualitative approach was used involving interviews and observations of meetings and community activities, supported by documentary analysis of minutes, grant applications, reports and quantitative descriptions of grant-level data. Participants included representatives from the funder and grant distributor, community advocates, applicants and recipients of CAC funding. Thirty-seven people were interviewed, all of whom were invited to a second follow-up interview. Twenty-one participants agreed to a second interview, resulting in 58 interviews in total. Interview transcripts and observation fieldnotes were analysed thematically.

RESULTS

CAC community grants encouraged: 1) healthy behaviours (e.g. families on low incomes reported healthier diets); 2) screening and PSA testing uptake (e.g. a group representing neurodivergent people created a film of a breast screening unit, encouraging attendance); 3) awareness of signs and symptoms (e.g. one radio station for South Asian communities broadcast an episode on signs of prostate cancer, their most downloaded programme); 4) help seeking behaviours (e.g. one South Asian community group held meetings with pharmacists, primary care and hospital staff, building trust with local services). Seven characteristics were identified for successful projects (defined as meeting at least one of the initiative's aims: raising awareness of healthy behaviours, screening uptake, awareness of signs and symptoms, and help-seeking behaviour). The characteristics were: 1) projects are designed with an understanding of the community; 2) effective planning before delivery; 3) projects are co-created with the community; 4) alignment with group values; 5) building community members' confidence; 6) effective communication; 7) adaptability and evaluation.

CONCLUSIONS

The community-based grant model adopted by CAC enabled community members to self-define effective strategies to deliver cancer messages to their communities. As a result, the CAC initiative met its aims of promoting cancer awareness, encouraging healthy lifestyles and help-seeking behaviours by ensuring activites were fully tailored and co-created with marginalised communities.

摘要

背景

边缘化社区(包括少数族裔群体和社会经济地位较低的人群)在癌症诊断时往往处于晚期,这影响了生存率。这是由多种因素造成的,包括文化障碍、对医疗服务的不信任以及癌症意识水平较低。抗癌社区组织(CAC)旨在通过一项资助计划来提高边缘化社区的癌症意识、促进健康生活方式和寻求帮助的行为,该计划为社区主导的项目提供资金,实施时间为2021年1月1日至2022年12月31日。本文报告了一项研究的结果,该研究评估了CAC是否实现了其目标以及成功实施项目的特点。

方法

采用定性研究方法,包括对会议和社区活动进行访谈和观察,并辅以会议记录、资助申请、报告的文献分析以及资助层面数据的定量描述。参与者包括资助者和资助分配者的代表、社区倡导者、CAC资助的申请者和受助者。共采访了37人,所有人都被邀请参加第二次跟进访谈。21名参与者同意参加第二次访谈,总共进行了58次访谈。对访谈记录和观察笔记进行了主题分析。

结果

CAC社区资助鼓励了以下方面:1)健康行为(例如,低收入家庭报告饮食更健康);2)筛查和前列腺特异性抗原检测的接受度(例如,一个代表神经发育障碍人群的团体制作了一部乳腺筛查单位的影片,鼓励人们前往筛查);3)对体征和症状的认识(例如,一个面向南亚社区的广播电台播出了一期关于前列腺癌体征的节目,这是他们下载量最高的节目);4)寻求帮助的行为(例如,一个南亚社区团体与药剂师、初级保健和医院工作人员举行会议,与当地服务机构建立信任)。确定了成功项目的七个特点(定义为至少实现该倡议的一个目标:提高对健康行为的认识、筛查接受度、体征和症状的认识以及寻求帮助的行为)。这些特点是:1)项目设计时了解社区情况;2)实施前进行有效规划;3)与社区共同创建项目;4)与团体价值观一致;5)增强社区成员的信心;6)有效沟通;7)适应性和评估。

结论

CAC采用的基于社区的资助模式使社区成员能够自行确定向其社区传递癌症信息的有效策略。因此,CAC倡议通过确保活动完全根据边缘化社区的情况进行量身定制和共同创建,实现了提高癌症意识、鼓励健康生活方式和寻求帮助行为的目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8f6/12125787/6a797b64099a/12889_2025_23179_Fig1_HTML.jpg

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