Memorial
Sloan
Kettering Cancer
Center
Immigrant
Health &
Cancer
Disparities Service
Towards
Equity in Health
Welcome to the Immigrant
Health
and
Cancer
Disparities
Service
For
more
than
20 years,
the
Immigrant
Health and
Cancer
Disparities
(IHCD) Service
has worked
to identify
and eliminate
disparities
in health
and
cancer treatment
among immigrants
and
minorities.
Housed
at Memorial
Sloan-Kettering
Cancer
Center
since
2011,
the
IHCD
Service
offers
a wide
range
of
programs
for patients,
healthcare
professionals,
and
patient advocates.
Our
team
uses
a
multidisciplinary
approach
to
address
gaps
in healthcare
at the
local, national,
and
global
levels.
Our
community-based programs
provide
a gateway
to health
education
and services
for immigrants
and
other medically
underserved
minorities
in New York
City
and
beyond.
Through
our
research
initiatives,
we
continually
assess
the
impact of
our
programs
and
seek
to
identify
disparities
in cancer
treatment
and
healthcare.
We
are
also working
to increase
the
representation
of
minorities
in clinical
trials.
In
addition,
our
team
offers
medical
translation
and cultural
competency
training
for healthcare
professionals
and
patient
advocates
at Memorial
Sloan-Kettering
and
at other
medical
centers
throughout
the
United
States.
We
are
currently
recruiting
for
our Internship
Program
in which
interns
can participate
in a
variety
of
our
programs
and
projects
(some
listed
below among
many
more!)
Our
internships
encompass
a wide
variety
of
disciplines
ranging from
public health
and medical
translation
services
to
community
outreach
and interdisciplinary
research
study.
We encourage
students
from
all
majors
to apply!
Below are descriptions of
the Immigrant
Health and
Cancer
Disparities Service and
the programs
conducted
FOOD
(Food
to
Overcome
Outcomes
Disparities)
Program/Outreach:
The Food
to
Overcome Outcomes Disparities
(FOOD) Program
is a hospital-based
pantry
program
designed to
address food
insecurity
among
cancer patients in
active
treatment,
in order
to improve cancer
treatment adherence
and
outcomes. The
Program runs pantries
in seven
different hospitals
across New
York
City boroughs on
a weekly
basis. FOOD also provides
case management to
patients enrolled
in the
Program, connecting them
to non-clinical
supportive
services for the
duration
of
their treatment. We
work with patients
with all
cancer diagnoses,
many
of
whom
are immigrants
who do
not have access to
necessary
resources.
Due to
overwhelming
need, FOOD
has been
rapidly growing and now
typically
sees
100
patients per week and
distributes over 3,700
meals per month.
We
participate in
the NYC
DOHMH’s Health
Bucks program, which provides coupons
that patients can redeem for
fresh
fruits and
vegetables at farmers markets
around New
York
City.
In 2015,
we distributed
1,628
coupons to
patients across all
sites.
Ongoing
Projects:
Nutrition workshops
FOOD
is
working with the
New
York
Common
Pantry to organize bilingual
nutrition education
workshops
for patients in
English and
Spanish. We have successfully piloted
a six-series,
Spanish
workshop
at
Lincoln
Hospital
in the Bronx, and
will
soon be
piloting the same workshops
in English at
a second
site.
MSKCC
pantry
FOOD
is
working with the
social
work and
nutrition departments
to establish the
first pantry
for
patients
being treated
at
MSKCC.
Examining
food
insecurity among
SNAP recipients
We are examining levels
of
food
insecurity among patients who
receive SNAP
and
pick up
food
at
our
pantries,
but who
still struggle
with insufficient
food access.
FOOD
Randomized
Controlled
Trial
We are
conducting
a three-arm randomized
controlled
trial
study
to evaluate whether participation in
FOOD
leads to
statistically
significant
improvements in
quality
of life, food
security,
medical
appointment keeping, a ‘Healthy
Eating
Index,’
and weight
maintenance.
Program Successes:
Targeted
programming for metastatic breast
cancer patients
We recently completed
targeted
programming
for metastatic
breast cancer (MBC) patients, supported
by Avon-Pfizer funding,
which included
recruiting, enrolling, and
case managing
30 women
with
MBC.
Program
of
excellence
FOOD
was named
a “program
of excellence”
by the Atlanta-based
Jackson
Healthcare, receiving
a
$10,000
award
at the
2016 Hospital
Charitable Services Conference on
community-based
work.
