Get the Conversation Started!

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Get the Conversation Started!

  1. 1. Get the Conversation Started! A Toolkit For Developing Events to Connect State Comprehensive Cancer Control Coalitions and Programs with Underrepresented Areas
  2. 2. Acknowledgements These products are dedicated to the late Barbara Wethers, Program Analyst at the Centers for Disease Control & Prevention. Barbara’s passion, dedication, and commitment made it possible to creatively meet its long term goals. The project was financed by a grant from the Appalachian Regional Commission, a regional economic development agency that represents a partnership of federal, state, and local governments, and the Centers for Disease Control, the US Department of Health and Human Services’ health promotion, prevention, and preparedness agency. We give credit to Bruce Behringer, former Director of the East Tennessee State University Office of Rural and Community Health and Community Partnerships (Associate VP for Health Affairs), who spearheaded this issue in Appalachia for over 12 years and was its conceptual architect, and to Jill Bumpus Edwards, the Project Coordinator who coordinated these projects.. Special thanks to Henry King, former director of Program Operations, and Eric Stockton, Health Program Manager, at the Appalachian Regional Commission, for their vision and encouragement. This project would not be possible without the enthusiastic support of the Project Advisory Group: Joe Barker, Director, Office of Epidemiology and Health, Promotion Bureau for Public Health, WVDHHR Pamela K. Brown, Director Cancer Prevention and Control, West Virginia University Morgan F. Daven, Director of Public Health Initiatives and State Contracts, American Cancer Society, South Atlantic Division Tina Gill, CDC Public Health Advisor, SE Region, Arkansas DHHS Henry B. King, Director Program Operations, Appalachian Regional Commission O. Anne Larkin, Acting Team Lead, Partnership Development and Collaboration Team, Comprehensive Cancer Control Branch, CDC Division of Cancer Prevention and Control Judy Miller, Director of Case Management, Mountain Empire Older Citizens Doug Wagner, Program Director, Mid-South Region Cancer Information Service at the University of Kentucky Barbara Wethers, Program Consultant, CDC Cancer Control Branch, Division of Cancer Prevention and Control Bob Wise, President of Alliance for Excellent Education, and former governor of West Virginia Overview 1
  3. 3. Welcome Welcome to ETSU’s toolkit on connecting communities with their formal state infrastructure for cancer control. This connection is important because community intuition in the Appalachian region has consistently suspected that there is more cancer in the mountains than other areas of their states, or the country. Like our neighbors we at ETSU have come to believe that health care, people’s health outcomes and cultural influences on health are place-related. The value in considering disparities from a geographic or regional basis allows a look beyond mortality to other disparities in the availability and accessibility of services and in the delivery of care that result in a higher documented cancer incidence and mortality. Considering cancer disparities from a systems perspective that includes individuals, communities, and their interactions with health systems led us to investigate ways to close the gap in communication about cancer prevention, treatment and survivorship. This toolkit offers an overview of our activities in a program that is the latest segment of ETSU’s involvement in regional health disparities, that is, engaging community partners with their statewide cancer coalitions. We invite you to use these ideas and tools to foster conversations between states and rural and underserved areas, between communities and individuals, and among families, health professionals, and cancer coalitions. Overview 2
  4. 4. Toolkit Contents OVERVIEW CCC Structure…………………………………. 4 Brief History of the Program……………….. 5 Introduction to the Toolkit…………...……… 6 TOOLS Develop Your Idea……………………………. 8 Assess Need ……………………………. 8 Identify Partners………………………... 9 Plan & Implement ……………………….…...12 Agenda Development …………………12 Recruitment Efforts ……………………16 Budget …………………………………...18 Logistics ………………………………...20 Evaluation ……………………………………. 22 Measurable Goals …………………….. 23 Stakeholder Needs …………………….23 Linking to a Logic Model……………...24 CONCLUSIONS ….………………………………26 Partnerships ……………………………….… 27 Outcomes ……………………………………..30 Lessons Learned …………………………….31 Give/Get Grid ………………………………....33 Five Outstanding Questions ……………….34 Appendix Bibliography …………………………………..36 Give/Get Grid…………………………………..37 Samples: Request for Proposals(Roundtables).38 Request for Proposals (Forums)……..45 Overview 3
  5. 5. OVERVIEW Use this toolkit as a “how to” guide to develop and conduct roundtable and forum meetings to engage local communities and Comprehensive Cancer Control coalitions. This toolkit is a product of the lessons learned over the two years we facilitated 28 similar meetings. We hope it helps you conduct your own events to increase cancer communication in Appalachia and beyond. Using This Model Can Using This Model Won’t Engage state and local people Broaden involvement Be a starting point and a guide post Develop short-term achievable tasks Solve cancer Force people to be involved Change past difficulties Become an annual activity Be a roadmap The focus of this program was to link Comprehensive Cancer Control (CCC) Programs and Coalitions to rural and underserved communities. The strategy used to more closely connect communities and cancer control groups was a series of events called Roundtables and Forums. The events were designed to develop relationships between the state cancer coalitions, soften active in rural areas, and rural parts of their states that were often less than fully engaged in coalition activities. These events were not meant to be another meeting or annual conference but were key to sharing data or new best practices to assure underrepresented regions or groups were included in state cancer control. Roundtables are shorter events (one day or less) focused specifically on presenting disparate cancer data in a region that has been less engaged in cancer control. Leaders and participants discuss causes, resources, and barriers. They provide a natural opportunity to talk about how people can work together for cancer control goals, share those resources, and address barriers in their own community. Forums are longer events (more than one day) that include data presentations, but also share best practices from under-represented areas. They focus on successes and draw attention to cancer control in the area. They may also include an interactive component where participants discuss what they can give and get from involvement in cancer control activities. Overview 4
  6. 6. Structure Comprehensive cancer control (CCC) programs across the nation work in their communities to promote healthy lifestyles and recommended cancer screenings, educate people about cancer symptoms, increase access to quality cancer care, and enhance cancer survivors' quality of life. They work to establish coalitions, assess the burden of cancer, determine priorities, and develop and implement cancer plans. CCCs were formed over 15 years ago by the CDC and 14 other organizations to reduce the burden of cancer. We have been working with cancer coalitions throughout the Appalachian region for quite a while. We understand that Cancer Coalition & Program structures vary widely from state to state. This may not affect your efforts, but it mattered as we developed these events. The way an event worked in one state was quite different from another state. You may adapt what we describe to fit your state. “No one way works for every state. You may not need to know about coalitions and programs in other states, but you do need to be sure you understand how your state organizes its cancer coalition, its cancer program, and cancer plan.” Some states have a cancer coalition closely linked to their CCC program. Some states have countylevel coalitions – and some only have county-level coalitions. Some cancer coalitions are non-profit organizations; some are moving that direction; and some have discovered that is not a benefit to become a non-profit. Cancer coalitions and programs can be organized through the state’s Department of Health, a university, or be closely allied with a national organization. Some coalitions function well with volunteer activity, but some states need more structure with hired coalition staff to provide support for. Some coalitions are closely allied to their state’s cancer registry and others are only beginning this relationship. Some cancer plans are designed to provide long-term structure. Others adapt and adjust their cancer plan frequently. No one way works for every state. You don’t need to know much about coalitions and programs in other states, but you do need to understand how your state organizes the cancer coalition, the cancer program, the cancer plan, and other services. Don’t just look at how the cancer control structure appears on paper recognize how things actually “function” in your state. Knowing this will help you develop your events in an effective way. Overview 5
