An east Toronto community health centre that primarily serves Black patients went from having abysmal screening rates for breast, cervical and colorectal cancers to ones that surpassed provincial averages in just a few years. The secret to this turnaround? An approach that advocates for health-care providers’ “cultural humility,” which can include anything from using Black models in informational posters to avoiding the word “cancer” when trying to get patients to schedule appointments.
“We know screening can save lives,” says Liben Gebremikael, the executive director at TAIBU, which serves a population that is 85 per cent foreign-born and 59 per cent Black. “Even when it comes to cost, by doing this prevention and early identification and early intervention, you are really saving the system lots of investments and services down the line.”
“With cancer, sometimes there’s a belief that perhaps God is punishing you, or something terrible is happening, or it’s a death sentence,” she said. “The recommendation was that if we were talking about cancer screening, to frame it as ‘preventive care’ if we’re talking to people over the phone, so that they don’t panic or don’t have kind of a visceral reaction to the word.”
Central to this new program was learning “cultural humility,” says Dr. Nnorom. When doctors, nurses and physicians’ assistants provide an emotionally safe space for their patient, without making judgments or assumptions about them, the patient feels empowered to share their opinion. He found that some patients who were newcomers, often immigrants from the African continent, were completely unfamiliar with a health care system such as Canada’s and had many concerns about the implications of getting tested. “Sometimes it’s the concern of ‘What if my screening comes up positive?’” he said, because they would then have to navigate new terrain that could feel overwhelming.
A major data set in the U.S. found the seven-year survival rate from breast cancer for African-American women was significantly worse than it was for white women, even when the cancer was detected at stage one, points out Ophira Ginsburg, a Canadian oncologist and global women’s health expert who is currently a senior visiting scientist at the International Agency for Research on Cancer.
OnyeActiveMD Great program and example of true patient centred care . Several learnings for other areas of healthcare . TY OnyeActiveMD TAIBU_CHC for sharing
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