ARAB
HEALTH
INITIATIVE
Program/Outreach
Immigrant Health
&
Cancer
Disparities’ Arab
Health Initiative (AHI)
provides patient education
in Arabic, helps
patients’
access to
healthcare services, and
conducts research to
improve health
outcomes
among
Arab communities both locally and
internationally.
AHI aims
to address cultural, linguistic and
socioeconomic barriers
to accessing health
services among
Arab
communities.
To
this end,
AHI collaborates
with community
and
religious-based organizations servicing
the Arab
community,
to conduct health awareness workshops
and
link community
members to
health resources.
The Arab
American
Breast Cancer Education and
Referral Program (AMBER) aims to
improve breast cancer
screening
rates and
treatment
outcomes among
Arab
American
women by
providing culturally
sensitive patient
education
about breast cancer and
facilitating access to
breast
health and
treatment
services
through Arabic
speaking
access facilitators.
The Colorectal
Cancer Initiative,
modeled
after the AMBER program, provides colorectal cancer education
and
assistance with screening
to Arab
men
and
women.
Events:
Educational
Workshops,
Teen
Workshops,
Health Fairs, Mammography
Van
Screenings, Cultural
Competency
Trainings
Research
Evaluation
of
a Culturally-Tailored
Education
and
Support
Program
for
Arab
American
Women
with
Breast
Cancer
Objectives:
To
obtain
participants feedback
on
the impact of an
Arabic language
support group
on
the
general wellbeing, coping
strategies, and
treatment appointment adherence
among women
who have
attended
one or more sessions.
Socioeconomic
determinants
of
breast
cancer
diagnosis
and
treatment
completion
in
Egypt
Objectives: To assess
the
socioeconomic
determinants of
breast
cancer diagnosis
and
treatment
completion
and
late-stage
diagnosis of Egyptian
breast cancer patients treated
at Ain
Shams University.
Colorectal
Cancer:
Arab
American
Community
Perspective
Objectives:
To assess knowledge of, and
perceived
susceptibility to,
colorectal
cancer
among
Arab
Americans;
To
explore the
influence of
cultural, social,
religious
and
healthcare-related
factors on
accessing colorectal
cancer screening
services;
To
compare the Arab
American
communities of
New
York
City and
Detroit,
Michigan vis-à-vis the above
two aims.
Language
Initiatives
Program
Program/Outreach:
Immigrant Health
&
Cancer Disparities’
Language Initiatives Program supports researchers,
community
hospitals
and
outreach
programs in
their endeavors
to serve
diverse populations
with linguistic and
cultural competence,
and by
extension,
support and
augment cross-cultural
research.
Our efforts to
this
end
include translation,
transcription, trans-creation,
localization, field-testing instruments,
as well as
interpreting in
research and
community participatory
research
settings
and
conducting focus
groups.
We
look to
collaborate
with
institutional
programs that provide patient services
to ensure linguistic and
cultural
responsiveness,
presently
supporting
patient
education
activities. We regularly
engage in
language neutral and
language specific training efforts,
staff interpreter
assessments in
various
languages
and
contribute to
the on-going
discourse
regarding best
practices within
the field of
medical
interpreting
and
language
access services.
Our Workshop
Series is
a vehicle
for nurturing
our
robust pool
of language
specialists, trainers
and
evaluators.
Our
training efforts
include
audio,
distance learning development and
innovation.
Our latest research
project is
an error analysis
to evaluate existing
validated
tools
that have
been
translated. Our
future plans include
implementing a
pilot
project in Remote
Simultaneous
Medical Interpreting at
MSK,
as well
as collaborating
with
COMSKIL
(a
key
center
for professional
development
in core
communication
skills).
Research support:
We
are
presently
providing
support
services to
various
researchers throughout
MSKCC.
Key Training
Programs
Include:
Medical
Interpreting
Training
Program:
Our
medical
interpreting training program offers
courses on
medical
terminology,
the role of
the
medical
interpreter,
and
medical
ethics
in a variety
of healthcare
settings. Bilingual
interns who
have an interest
in medical
interpreting
(and
can
pass a fluency
assessment) are welcomed
to participate in
these
trainings.
Cultural
Responsiveness Training:
This
dynamic
program
trains
clinical and
medical
administrative
professionals in
how to
improve cross-cultural communication in
healthcare settings, and
offers
resources to
circumvent language barriers with
the use
of
interpreters.
Consulting Services:
Our staff works
with individual healthcare
facilities
to help them
address their
language
and
translation
needs.