  7. 7. Brief History of the Program East Tennessee State University (ETSU) began to understand cancer issues in the Appalachian region more deeply in 2001 through the Rural Appalachian Cancer Demonstration Find the 2004 Report on Program supported by funding from the health disparities, Centers for Disease Control and including cancer, in Prevention (CDC). Over several decades cancer has been a community health Appalachia at concern in almost every ETSU community http://www.arc.gov/rese education and service project. From 2001arch/researchreportdeta 2006 ETSU partnered with the University ils.asp?REPORT_ID=82 of Kentucky and the LENOWISCO Health District in Southwest Virginia to identify personal, community, and cultural factors influencing cancer care use and outcomes. This Partnership sponsored over twenty communitybased participatory studies to understand cancer from a rural community perspective. Concurrently the Appalachian Regional Commission (ARC) supported a study by West Virginia University to document health disparities including cancer in the mountainous 420 county region resulting in its 2004 findings. Beginning in 2006 the ARC and CDC’s Division of Cancer Control collaborated in an Interagency Agreement to sponsor the Comprehensive Cancer Control Plans Implementation in Appalachian Communities Program (from here on we’ll call it “The Program”). The Program was designed to understand how Appalachian community factors influence involvement in organized cancer control activities, from planning to implementation. ARC and CDC wanted to find ways to enhance involvement from the Appalachian regions of states. An Advisory Group of regional cancer leaders, along with ARC and CDC representatives guided the Program, which designed and demonstrated multiple new approaches. The Program partnered local communities with state CCC programs and coalitions in eleven of thirteen Appalachian states. Communities helped identify unique characteristics of their population and their influences on community participation in state programs. ETSU provided small grants for a variety of activities – regional cancer forums, data-based cancer roundtables, community cancer storytelling projects, and development and distribution of professional publications about Appalachian cancer issues. This toolkit relates specifically to the regional forums and data-based roundtables, and is part of the final phase of this program – to share the information we have gathered. Overview 6
  8. 8. Introduction to the toolkit This toolkit is broken into a few sections, Overview, Tools, and Outcomes. We also have an Appendix of resources, and sidebars throughout the toolkit to provide more information. You can review the elements in the What is Inside This Toolkit section at the beginning of this kit. The bulk of the toolkit is found in the Tools section. The Develop Your Idea section will walk you through identifying the purpose for your event and engaging the necessary partners. In the Plan and Implement section take time to develop your agenda, publicize your event effectively, and consider the details. The Evaluation section is one you should bear in mind throughout your planning process. Each stage is important to the success of your event and ultimately to cancer control. How to Make This Toolkit Work for You 1. Adopt when practical Roundtables and Forums can be quite useful in building coalitions. 2. Adapt as needed These tools are not rules. There may be elements not useful to your cause, and there may be additional things you need to incorporate. Don’t discount something because it seems tedious, but don’t hang on to an element if it is not helpful. 3. Be flexible Your situation will be slightly different from everybody else’s. Don’t be afraid to take these ideas and run with them. Overview 7
  9. 9. TOOLS DEVELOP YOUR IDEA Be clear about what you want to accomplish when you decide to hold a Roundtable or Forum. Leaders from our meetings said it was critical that these meetings were not just meeting for meeting’s sake. Start with two key steps – decide why you need to meet and who needs to be involved in the planning. Have “feet on the ground” early in the planning. You want someone who lives and works in the area. If you’re from that area, you want to find feet on the ground in your state CCC coalition or program. Find reports about community-based participatory studies to understand cancer from a rural perspective at: http://www.etsu.edu/kell ogg/racdphomw.htm Assess Need Why do you need to pull people under one roof? Do you want to highlight the work that is already happening? Would you like to share data and talk about it? Whatever your reason for holding the meeting, an important first step is to determine your purpose and build from it. Examples of Needs Assessment for Roundtable or Forum Events Example Komen Affiliate required regular data collection A regional Komen Affiliate developed its proposal in response to a need for community level data. Komen Affiliates are required to assess needs and resources in their communities. This Komen Affiliate used Roundtable meetings to bring people together and present data about cancer incidence and mortality in their area. They discussed the data and listed resources and unmet needs as part of the discussion. This was particularly well-suited to a roundtable discussion. Highlight a Topic of Importance Example Hospice was an issue related to cancer care identified in the Alabama State Cancer Plan. In this Forum, organizers highlighted examples of hospice care and topics of importance related to hospice. The meeting was held at a hospice facility in the highlighted region. The meetings were planned to engage local and state partners so they emphasized the issue in a tangible way by holding it at a hospice center. Tools 8
  10. 10. Example Gather data about a particular cancer Introduce this issue as important The Rural Health Association of Tennessee was interested in drawing attention to Tobacco as an important health issue. Holding a meeting gave them a reason to pull together data about cancers related to tobacco. After data were presented the group facilitated discussion about the issue of tobacco and rallied a coalition of local partners to take action around tobacco-related issues. This was useful to pull together partners who would not normally be around the same table. Identify Partners There are two types of partners to consider. You will have obvious partners which may overlap with another type – “mandatory” partners. Because our meetings were developed to bring together state-level partners with local partners, we required some of each. In some cases that meant a local partner took the lead but was required to engage their state cancer coalition in the planning and execution of a meeting. In other cases the state cancer coalition drove the meeting – with assistance from local partners. It was important to require this cooperation because without the mandate, the meeting might not have happened. Participants and partners in our meetings supported this in their feedback and comments. There were many types of partners in these meetings. They included local organizations, affiliates of national organizations (like American Cancer Society or Komen), hospitals, universities, religious organizations, cultural organizations, state health associations, and other “types.” Whatever their primary affiliation, these partners were organized differently. Steering Committees Most events were organized by a steering committee. In addition to the mandatory partners (representative from the state cancer coalition and a locally-based organization), every meeting had other partners to direct the planning process. Some steering committees were convened specifically to develop this event. Other committees were developed from preexisting networks or used structures that already existed. Below are a few examples. Tools 9
  11. 11. Regional Cancer Networks Example Some states or regions have cancer networks that exist for specific purposes. Some of these are oriented toward research. Events like this can be an opportunity for preexisting networks to branch out into areas or topics. Typically these networks have connections, or ways to develop connections, but may lack a specific motivation to strengthen their work. These meetings could bridge the gap. Remember that these networks usually need to add to or develop their connections to make meetings like this happen. Networks that are more than Cancer (e.g. Rural Health Association) Example One state used preexisting networks and organizational structures that existed for other reasons. They developed new partnerships and engaged new people. Build on Your Cancer Coalition Example Cancer coalitions (and cancer programs) function differently in every state. Some states with well-developed coalitions just needed a reason to rally around a cause. These coalitions drew on the strengths of existing partners. For example, one coalition had a partner who excelled at identifying best practices in a region that wasn’t yet wellrepresented in their coalition. Another partner had the framework to handle the logistics easily. This is a common-sense way to organize a meeting - identify strengths and build areas that need attention. Engage Local Affiliates on a Deeper Level Example Many states with national partners in their coalitions (e.g., American Cancer Society) may lack are local-level representatives. One such partner was a regional Komen Affiliate. The affiliate office didn’t know the communities as well as their local people. They asked someone from each community to handle the logistics of the meeting and the office provided the broader support and framework. This Komen Affiliate held meetings in six different counties –what worked in one county may not have worked as well in another. Empowering local people to use their community knowledge enabled the affiliate to focus on its own strengths and to organize an event that neither the local person nor the affiliate could have done as well on their own. Tools 10
