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Environmental/Lifestyle Cancer
Communication Workshop
Principles in Action
This Toolkit describes a workshop
related to environmental cancers
exploring effective communication
between health and environmental
professionals and community groups.
Cancer Communication Workshop Toolkit
Contents
 Background
 Objectives
 Meeting Format
 Attendees
 Agenda
 Case Scenario
 Break-Out Sessions
 Conclusions/Recommendations
Cancer Communication Workshop Toolkit
Background
Information from 30 Roundtables and Forums
determined that Appalachian communities viewed
cancer as an environmental issue
and that ……..
Project was funded by an Appalachian Regional Commission(ARC)
and Centers for Disease Control and Prevention(CDC) interagency
agreement with East Tennessee State University
Cancer Communication Workshop Toolkit
Background
(continued)
 Rural communities blame high cancer rates on
immediate environmental threats such as
employment exposures or coal mine run-off.
 However, professional health agencies blame the
high rates on personal lifestyle choices and behaviors
such as smoking, poor diet, and lack of exercise.
 As a result, a gap occurs in the knowledge or beliefs
about the roles of environment and lifestyle choices
as causal factors for cancer.
Cancer Communication Workshop Toolkit
Background
(continued)
This Toolkit describes the Appalachian Environmental
Cancer Communication Workshop held at ETSU,
Johnson City, Tennessee, March 28-29, 2011.
Cancer Communication Workshop Toolkit
Objectives
Objectives of this Workshop were to:
 Bring professional and community representatives
together to determine common barriers to effective
communication about environmental issues related to
cancer,
 Identify approaches to improve their interaction, and
 Determine how comprehensive cancer coalitions can
effectively engage and assist communities around
issues enmeshed in lifestyle and environmental
causes of cancer.
Cancer Communication Workshop Toolkit
Workshop Format
The Workshop was scheduled as a two-day
event including attendee travel time to and
from the event. Arrangements were made
for extended accommodations for
attendees who required longer
than four hours travel time. A
venue was selected that provided
space for plenary, breakout
sessions, and meals.
Cancer Communication Workshop Toolkit
Agenda
March 28, 2011
5:00-7:00
Dinner Meeting
March 29, 2011
8:00-8:30
Breakfast
8:30-9:00
Case Scenario Presentation
9:00-9:15
Charge to Groups
9:30-10:30
Breakout Session 1
10:30-10:45
Break
10:45-11:45
Breakout Session 2
11:45-12:30
Lunch
12:30-1:15
Group Reports
1:15-2:30
Breakout Session 3
2:30-3:00
Conclusions and Recommendations
Cancer Communication Workshop Toolkit
Workshop Format (continued)
Day 1:
A dinner for the attendees held the evening
before the Workshop introduced participants.
Leaders discussed what the attendees should
expect and what was expected from the
attendees during the event. Attendees were
given instructions that the major focus of the
Workshop was to address communication
issues, not to resolve the schism between the
groups.
Cancer Communication Workshop Toolkit
Workshop Format (continued)
Day 2:
 A constructed case scenario presented as a
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three-act vignette set the scene for the group
discussions
Two break-out sessions for facilitated group
discussions related to the case scenario
Group reports
Discussions of the reports
Conclusions and recommendations on
communication issues
Cancer Communication Workshop Toolkit
Attendees
Three groups were invited to participate in the Workshop:
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Health and Environmental Professionals:
Environmental epidemiology, government
environmental control, local/regional/state health
departments
Community Groups: Environmental activists, local
government officials, concerned citizens
Comprehensive Cancer Control: state program
staff, state/regional coalition representatives
(Four Appalachian States were represented by groups
participating in this Workshop.)
Cancer Communication Workshop Toolkit
Attendees (continued)
When developing the list of attendees:
Health and environmental professionals may be found
by contacting the state Departments of Health and
Environment. The federal Agency for Toxic
Substances and Disease Registry (ATSDR) can identify
state and local contacts.