Taxi
Network
Programs/Initiatives:
Taxi
Health
Fairs:
Our
health fairs provide
hundreds
of
taxi
drivers
with free health screening services,
health counseling, and
referrals to primary
care providers to
prevent and manage
chronic diseases such as
diabetes, high blood
pressure, and
high cholesterol.
We
also provide free referrals to
cancer screening and
treatment centers.
In addition,
we implement
a robust follow-up
protocol
for
all participants
in need
of further counseling.
Community Advisory
Board
(CAB):
The
Taxi
Network
CAB includes fourteen
drivers who
maintain strong
connections
within
the taxi
driver community,
and
represent the
full
range
of the
taxi
driver
experience,
including
varied
shifts, income, education, age,
ownership/lease arrangements, and
countries
of
origins.
Data and
Research
on Interventions
to Improve
the
Vehicular
Environment (DRIIVE):
This pilot
study
aims
to
fulfill three primary
objectives: obtain
preliminary
data on
the
association
between particulate matter and
physiological
markers in
taxi drivers,
determine the impact
of
a HEPA
air filter
intervention
by evaluating physiological
markers and
measurements,
and
build
evidence for
the exacerbated
risk
of
health problems that
drivers face
due to
exposure to
particulate matter.
Three groups
of
14
participants
are being recruited
for this study.
A
Pedometer Based
Health
Intervention
among NYC
Taxi Drivers:
To
address
the
lack
of
regular
physical
activity
and
related health concerns
within
the NYC
taxi
driver community,
a feasibility
study implementing
a pedometer
service
delivery program across
taxi driver social
network
sites is being
conducted.
Sixty NYC
taxi
cab
drivers are being
recruited via
their social networks
at separate driver-
frequented
locations
in NYC
.
Community
Needs Assessment
Among
NYC
Taxi
Drivers:
This street-side
survey is
being conducted
to describe
and
assess
the health and
occupational
needs and
priorities of NYC
taxi
drivers as the
first
step
towards
understanding cardiovascular (CVD)
and
cancer related risk and
health
disparities in
this
population.
In
Depth Interviews:
This
qualitative study
aims
to
detail
the drivers’ understanding
of
stress,
its role in
their lives,
and
the range of strategies
in
use to
ameliorate it. Semi-structured
in-depth interviews were
conducted with
English-speaking
yellow cab
drivers in
New York
City.
Affordable
Care
Act (ACA)
Workshops at
Driver Frequented
Sites:
The
complexity
of
the health care
system deters immigrant taxi
drivers from utilizing health insurance.
To
address this issue,
IHCD
has
developed an
outreach
intervention to
navigate drivers into
the health care system through
educational
workshops on
the
Affordable
Care Act.
Ventilla
de
Salud
Program
Ventanilla de Salud (VDS)
is
a partnership
between
the Mexican
Consulate and
IHCD
to provide disease
prevention
services, increase access
to preventive care, raise awareness around
health related
issues, and promote
healthy
lifestyle
choices for Latino
communities in
New York
City.
Through
this collaborative
effort the
VDS
program addresses
its key
objective: to decrease health
disparities
in the Mexican
community. When
visiting a Ventanilla de Salud,
Mexicans, Mexican
Americans
and
Latinos have access
to diversity
of services,
resources and
on
site programming designed
to raise
awareness,
inform and
provide options for
care.
We are launching
a
new
nutrition
project
entitled
“COMIDA”, aiming to assess
and address obesity
and food
insecurity
among the
Mexican
community
members who
attend
(VDS).
The
COMIDA
intervention consists of
BMI
and food
insecurity assessment;
administration
of
a 24 hour
dietary
recall with qualitative capture
of
food
choice reasons;
either
a tailored
individual
education
session
or an educational
group workshop; weekly
nutrition
text messages;
low
literacy
Spanish-language written
materials; and
linkages with
food
resources (e.g. food
pantries).
We plan
to enroll
a convenience sample
of
100
food
insecure, overweight
or obese participants
in the individual
sessions and 100
participants in
the group sessions.
Programs/Initiatives:
Health
Fairs: At
the
Mexican
Consulate and
throughout
New
York
City; staff
provides assistance with:
1.
Case management
2.
Assistance
with
enrollment
in
health insurance
plans
3.
Free cancer screenings
and
referrals
4.
We are
also
working to
combat cervical
cancer in
the Mexican
community, through
referrals
for
Pap testing and
programs to
increase human
papillomavirus (HPV) vaccination
rates.
5.
Free
cholesterol, glucose, and
blood pressure
screenings
6.
Referrals to
low cost health clinics
7.
Educational workshops in
nutrition, high blood pressure,
and
cancer screenings.
8.
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