  12. 12. Key Partners Whom do you want to engage? Engage whomever it makes sense to involve. These are key partners we noticed at our events. State CCC program State Cancer Registry State Department of Health Local/regional departments of health National Cancer Institute American Cancer Society Regional Komen affiliate State or private universities (and colleges) Hospice organization Regional cancer networks & health networks Cancer resource & treatment centers Office of Rural Health Policy State or regional Rural Health Association Some additional and helpful links to cancer partners are located on the CDC’s Comprehensive Cancer Control National Partnership website. Possible Data Sources: National Cancer Institute (NCI) http://www.cancer.gov/ CDC State Cancer Profiles http://statecancerprofiles.cancer.gov/ Surveillance Epidemiology and End Results (SEER) http://seer.cancer.gov/ Centers for Disease Control & Prevention http://www.cdc.gov National Program of Cancer Registries http://www.cdc.gov/cancer/npcr/ National Center for Health Statistics (NCHS) http://www.cdc.gov/nchs/ Youth Risk Behavior Surveillance System (YRBSS) www.cdc.gov/yrbs/ Behavioral Risk Factor Surveillance System (BRFSS) http://www.cdc.gov/BRFSS/ North American Association of Central Cancer Registries (NAACCR) http://www.naaccr.org/ Next Steps You’ve developed your idea and identified partners. Hands-on planning is next on the agenda! Tools 11
  13. 13. PLAN & IMPLEMENT Below are some standout examples to provide you with pieces we developed and tested with our events. Agenda Development A predesigned agenda is very useful. While all of our events were designed to engage state cancer coalitions and local partners, we developed two different models to suit the needs we discussed above. Sample agendas are included in the Appendix, but a few key components to each agenda worth discussing here. Agenda Item: Data Presentation Assessing the burden of cancer in a region helps to prioritize programs and interventions. Data can also help to identify needs or gaps in existing program activities. Cancer data usually focus on mortality, incidence, or survival. Coalitions could use data to compile and share information about cancer in a region with respect to: 1) Person (by socioeconomic status, age, race/ethnicity) 2) Place (by location, population density) 3) Time (long-term trends, cycles) 4) Topic (type of cancer, specific risk factors or indicators) Every event in our program had to involve a presentation of cancer data. Groups presented different data in different ways. Being able to visualize your data makes the message real whether a map, charts and graphs, or a combination. Below are some tips to make data presentations more effective. Present Relevant Data A Tip In our meetings we wanted to break down the data in a new way– by sub-state region (Appalachian vs. non-Appalachian). Your situation may be different. Share relevant data – participants expressed appreciation when the data represented their local concerns. Cancer does not affect all populations equally. A critical first step is to identify common areas where improvements may be possible. Below is a glimpse of Joel Halvorsen’s 2009 study that began the talk about cancer rates in Appalachia. Tools 12
  14. 14. Find reliable data from the sources listed. Data is just another word for information. You might present the raw data as numbers or you might illustrate it with maps (like the map below). Present your data in a way that most people can use. Many people use visual cues to understand. Present Data in Lay Terms A Tip Jim Martin, the director of the cancer registry in Virginia, constantly seeks to improve his data presentation. He uses presentations to help explain basic concepts about data. Select someone to present your data who can speak at an understandable level. Attendees left Jim’s presentations with a better understanding of their cancer data. Develop an Index Example Stakeholders interested in colorectal cancer (in Kentucky) and lung cancer (in Tennessee) developed “indexes” to present regional cancer incidence data, mortality, and stage at diagnosis. Concurrent data on risk factors or behavioral indicators (e.g., smoking rates for lung cancer or screening rates for colorectal cancer) also gave a more comprehensive snapshot of the factors influencing regional cancer variations within the state. Below is an example of Kentucky data. Tools 13
  15. 15. Agenda Item: Identify the Best Practices In their Forums our groups highlighted best practices from the Appalachian region of their states using various methods. The Roundtable meetings identified some best practices, as well. By Stage of the Cancer Continuum Example The group in North Carolina identified a variety of best practices and gaps for each stage of the continuum. Because their coalition representative in the targeted geographic part of the state had developed those key relationships throughout the region, they were able to focus their intentions. This is an important part of the process. Get out, meet people, and develop relationships. Roundtable events frequently pinpointed topics of conversation that needed to be developed. After the data presentation, attendees recounted success stories and areas that needed development –by the part of the continuum that was touched. Tools 14
  16. 16. We asked organizers to highlight best practices because the process involves people who are already active in cancer control activities and connected with their CCC coalition. CCC coalitions became more aware of what is already happening in these underrepresented areas. But to identify best practices, someone had to find them. A Tip Develop Relationships on the Ground Key local persons have an important role to play. Ohio organizers were able to identify several best practices because an engaged member of their cancer coalition is connected to local groups. Have a trusted local person involved in your planning. State CCC coalition members may know about what is happening in underrepresented areas. This could be an opportunity for them to highlight outstanding examples taking place. Giving them a framework to identify best practices was helpful to our participants. Different states used different methods. North Carolina identified best practices related to each aspect of the cancer continuum. Stratified Best Practices Example Similar to identifying best practices by part of the continuum, a Pennsylvania group identified similar practices across a region. They broke their Appalachian county regions into sections and found a best practice from each region, allowing for a balanced focus. Other Elements to Consider Some integral agenda elements don’t easily fit into categories. Topical Focus Some meetings looked at the broad spectrum of a specific topic. Two of these (Kentucky and Komen of the Tri-Cities) zeroed in on a type of cancer (colorectal and breast cancers) in their events. The Alabama meeting emphasized an important topic – hospice care. And Tennessee Rural Health Association took the opportunity to focus on a cancer causing agent (tobacco) connected to a few key types of cancer. Choose an interest relevant to your meeting. In preparation for a major campaign to combat a cancer that affects their citizens disproportionately, Kentucky event organizers announced the availability of small grants at their initial meetings then selected from the submitted projects to highlight best practices at a second forum focused on colorectal cancer. Be creative and relevant with topics. Tools 15
