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Black Corals Cancer Education

Summary 
  • Need: African American women in rural South Carolina are almost 40% more likely to die from breast cancer and over 3 times more likely to die from cervical cancer than Caucasian women in the state.
  • Intervention: St. James-Santee Family Health Center implemented a breast and cervical cancer screening promotion program called Black Corals.
  • Results: In 2 years, Pap smear and mammogram rates increased by over 10% and missed appointment rates were decreased by over 30%.
Description

St. James-Santee Family Health Center created Black Corals in order to increase breast and cervical cancer screenings by using recommendations from the Community Preventive Services Task Force. This community health center offers primary and preventive healthcare to underserved community members in 3 rural South Carolina counties.

African American women in rural South Carolina are almost 40% more likely to die from breast cancer and over 3 times more likely to die from cervical cancer than Caucasian women in the state. South Carolina has one of the highest national rates of women without health insurance, which likely limits accessibility to proper healthcare for the early diagnosis and treatment of breast and cervical cancers. In September 2008, the St. James-Santee Family Health Center used The Guide to Community Preventive Services (The Community Guide) to select interventions to implement a breast and cervical cancer screening promotion program in rural African American communities.

Black Corals was a collaborative effort with:

St. James-Santee Family Health Center received grant funding from the Southeastern U.S. Collaborative Center of Excellence for Eliminating Health Disparities, a partnership steered by the Morehouse School of Medicine Prevention Research Center.

Services offered

Nurses and case managers handed out black coral bracelets to African American women in local churches. An insert included with the bracelet provided positive messages about self-worth and the importance of regular medical screenings, particularly for breast and cervical cancers. They also led workshops on the risks and symptoms of such cancers as well as early detection.

A media campaign consisting of posters and flyers was used to inform women of free exams given at the health center. Local churches, restaurants, and other community locations were used to spread awareness about the services provided by Black Corals and the screening programs.

Mammography screening locations were expanded through a mobile health unit provided by the Medical University of South Carolina.

Red folders were inserted into patients’ medical charts as a way to prompt healthcare professionals to inform and educate their patients on the importance and necessity of setting up breast and cervical cancer screenings.

The following cancer interventions from The Community Guide were included:

  • Client reminders and incentives
  • Group education
  • Reducing structural barriers
  • Reducing client out-of-pocket costs
  • Mass media
  • Small media
  • Provider assessment and feedback
  • Provider reminder and recall systems
  • 1-on-1 education

Watch this video to find out more about Black Corals and its impact on the lives of rural women throughout rural South Carolina:

Results

In 2 years, Pap smear and mammogram rates increased by 10% and missed appointment rates were decreased by 30%. There has been a slight increase in the numbers due to patients obtaining medical coverage through a new Medicaid program called Healthy Connections Checkup.

The following 2 new community projects are in progress after St. James-Santee Family Health Center hosted workshops for cancer education:

  • Local African Methodist Episcopal church
    • Applied for grant funds for a cancer screening promotion project
    • Reminders, incentives, social marketing, and group education used to implement the interventions learned from the cancer education workshop
  • Oatland Community Outreach group
    • Formed from a grassroots group of African American women
    • The group founder attended a Black Corals workshop
    • In October 2010 they put on the first breast cancer survivors’ charity walk and cookout
    • Invited to join the Coastal Center Collaborative, which promotes awareness, education, and advocacy in an effort to reduce cancer mortality in this region

Two new policies were created for primary care facilities based on the St. James-Santee Family Health Center’s use of The Community Guide:

  • Free “quick visits” with nursing staff
    • Provides shortened wait times for patients with chronic diseases
    • Serves to motivate patients with diabetes and high blood pressure to comply with their medical care
  • Nurse case management services
    • Assists with mammograms, Pap smears, and self-managing chronic diseases
    • Promotes healthy eating through the upkeep of a community garden to increase fresh fruit and vegetable consumption, physical activity, and overall community wellness

Read this article for more information on interventions, new community programs, and implemented policies.

The program is still being implemented primarily for screening purposes at the health center. Various church groups are continuing to provide the cancer education with materials provided by the St. James-Santee Family Health Center and the American Cancer Society.

Replication

Lessons learned:
As program coordinators plan accordingly, they should consider their population’s needs and local resource availability.

Use messages supporting personal value and self-worth as well as cultural-appropriateness. This helped the Black Corals program reach and engage the audience they were targeting.

Contact Information
Myra Pinckney, LPC, RN-BC, Case Manager & Outreach Coordinator
St. James-Santee Family Health Center
Black Corals
pinckneymd@tds.net
Topics
African Americans
Cancer
Health screening
Wellness, health promotion, and disease prevention
Women
States served
South Carolina
Date added
October 21, 2015

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.