Colon cancer was identified as a priority in Livingston County through the Mobilizing for Action through Planning and Partnership (MAPP) process in 20 IO and a Community Health Assessment in 2013. In addition to community surveys and forums, data revealed the incidence of colon cancer among males was 79.8 and 61.8 for female, both of which were higher than New York State rates. In an effort to reach a greater number of individuals, the Livingston County Department of Health originally chose to implement the practice in the Village of Geneseo because it is centrally located with many businesses and high traffic flow. The Village of Mt. Morris was selected for the second year because there are a higher number of low-income residents and a revitalization of Main Street was drawing an increasing amount of visitors to the area. From 2012 to 2015 the practice was implemented in all of the villages.
A survey was conducted at the Parish Outreach Center, which serves the uninsured population. Of those surveyed, only 57. I% oflndividuals over 50 years old had colonoscopies. The most common reason for getting a colonoscopy was doctor recommendation. Common reasons for not getting a colonoscopy from those over 50 included no health insurance and fear of the experience or the results of the colonoscopy. About 51.7% of the individuals surveyed have talked to their doctors about colonoscopies. The Cancer Quality Improvement revised the media and outreach campaign as per the survey responses to better met the target populations' needs. Meetings and mailings to primary stakeholders, which included elected village officials, Main Street Managers and local business owners, were vital to the success of the planning and implementation of the practice. This practice intends to encourage local residents to receive regular, age-appropriate colon cancer screenings to improve the health of Livingston County residents. The objectives are to have all villages participate in the initiative from 2013 to 2015, to implement a media outreach campaign to increase the community's awareness regarding the importance of these screenings and the Cancer Services Program, and to increase the number ofcolonoscopies by 10% from 2012 to 2014. All of the objectives were met. Strategies included developing and/ or revising outreach and media campaign efforts, ordering supplies and purchasing additional items, contacting local groups gain their support to assist in planning, collaborating with local officials, and conducting planning and debriefing meetings.
The Livingston County Department of Health continues to foster collaboration with community stakeholders by ensuring their participation in the practice prior to, during and after the event. Input and suggestions from stakeholders are strongly encouraged. Recognition of the stakeholders' assistance and dedication to the cause is noted through thank you letters, ads and during committee meetings.
The first primary objective of Main Street Goes Blue is to implement the practice in all villages in 2013-2015. Performance measures included the number of participating villages. The Cancer Service Program of Livingston County Coordinator sends letters and meets with elected officials to ensure participation. The Department has learned that contact with elected officials at least one year before implementation of the practice is helpful to allow the official time to consider participating and discuss issues with other village officials and business leaders. The Cancer Services Program Coordinator requests feedback from the local elected officials and business owners.
The second objective is to implement a media and outreach campaign to increase the community's awareness regarding the importance of these screenings and the Cancer Services Program. The LCDOH track media and outreach activity to ensure appropriate implementation. Additionally, this was measured by the number of individuals who responded to the free drawings and the number of participants who received information at businesses and display tables. The Cancer Service Program Coordinator tracked the number of individuals impacted by the practice.
The third objective is to increase the number of colonoscopies by 10% from 2012 to 2014. The LCDOH exceeded this objective as the increase was 24%. Noyes Memorial Hospital has developed a tracking system which provides the number of colonoscopies monthly and yearly basis.
Sustaining the Work:
There is sufficient stakeholder commitment to sustain the practice. The Livingston County Department of Health administration and staff are committed to the practice as it saves lives and it was identified in the MAPP and Community Health Assessment process as a priority. The Cancer Services Program Grant continues to be implemented in our community. Additionally local elected officials have expressed an interest in participating in the practice as they have seen the success in the past two years. The University of Rochester Division of Gastroenterology and Hepatology has agreed to continue to fund the practice for 2013 and beyond. The educational materials are free of charge and the participation packets for local businesses need minor revisions from year to year, which made the practice easy to expand to the entire county.
This innovative practice addresses an important public health issue by collaborating with elected officials, local businesses and community partners to engage employees and customers by encouraging individuals who are 50 and older to get screened for colon cancer. The practice reduces stigma and misinformation regarding these screenings. The Cancer Services Partnership provides support and free cancer screening services to eligible residents, which increases access to healthcare among the disparate population. The goals are to raise awareness regarding colon cancer and to increase the number of County resident who are screened for colon cancer. The objectives are to have all villages participate in the initiative from 2013 to 2015, to implement a media/ outreach campaign to increase the community's awareness regarding the importance of these screenings and the Cancer Services Program and to increase the number of colonoscopies by 10% from 2012 to 2014. All of the objectives were met.