  17. 17. Multiple Meetings A few groups took a multiple meeting approach. The first Mississippi meeting fed into the second meeting. Kentucky held one general Forum, which led into Roundtable meetings within six of the development districts (each with data focused on that district). A second Forum focused on a topic introduced throughout the Roundtable meetings. In the Tri-Cities region of Tennessee/North Carolina/Virginia, the Tri-Cities Komen foundation held two meetings in each state – one in a rural county and another in an urban location. While each meeting focused on breast cancer, concentrated data presentations for each county were coordinated by a local partner. Outside Help South Carolina organizers asked an outside person to facilitate their meeting. If you have trouble getting people to talk, an independent impartial facilitator moderating conversation may be an advantage. If you are interested in this option, consider checking with national partners for someone to moderate your event, or seek out local university faculty who have strengths in facilitation. Recruitment One message related to recruitment is that people won’t come to your meeting just because you want them to (known as the “if you build it, they will come” approach to promotion). It is not enough to put up a flyer in the grocery store or put an ad in the local paper. Seek out the unique ways people communicate locally. First, think about who you want to attend your meeting. Remember back when you were developing your idea? If you want people who volunteer with survivorship efforts, think about where to find survivors. Of course, they go to the grocery store and subscribe to newspapers. But you will get a better response for your efforts by contacting local support groups or perhaps an organization that offers support services for cancer patients (and uses volunteers). Once you have identified your target audience and the places you may find them, think about what would motivate them to attend your meeting. You know your need to hold this meeting, what is their need to attend it? Door prizes are nice incentives, but a plant or gift certificate will not to motivate people to come, only to remain until the end of the day. If you are targeting survivors who volunteer, perhaps they will be more motivated to register if they know how their participation will improve services for cancer patients. Tools 16
  18. 18. In developing a recruitment plan, you may find different barriers in different communities. Here are some tools that have proved effective for others. Incentives (Money) Many people are motivated by money. If you have some spare funds, figure out the best way to use it to your advantage. Kentucky organizers created small awards to fund local efforts around colorectal cancer awareness because they wished to involve local groups with an interest in this cancer. Tennessee organizers wanted to get local officials engaged in cancer control and use this meeting as a first step. But local officials have busy schedules and tight travel budgets so the they offered travel reimbursement as incentive to attend the meeting and as a result quite a few officials were able to be involved. How do Locals Get their News? We suggested earlier that only placing an ad in the local paper or sending in a notice for the community calendar on a local TV station is a less effective method than a broad spectrum of promotion efforts. Consider the local culture and natural communication outlets. For example, in a small town in Mississippi, the local newspaper is still an important source of information. Rather than putting a note in the community calendar session, the organizer of their local meeting personally contacted a known writer at the local paper to develop a series of articles about local cancer rates that mentioned the meeting as an opportunity to get involved. They did a similar thing with the local television station. It worked to ensure good attendance at their meeting. See how you might get local news media engaged and how you might share important information with people who care that are likely to attend your meeting if they hear about it from multiple sources. Ask a Local for Help It is very important to have a local leader involved in the planning of your meeting. Involvement from a local opinion leader garners stronger local support. He or she will know how to get people engaged in your activity and they will know who else should get involved. The Tri-Cities Komen Affiliate had a different local person organizing and promoting each meeting. Although each meeting was handled slightly differently, the effective local contacts knew which days of the week, locations, and promotional avenues worked best in their communities. Tools 17
  19. 19. Budget Many items must be considered when developing the budget for the event, and these should be identified when the idea for the meeting is beginning to grow. Partners will offer items they can bring to the table. Other opportunities for support will be identified as your team realizes what will help make this meeting successful. Be thoughtful about your budget – incorporate items that will enhance your meeting and potential outcomes. Remember details that may remove barriers (whether perceived or actual) for participants. For example, state staff may see travel to region, or staying overnight, as a barrier (and their regular budget may not allow for these costs). Even people who don’t have to travel far but are used to travel costs being reimbursed need to be remembered. Budgeting became an even more important part of our events in the middle of our events because most state agencies and local organizations saw their budgets cut mid-year in unexpected ways. Here are some suggestions for items that might help your event – whether they are part of the budget or not. Potential Budget/Support Expenses Keep the following budget items in mind during planning:  Healthy foods – Serving food makes the event more hospitable, but be sure your menu is in keeping with the purpose of your meeting (good health).  Travel expenses for state staff to travel to or stay in a local area and for local participants to afford travel to an away meeting may be an incentive. Also to use current/recognized mileage rates and the official per diem rates for lodging in your event location when planning. Different organizations have different rates for these – use the rates approved by the organization managing the funds.  Meeting space may have been donated, but know how the venue will be procured before setting your budget  Audio and visual support – check on this with your venue during the arrangements. Some require that you provide or pay for audio visual support, a necessity if you’re presenting data or will allow a mix of your own equipment. Know who is providing what.  Printing is another expense that may be provided in-kind, but consider how necessary printing costs will be absorbed. Electronic media has become more usual but may not fit all locations or populations. Consider the purpose of your printing. Is it useful? Or is it just for the sake of having something to hand out? Here are a few sample budgets to help you think about your own budget. Tools 18
  20. 20. Sample Roundtable Budget (This budget was specific and quoted actual costs) Lodging for 3 state-capital staff $359.55 Lunch for 30 $475.20 [Healthy] Afternoon Break Snack $162.20 Travel Stipends for 25 participants $1,250.00 Supplies (Invitations/postage/printing/ $253.05 printing/postage for meeting report) Total: $2,500.00 Developing a budget with specific numbers of participants will help you stay on track. You may have to develop the budget before you know who will attend. The next one may help if you don’t have attendance numbers. Sample Forum Budget (general categories) Facility Rental Printing (incl. copies of Cancer Plan) Supplies (folders, pens, paper, etc.) Travel (mileage/lodging for those who need it) Food (breakfast, lunch, break) AV support Total $150 $1,300 $550 $1,450 $1,000 $450 $4,900 This is a good general budget which includes the general spending categories for most events. This group spent close to their projections. Sample Forum Budget Budget Category Travel mileage for panelists and community partners Other (facility rental, AV support, food) Other (copies, supplies) Other (postage) Total: Remainder: Budgeted Amount Actual Spending $2,691 $1,550 $1,903 $1,564 $634 $125 $5,000 $302 $34 $3,803 $1,197
  21. 21. Budget Category Follow-Up Forum Budget Budgeted Actual Amount Spending Other (facility rental, Meals for 50) Other (postage) In-kind (printing, travel) $1,072 $125 (same) (same) Total: $1,197 This shows a good projected budget that came in under spent. Consider whether “padding” your budget will help or hinder your situation. This organization submitted a proposal to use the remaining grant funds to hold a second forum with a specific topic (they didn’t hold the same meeting twice; they just managed well). To make the second meeting possible they were creative with budget items and alternative ways they might be provided. Logistics In planning your event, think about the details of making it happen. Somebody has to spend time setting up the location, the audiovisual support, the food… all of those details you feel are necessary. It might take some coordination between your coalition leadership and local partners to meet everyone’s needs. Do you have state employees coming in to participate? Make sure that lodging is appropriate to their needs (Can they receive the “state rate”?). Unsure of which local caterer can accept your funds or provide a well-balanced meal? Somebody knows that information. Keeping It Local When it comes to handling the details, make sure you base decisions on local culture. One way to do this is to involve local organizations in the actual logistics. Ask about good locations for your meetings – a local organization may provide space in-kind (a great indicator of “buy in”). In Alabama they wanted to focus their Forum around the topic of hospice. They did this by emphasizing a good working model and held the meeting at a local hospice facility. Participants were able to tour the facility and gain a level of familiarity with something most don’t see. What Worked, & What Didn’t We’ve been collecting tidbits from the final reports of these meetings, and our own observations. Here’s a handy collection of specific tips, reminders, and details that don’t easily fit in other places. Tools 20