Community groups may be found by contacting local
government officials and local/state/national advocacy
groups.
Comprehensive cancer control attendees may be found
by contacting the state Comprehensive Cancer Control
Program.
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Cancer Communication Workshop Toolkit
Case Scenario
A three-act vignette was developed to visually,
emotionally, and realistically portray the process of
community and government interaction related to a
possible exposure to environmental carcinogens.
The scenario developed for this Workshop involved
the possible exposure of children to arsenic and
lead from a 100 year-old abandoned foundry site.
The fictitious scenario for this Workshop is available
on this website for download – or you may develop
your own.
Cancer Communication Workshop Toolkit
Case Scenario (continued)
Each Workshop should develop a scenario for
presentation that includes
a realistic environmental cancer problem
that could occur in the surrounding
geographic area and
a community fact-finding investigation by
environmental cancer professionals that
involving citizens, government officials
(political, health, environment),
environmental advocates, and cancer
coalition members.
•
•
Cancer Communication Workshop Toolkit
Case Scenario (continued)
 State and federal health and environmental

agencies have protocols in place to respond to
citizen complaints about environmental
contaminants. Past community investigations
are public record and are available for
information for creating a scenario.
Public Health and Communications students
participated as actors in the vignette for this
Workshop but other local people could be
enlisted.
Cancer Communication Workshop Toolkit
Breakout Sessions
Sessions 1 & 2
These Sessions were facilitated discussions using
questions intended to determine communications
issues related to the Scenario.
Three group breakouts worked best:
Health and Environmental Professionals
Community Citizen Representatives
Cancer Control Program/Coalition Representatives
Each group discussed the issues and made
communication recommendations from their
viewpoint.
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Cancer Communication Workshop Toolkit
Breakout Sessions
Sessions 1 & 2
Questions for discussion for the Professional and Community Groups:
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What are the fundamental facts of the Case Scenario?
What action was taken by the investigators?
How would your group present your case to another group?
Was there marginalization by either group?
What impact does action or no action have on community
participation in the local cancer coalition?
How does the community participate in the cancer coalition
and what are the mechanisms for their participation?
Do lifestyle issues related to cancer etiology play a role?
What makes Appalachia different from non-Appalachia? Or
rural from non-rural or urban?
Cancer Communication Workshop Toolkit
Breakout Sessions
Sessions 1 & 2
Questions for discussion for the Cancer Control Group:
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What are the fundamental facts of the Case Scenario?
What role would the Comprehensive Cancer Control
program play?
What impact does action or no action by the professional
group have on community participation in the local cancer
coalition?
How does the community participate in the cancer coalition
and what are the mechanisms for their participation?
How do coalitions manage these issues when they arise?
Does your state cancer plan include environmental/lifestyle
issues? If so, does it separate environmental issues from
lifestyle issues?
What makes Appalachia different from non-Appalachia? Or
rural from non-rural or urban?
Cancer Communication Workshop Toolkit
Breakout Sessions
Session 3
This Session consisted of a mixture of all groups in
two Breakouts.
Breakout 1: Develop an agenda for a future follow-up
communication conference.
Breakout 2: Generate a list of 10 Do’s and 10 Don’ts
that could help improve communication.
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 A reminder to the attendees was required for these
Breakouts: the topic for discussion is how to better
communicate, not to discuss or resolve
environmental contamination issues.
Cancer Communication Workshop Toolkit
Breakout Sessions
Provide for each group:
Separate meeting spaces, a facilitator, a copy of
the questions, flip charts, and pens.
Public Health and Communications students
participated as facilitators for this Workshop.
Instruction for facilitators was provided prior to
the Workshop.
During the Breakout:
Select a reporter who will take notes on the flip
charts and report back to the plenary group.
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Cancer Communication Workshop Toolkit
10 Do’s
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Offer the solution with
the problem
Provide meaningful
explanation of statistics
Address questions you
receive
Listen and understand
Lead with an action
strategy
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Provide an impartial
facilitator
Have a local champion
present
Spend time with the
community
Draw on local support
Speak up!