  22. 22. Dos DON’Ts DO identify local leaders and individuals with time & resources to continue beyond the meeting. DON’T pick leaders who can’t maintain momentum after your meeting DO have a reason for meeting DON’T meet for meeting’s sake DO use the prescribed agenda DON’T add items to the agenda unless they’re useful to your purpose DO consider local events, and the time of day that works for your type of participants DON’T schedule Friday afternoon (unless it’s truly a good time for the participants) DO use your resources DON’T hesitate to ask your partners for key items. DO develop a reasonable budget DON’T pad your budget with unnecessary items, or leave out the necessary ones DO invite survivors DON’T ignore survivors, who are important stakeholders (and keys to success) DO plan ahead – pick the appropriate time, venue, and location DON’T plan for a notoriously bad time (consider weather, local events, etc.) DO track your invitees (Who attended? Who didn’t?) Keep contact information DON’T forget to share an attendee list (people refer to these later on) DO have good presenters DON’T pick presenters that aren’t engaging or can’t talk on a ‘real’ level. DO keep it simple and focused DON’T overwhelm your audience – use simple presentations and take breaks. DO identify what is important by your goals DON’T pick speaker or invite people who aren’t related to your topic DO repeat important things DON’T say important things just once Tools 21
  23. 23. EVALUATION There are many reasons to evaluate your event. This event is probably helping the goals you need to address. You may be asked to report on whether (or how) you achieved your goals. A planned evaluation will help you explain your answer. You may need to do strategic planning or you may need to review your cancer plan objectives. You may even be gearing up to become an official non-profit organization or apply for a grant to support future efforts. Evaluation preparation can help you with justifying your goals. The bottom line is that you need to prove to yourselves the effectiveness of this tool for engaging stakeholders. All along you have been preparing for evaluation; you just might not have realized it. For example, 1. What is the reason for your meeting? 2. How will you know if you accomplished your goal? 3. How might you measure your success at meeting that goal? and, A. Who are the partners? B. What are the needs of the partners? C. What are the hopes of the partners? and finally, i. What did you “do” at your meeting? ii. Who attended your meeting? iii. What was “spent” or donated for this meeting? How does all of this interact with evaluation? The questions above outline your evaluation plan. You need to understand your goals from the start, develop your plans in a way to address those goals – and end by measuring your success at addressing those goals. It’s a simple method, but do spend some time thinking about the evaluative processes and the results. To know if you’ve achieved your goals, evaluation can be accomplished with a simple evaluation form (see Appendix for a copy of ours). We wanted to know, a. Who came to the meetings? b. What did attendees take away from the meetings? We included questions about who these people were and where they lived in the targeted region. Or were they people we wanted to bring to that region? We also asked what one idea they are taking away and who they planned to contact – not only because we wanted to know what was useful and what their plans and needs were, but because the question made them pause to consider it themselves. Tools: Evaluation22
  24. 24. Measurable Goals How do you get from a ‘nice’ idea to a measurable goal? Here are some examples and space to add your own. Nice Idea Cancer control in our state would be enhanced by engaging partners from this underrepresented area. It would be great to know about things happening in remote parts of our state. Measurable Goal We plan to engage five new partners from these five counties (if you want one from each county – state that) Identify XX best practices (per county. By region. One per part of the cancer continuum. State in measurable terms.) Take your “fluffy” goal and dig around to figure out how you will achieve it. You don’t just want to engage new partners – you want to engage specific partners. Where are they? Who are they? How will you know if you find them? Stakeholder Needs In addition to your group’s collective goals, address the goals of any key stakeholders. These members of your planning committee and the invisible stakeholders are the people you want to engage. Keep in mind that because though they may not be collective goals, the stakeholders’ goals may need to be part of the evaluation plan – happy stakeholders keep everything moving. Plan with evaluation in mind. Key Stakeholder Comprehensive Cancer Control Coalition Community at large Stakeholder Need Engage new members from underrepresented part of state Receive information about cancer prevention and control in an understandable way. Key Partners (ACS, Komen, etc.) Tools: Evaluation23
  25. 25. Linking to a Logic Model The Program Logic Model can guide your efforts throughout the planning stages. The CCC program or coalition might have something similar to a road map that could lead you to a successful event and an effective organization. This is one example of a logic model: l Resources Mini-grant development Program Activities Increased initiation and interaction Outputs Awareness/ attitude changes Program benefits Impact Outcomes Community engagement methods Give/Get More cancer control in Appalachia Outcome evaluation Process evaluation Your evaluation should reflect the various parts of your logic model. The focus for our meetings was to pinpoint Outputs (Change awareness and attitudes of the region and CCC). Your meeting could be one part of the logic model that is a key component of getting from program activities to outcomes. What We Learned from Evaluation We received evaluations from 578 persons who attended the 24 meetings. As planned, 85% of attendees lived in the Appalachian region(s) of their states (that also meant 15% of the attendees were people coming to these rural locations and “rubbing elbows” with local people and learning about local issues). Unsurprisingly, because we knew these regions were underrepresented, only 22% of respondents were members of their cancer coalitions (and many were unaware of the coalitions before the meeting). Tools: Evaluation24
  26. 26. After these events we called the Comprehensive Cancer Control Programs in the states and the primary awardees involved in these events. This is a summary of the outcomes they experienced:  New coalition collaborations  New members in underrepresented region of state  New dedicated resources for cancer control in the region  Revisions to the state cancer plan  New shared priorities for programming  Use of new data in regional presentations and planning. In short, evaluation is important and it’s not difficult. Take a few minutes to sit down as a group to walk through your goals and how you will know if you’ve achieved them. If you need more detailed plans, (e.g., if your event is connected to your logic model or a part of your cancer plan) see the CDC Evaluation Toolkit http://www.cdc.gov/cancer/ncccp/pdf/CCC_Program_Evaluation_Toolkit.pdf . Tools: Evaluation25
  27. 27. Conclusions As we reviewed our experience with Roundtables and Forums, we identified some best practices in cancer control within each state’s region as state cancer plans were presented to new audiences. We identified and connected local and state cancer coalitions, and involved state cancer registries in the preparation and presentation of state cancer data. These meetings also identified the contributions and benefits of state and Appalachian community engagement in regional and state cancer control activities. These events brought new people to the table and facilitated important partnerships. The short-term outcomes of our events included greater visibility of the Appalachian region being written into state cancer plans, networking at the regional and state levels, forums and roundtables as new models for engagement, new Appalachian regional cancer data, new ways to present data to community audiences, new cancer coalition members, and new coalition collaborations. The long-term outcomes included new partners in the Appalachian region identified for cancer control activities (schools, faith-based organizations, and rural organizations), new regional cancer coalitions organized, forums and roundtables seen as best practice, awareness of differences in regional cancer and cancer care attitudes and beliefs, and use in cancer messaging and campaigns. Unexpected Outcomes States involved have adopted the forum process for other non-Appalachian regions of their states with the discovery of best practices in Appalachian counties with high cancer rates. Events raised different themes for states: - a desire to involve new partners, - data analysis conducted by sub-regions and expanded to multiple sub-state areas, and - new Appalachian community members who became active in statewide cancer control efforts outside their own areas. Conclusions 26
  28. 28. Partnerships Regional forums and roundtables encouraged greater familiarity with and interaction between rural Appalachian communities and their state’s CCC coalitions and programs. Joint activities included writing and submitting proposals, planning and conducting events, and identifying and presenting best practices, data, and cancer concerns. A range of community organizations sponsored the roundtables and forums with their state CCCs. Half of the partners were cancer oriented organizations; others represented new partners in cancer control. Mail, e-mail, phone and conference calls were used to contact CCCs, Local Development Districts (multicounty planning and development organizations), state and local health departments, regional multi-state cancer meetings, and national cancer partner affiliates. This table highlights the involvement throughout Appalachian states in our series of events: State Alabama Kentucky Mississippi New York North Carolina Ohio Pennsylvania South Carolina Tennessee Virginia Virginia, Tennessee and North Carolina Event Type Forum Roundtables and forum Roundtables Roundtable Roundtable Forum Roundtable Forum Roundtable Roundtables Forum Forum Forum Roundtables Primary Community Partner Local hospice organization Kentucky Cancer Program Regional women’s university County cancer coalition American Cancer Society American Cancer Society American Cancer Society State university American Cancer Society Rural Health Association of Tennessee Community health center Area Agency on Aging Regional hospital system Regional Tri-State Komen Affiliate The events were organized locally and by different methods to demonstrate the flexibility of engagement. The following approaches may help you to develop your plans in ways that work for you and your community. Conclusions 27
  29. 29. Approach 1: Consecutive meetings that build and draw from each other 1. General Regional Forum 2. Six Sub-Region Roundtables (Sharing funding for Colorectal Cancer Projects) 3. Topical Regional Forum (Highlighted projects focused on Colorectal Cancer as best practices) Approach 2: Sequential Regional Roundtables that provide general information and then respond to local interest Introductory Roundtable to present general information Follow-Up Roundtable to address specific issues of interest Approach 3: Regional Event– Used Model across State or Region Regional Event in Appalachian part of state • Funded by the mini-grant we provided Regional Event in other sub-state regions • Funded by local sponsorship with CCC support Conclusions 28
  30. 30. Approach 4: Topical Focus Event highlighting Colorectal Cancer data and best practices Event focused on tobacco-related cancers Event with Breast Cancer focus Approach 5: Population Focus Event targeting African American community in urban/rural area Event concerned with those needing end-of-life care Event focused on survivors & their role in cancer care Conclusions 29
  31. 31. Outcomes ETSU documented the program outcomes through a series of published articles. A short summary of the contents of each article may guide you reading (detailed citations can be found in the Appendix). Title The Mini-Grant Model: A Strategy to Promote Local Implementation of State Cancer Plans in Appalachian Communities Models for Local Implementation of Comprehensive Cancer Control: Meeting local cancer control needs through community collaboration Culturally tailored cancer communication, education, and research: the highways and back roads of Appalachia Local implementation of cancer control activities in rural Appalachia, 2006: Preventing Chronic Disease Appalachia: Where Place Matters in Health Summary Provides a step-by-step description of the roundtables and forums process. Evaluation data is provided that documents successful engagement, issues identification and cooperative strategies between states and local communities. Profiles recent Comprehensive Cancer Control local implementation activities from a national and state viewpoint. Describes key findings described by communities about how to craft cancer control messages for the Appalachian region. Input from many community focus groups and cancer meetings are summarized into set of guideposts on how to work in the region. Describes a community-based participatory approach using community cancer research review work groups to link Appalachian community members’ interpretation-enhanced findings and recommendations about using quantitative and qualitative data to engage people in cancer issues. Summarizes findings from a special issue of Preventing Chronic Disease and poses five Appalachian regional dilemmas that address underlying cancer control issues in the region. Conclusions 30
  32. 32. Lessons Learned In reviewing our experiences with Roundtables and Forums, we developed a set of “lessons learned” to help you develop your plans. Lesson 1: A lot can be accomplished with a little investment. With time concerns in mind, we were excited to realize that a great deal of engagement can be fostered with very little money. Throughout Appalachia, organizers were able to listen to participants and take that information back to their offices with only small financial investments in the outset. Feedback from sub-awardees during the Second Appalachian Regional Cancer Forum was gratifying to hear. Subawardees who were initially doubtful with the small funding awards available were able to multiply their resources. Lesson 2: If you want local success, involve a successful local advocate or organization. Local people know best locations for meetings, how to balance attendance to avoid narrow biases, and how to be inclusive in invitations to important groups. They also recognize local calendars and have an awareness of times and days within a community. Local organizers are also aware of informal methods to encourage individual attendance. These local organizers were represented by both comprehensive cancer control regional paid staff, by local representatives of national cancer partners, or by local community volunteers interested in cancer issues. Lesson 3: People like to gather new information. Not surprisingly, every participant reported leaving the roundtable or forum with new information to aid their cancer control efforts. Participants networked and shared information about resources, as well as ideas. Lesson 4: Time is the essence of planning for implementation. Applicants and potential applicants felt they needed more time to plan and implement. More time was required for multiple aspects of the mini-grant effort. Proposal deadlines accelerated for some applicants, leading some organizations not to apply. The most common reason cited was insufficient time to plan, conduct the event, and report on findings. Some interested organizations said the timing was out of sequence with their annual work plans - a timing issue of importance to cancer coalitions and programs. Conclusions 31
  33. 33. Lesson 5: Be clear, be transparent, and be flexible. Challenges included encouraging applicants to access their own cancer registry data, ideas on how and who to invite, sharing ideas of other event partnership configurations, agenda review, ensuring completion of evaluation forms, contracting details, and documentation of meetings. Keep clarity in mind as you plan your events. Lesson 6: Local resources are often limited and payment methods for expenses are important. State regulations and financial and contracting protocols for awarding money proved time consuming and difficult for a few sub-awardees. Cost-reimbursement contracts became an issue for community-based sub-awardees that did not have unrestricted cash to pay costs and await reimbursement of large invoices. As we organized and buffered these contractual concerns, community organizations were able to leverage local support and build relationships. If you are thinking of a similar subaward project, bear any restrictions in mind and how they will work with the people you want involved. Lesson 7: Local views of cancer causes and solutions are varied but follow some common themes. Appalachian perceptions about cancer have been formed over time, through personal and community experience, and are often unexpectedly place-bound. One example consistently raised was environmental causation. The example of Webster County, Mississippi, was instructive to future events. Participants in a first roundtable expressed so much concern about suspected relationships between municipal water supply and cancer rates that the organizers researched local and state water supply data and amended its second roundtable agenda to include the mayor’s response to concerns. Acknowledging a theme may be important, as is the need to be prepared for the surrounding discussions. Lesson 8: Attention to the events and success of engagement is more likely if it is part of someone’s on-going agenda. These forums and roundtables fit into cancer control activities with little adjusting. Most sub-awardees agreed that earlier notice about the opportunity would have allowed the events to fit better into their fiscal year and strategic plans. As event organizers became more invested in the project, all parties realized stronger and better rewards and greater involvement. Many reported they would be happy to have this opportunity again, and some continued using this model throughout their Appalachian regions and across their states with other funding sources. Conclusions 32