Cancer Communication Workshop Toolkit
10 Don’ts
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Don’t arrive with the
solution
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Don’t manipulate the
conversation
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Don’t get hysterical
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Don’t use statistical
jargon
Don’t talk down to
people
Don’t get marginalized
Don’t give up ground
Don’t accept
invalidated information
Don’t “lie” with
statistics
Don’t be a tourist
(know your audience)
Cancer Communication Workshop Toolkit
Workshop Evaluation
The workshop evaluation consisted of:
Five logistic items on a 5-point scale including:
1. Overall Workshop
2. Hotel
3. Meeting Space
4. Food
5. Networking Opportunities
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Eight questions about the workshop
One ‘Other Comments’ section
Cancer Communication Workshop Toolkit
Workshop Evaluation (continued)
•
Eight questions about the Workshop
1. How close was the workshop scenario to actual experiences
that you have encountered regarding environmental and lifestyle
cancer issues?
2. Was this meeting design a helpful way to identify and discuss
communication issues that arise from environmental and lifestyle
cancer risk discussions?
3. Will what you learned at this workshop be helpful to you in
your professional practice or personal advocacy? If yes, in what
way(s)?
4. Please describe your awareness of and involvement in your
state’s Comprehensive Cancer Control Coalition or Program.
Cancer Communication Workshop Toolkit
Workshop Evaluation (continued)
•
Eight questions about the Workshop (continued)
5. What ideas emerged that could be useful to
Comprehensive Cancer Control Coalitions and Programs to
improve cancer education and communication around
environmental and lifestyle issues in the Appalachian region?
6. What was the MOST satisfying thing about this workshop
for you?
7. What was the LEAST satisfying thing about this workshop
for you?
8. I participated in the following group:
Community
Environmental
Comp Cancer
Cancer Communication Workshop Toolkit
Outcomes
We noted these outcomes from our event:
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The meeting design helped to identify causal
issues and differing perspectives on
epidemiology, contamination and advocacy
Networking led to wider connectivity.
Case study scenarios were real and identified
core problems.
Cancer Communication Workshop Toolkit
Summary
The Appalachian Environmental Cancer Communication
Workshop provided an effective forum for bring people
together to develop communication skills to help
narrow the schism that often exists between Health
and Environmental Professionals and Community
Groups related to environmental cancer issues.
Cancer Communication Workshop Toolkit
Sample Agenda and Plan for a Future
Workshop/Forum
1.
Learning Objectives
2.
Agenda – Potential Content
3.
Potential Presenters
Cancer Communication Workshop Toolkit
1. Future Conference Agenda
Learning Objectives:
By the end of this session, participants will be able to:
1) Define “environment” as it relates to cancer
2) Understand how risk estimates are developed
3) Describe how cancer develops
4) Take action in the community through educational
sessions and presentations
Cancer Communication Workshop Toolkit
2. Future Conference Agenda
Potential Content:
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Speaking the same language
Case Studies (arsenic, lead, etc.)
Panel discussion on defining “environment”
Clinical expressions of cancers
Social media and the environment
Risk estimation
Cancer Communication Workshop Toolkit
3. Potential Presenters From:
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Environmental Health
Epidemiology
Clinical Toxicology
Oncology
Comprehensive Cancer Control
Communications or Health Literacy
Cancer Communication Workshop Toolkit
Links to resources about additional Cancer
Causes and Risk Factors
•
National Cancer Institute
http://www.cancer.gov/cancertopics/causes
•
National Institutes of Health- NCI 2009
Annual Report
http://deainfo.nci.nih.gov/advisory/pcp/annualReports/p
cp08-09rpt/PCP_Report_08-09_508.pdf
Environmental/Lifestyle
Cancer Communication Workshop
Toolkit
Contact
Joellen Edwards
East Tennessee State University
College of Nursing
PO Box 70551
Johnson City, TN 37614
423-439-4082
[email protected]