  34. 34. Give/Get Grid Read more about the Give-Get Grid in an article published by McLean & Behringer The Give/Get Grid was a useful relationship building tool that promoted discussion concerning anticipated contributions and benefits that could foster working relationships. This grid is a square matrix with four parts. Each part contains what partners could contribute (give) to the relationship or what they could expect (get) in return as a benefit. All partners would know what to expect to give and get from the relationship, and use of this tool might identify opportunities they didn’t realize they had to offer, or things they could expect. A blank Give/Get Grid can be found in the Appendix. Here is an example (often these involve more details, but this will give you an idea). CCC Coalitions & Programs Gives Gets Items the CCCs can expect to give/provide to make this event happen  Cancer incidence and mortality data for Appalachian region  Statewide communication network Items the CCCs can expect to get/receive as a result of this event  Improved regional networks and contacts  Identification of strategies and factors that promote cooperation Appalachian Communities & Organizations Items the Appalachian partners can expect to give/provide to make this event happen  Access and connections to local leaders and culture  Examples of successful implementation strategies Items the Appalachian partners can expect to get/receive as a result of this event  Reliable information about the cancer rates in their region  Access to cancer education, resources, and technical assistance Conclusions 33
  35. 35. Five Outstanding Questions One unexpected outcome was an additional Lesson Learned. As we attended these events and received feedback and reports, we heard some of the same questions and interests arise time and again. After much discussion and analysis in our Advisory Group, five issues proved important in New York, Mississippi, Ohio, and all the areas inbetween. We asked willing organizations to discuss how they would investigate these topics. Think about organizing your event with regard to these questions, and/or listen for your own unanswered questions. The following issues are germane to rural Appalachian communities, but may also be pertinent in your rural (or urban) regions. 1. Use of Storytelling as a Cancer Communication Methodology How is storytelling used throughout Appalachian region with regard to cancer? 2. Successful Methods for Engaging Physicians and other Direct Health Care Service Providers in Appalachian Community Cancer Control Activities We met a few “physician champions” during these events. Why do busy direct-care-providers become involved in cancer control activities? 3. Organization and Financial Support of Rural Cancer Care Navigation Models Patient navigation is growing as an important aspect of cancer care, but it is handled in different ways in different states (even in different healthcare organizations within the same state or region). How are these funded and managed across Appalachia? 4. Process of Organizing, Quantifying Costs, and Documenting Benefits of Mobile Cancer Screening Units in Rural Areas How do mobile screening units work in a region with high rates of poverty and limited access? 5. Communication about cancer that combined Environment and Lifestyle risk factors How can people communicate effectively about the causes and risk factors of cancer without tension about these concerns? Conclusions 34
  36. 36. A Final Word We hope we’ve helped you think about how you might develop events that bring together key players. As one of our staff remarked about these meetings: “On the surface they appear to be about data presentations and information, but what they’re really about is developing connections that will help us beat cancer!” See the Appendix for additional information. You can also check out our website for details on the other parts of this program, and what we’re doing next. Please respond to the survey so we can understand what you’re doing and plan to do with these tools. A special thanks to both Henry King and Eric Stockton at the Appalachian Regional Commission, Barbara Wethers at the Centers for Disease Control & Prevention, and our Advisory Group. This project would not have been possible without their enthusiastic support. Conclusions 35
  37. 37. Bibliography Behringer B and Friedell GH. (2006). Appalachia: Where place matters in health. Preventing Chronic Disease [serial online] October. Available from: http://www.cdc.gov/pcd/issues/2006/oct/06_0067.htm. Behringer B, Friedell GH, Dorgan K, Hutson S, Krishnan K, Phillips A, Naney C, and Cantrell ES. (2007). Understanding the challenges of reducing cancer in Appalachia: Addressing a place-based health disparity population. California Journal of Health Promotion. May 2007, 40-49. Behringer B and Krishnan K. (2011). Understanding the Role of Religion in Cancer Care in Appalachia. Southern Medical Journal. 104(4):295-296, April 2011. doi: 10.1097/SMJ.0b013e3182084108. Behringer B, Mabe KH, Dorgan KA, Hutson SP. (2009) Local implementation of cancer control activities in rural Appalachia. Preventing Chronic Disease. 6(1). Available from: http://www.cdc.gov/pcd/issues/2009/jan/08_0064.htm Behringer B, Lofton S, and McKnight P. (2010). Models for Local Implementation of Comprehensive Cancer Control: Meeting local cancer control needs through community collaboration. Cancer Causes and Control. 21(1), 1995.* Bounds T, Bumpus J and Behringer B. (2011). "The Mini-Grant Model: A Strategy to Promote Local Implementation of State Cancer Plans in Appalachian Communities". Preventing Chronic Disease. 8(4)a89. http://www.cdc.gov/pcd/issues/2011/jul/10_1035.htm. Dorgan KA, Hutson SP, Gerding G, and Duvall KL. (2009). Culturally tailored cancer communication, education, and research: the highways and back roads of Appalachia. Preventing Chronic Disease 2009;6(2). http://www.cdc.gov/pcd/issues/2009/apr/08_0194.htm. Dorgan KA, Hutson SP and Phillips A. (2007). {In}credible agent: Cancer communication partners in Appalachia. Business Research yearbook, 14(1), 597-602. Hutson, S.P., Dorgan, K.A., Phillips, A. and Behringer, B. (2007). The mountains hold things in: The use of community research review workgroups to address cancer disparities in Appalachia. Oncology Nursing Forum. 34(6), 1133-1139. McLean J.E. and Behringer, B. (2008). Establishing and evaluating equitable partnerships. Journal of Community Engagement and Scholarship 1(1). 6627. These articles were made possible by an interagency agreement between the Centers for Disease Control and Prevention (CDC) and the Appalachian Regional Commission (ARC) (CO-15409-06). Bibliography 36
  38. 38. The Give Get Grid CCC Coalitions & Programs Appalachian Communities & Organizations Gives Items the CCCs can expect to give/provide to make this event happen Items the Appalachian partners can expect to give/provide to make this event happen Items the CCCs can expect to get/receive as a result of this event Items the Appalachian partners can expect to get/receive as a result of this event Gets Appendix 37: Give Get Grid
  39. 39. Request for Proposal Comprehensive Cancer Control Plans Implementation In Appalachian Communities Program Conducting Regional Roundtable Discussions to Understand Cancer Differences between Bordering Counties and Regions GENERAL STATEMENT OF PURPOSE In 2007 the Centers for Disease Control and Prevention (CDC) and the Appalachian Regional Commission (ARC) entered into an Interagency Agreement to support the Comprehensive Cancer Control Plans Implementation in Appalachian Communities Program. The program is managed by East Tennessee State University (ETSU). A multi-state Advisory Board was developed to guide the project, and the Community Cancer Control in Appalachia Forum was held in October 2007. This Forum provides a blueprint to successfully engage Comprehensive Cancer Control Coalitions (CCCCs) and rural Appalachian communities. One important component of the Forum was presentation of cancer incidence and mortality data using maps to illustrate regional and county differences. The purpose of this Request for Proposals (RFP) is to support community-based regional roundtable discussions that promote collaborative thinking between bordering counties or regions about differences in cancer rates. Roundtables will present cancer data and discuss differences between counties or multi-county areas to explore similarities and differences in cancer rates, cancer control activities, resources and environmental issues. The roundtables will engage regional stakeholders in identifying issues and challenges, discussing priorities, and recruiting new members and partners to the local implementation process of cancer control activities. Through the required involvement of CCCCs in the regional roundtables, increased support and commitment to state cancer control activities in Appalachian communities is expected. To see data, please visit: (http://www.etsu.edu/kellogg/Cancer/FAQ.htm). This RFP will provide funding to local organizations and state CCCCs to:   Support one or multiple community-based regional roundtable discussion(s) to explore differences and inequalities in regional cancer rates (new cases and/or death rates for all cancers or specific cancers) and the possible causes of cancer. Allow communities to share information, develop ideas, and consider actions that may reduce the regional differences. Appendix 38: Original Request for Proposals (Roundtable)
  40. 40.  Encourage greater communication between state CCCCs and the Appalachian regions of their states, as well as between and among groups in communities. Potential Applicants and Eligibility Criteria - - Applications must represent a commitment to a combined sponsorship of Appalachian community-based regional roundtable discussions that include: o Appalachian community organizations such as health departments, health providers, regional development districts, local governments, regional cancer centers, affiliates of national cancer partners, community cancer organizations or other organizations concerned about cancer; and o State CCCCs or regional coalitions of State CCCCs as recognized by the CDC with support from the statewide CCCC. Applications must represent partnerships of organizations within the Appalachian region that can demonstrate inequalities in general cancer rates or rates of all or specific types of cancer. Applications must cite evidence of these differences in local cancer rates. Maps and other information are provided for review and use by interested applicants available at http://www.etsu.edu/kellogg/cancer/forum_report/part 2.pdf Key Dates Forums must take place before June 30, 2009. This RFP will be distributed beginning May 22, 2008 and inquiries will be entertained until all funds have been distributed. PROPOSALS MUST BE ELECTRONICALLY RECEIVED. Paper copies of proposals, including original signature pages must be received via US Postal Service, to the address listed on the submission page before proposals will be considered (see Submission Instructions below). We are now accepting proposals on a First-Come, First-Served Basis, until we have allocated all funds. Funding Information      Up to $2,500 will be awarded to ten applications. This is a cost reimbursement contract. Documentation of paid expenses will be required with an invoice upon completion of project. Funds must be expended by June 30, 2009. Reimbursement will occur with one or two invoices. Funds may be used for roundtable discussion expenses including meeting space, meals and lodging, production of meeting materials, travel, and distribution of invitations as well as information resulting from the meeting. Funds may not be used for honoraria expenses or other personnel expenses Matching funds are not required. FORMAT OF SUBMISSION Appendix 39: Original Request for Proposals (Roundtable)
  41. 41. All proposals must use the following headings and order, and must be 12 point Arial font, single spaced, with one-inch margins on 8½ x 11” pages. A. Cover Sheet (2 pages)  Title of Proposal  Primary Applicant (CCCC or partnering organization that will be primarily responsible for this proposal)  Contact Information  Identify Project Director, Administrative Contact, Financial Contact, and Authorized Official for contracting purposes. *Applicants must submit the substitute W-9 form in appendix (found at http://www.etsu.edu/kellogg/Cancer/RFPs/Substitute W9 Form.doc).  Identify key partners who will take an active role in developing this project and list contact information (attach commitment letters and/or signature pages in appendix)  List of counties/states to be involved B. Plan for Discussion Roundtable (up to 5 pages)  Description of applicant and partners o Identify the organizations that will participate in the roundtable discussions. o Describe the process used to identify areas (multi-county) within the Appalachian region that have identifiable differences in cancer rates. o Describe how organizations from bordering counties were identified, Note, the geographic area for discussion may extend beyond state boundaries to include multi-state regions.  History of participation and involvement in CCCC activities o Describe past and current cancer control activities conducted in Appalachian communities involved in the application. Identify any state cancer control coalition activities sponsored in the selected region. o Identify whether special places or populations are included in state cancer plans (including if Appalachia is defined as a special place or population in the state cancer plan) o Describe if this application represents a continuing partnership or new relationship between Appalachian community organizations and CDC supported state cancer control programs (Cancer Registry, CCCC and Breast and Cervical Cancer Programs) or regional CCCC coalitions.  Cancer data that will be used to promote discussion o Identify data (cancer risk, incidence [new cases], or mortality [deaths]) that will be used in roundtable discussions (Either refer to website where information is found, or attach information in appendix) o Identify the counties in the area to be involved in the roundtable discussion o Note whether data is for all cancers or a specific type of cancer Appendix 40: Original Request for Proposals (Roundtable)
  42. 42.   Proposed format for roundtable discussion o Include agenda for the roundtable discussion meeting(s). If multiple meetings are proposed, describe your proposed process for the multiple meetings. o List location of roundtable(s) (note, roundtable must occur in region with documented differences) o Describe your plan to present and discuss data. o Identify invitees to the roundtable activities. Note which invitees have confirmed their attendance. Anticipated outcomes of discussions o Describe how the dialogue between bordering counties/regions is expected to promote county or regional community cancer control efforts. o Describe how the roundtable process and its findings will become part of the state(s)’ CCCC plan and activities C. Budget (including details and justification) and timeline (1 page) *Identify any additional funding in budget details. D. List of contributions and expected benefits (1 page)  What will Appalachian communities and organizations contribute to this process?  How will Appalachian communities and organizations benefit from this process?  What will the state CCCC and other national partners contribute to this process?  How will the state CCCC and other state/national partners benefit from this process? E. Appendix  Substitute W-9 from primary applicant  Append Letters of Commitment and/or Signature Pages from each applicant and other partners  Complete Signature Page (see website to download form).  Data that identifies differences in cancer rates (or list website where data can be found)  Other information considered important to the application SUBMISSION INSTRUCTIONS Each community or regional applicant may submit one proposal. State CCCCs are expected to be involved in each application within its state. All submissions must be made electronically through the ETSU Office of Rural and Community Health and Community Partnerships website (http://www.etsu.edu/kellogg/Cancer/dropbox.htm). Paper copies of proposal and original signature pages must be sent to address listed on the website. Call or email Jill Bumpus with questions concerning submission at bumpus@etsu.edu, or 423-439-4093. Appendix 41: Original Request for Proposals (Roundtable)
  43. 43. Since email/the internet can be unreliable, it is the responsibility of the applicant to confirm that the proposal was received. REVIEW PROCESS      Proposals will be reviewed by a committee. Proposals that do not follow the application guidelines will not be reviewed. Applicants will be notified by e-mail and mail as they are selected. Applications will be reviewed using the following criteria: o Quality & completeness of the plan for the Roundtable (per requirements listed above) o Participation of State CCCC in Roundtable Preference will be given to proposals that include: o Partnerships that include Distressed Counties designated by the Appalachian Regional Commission. o Multiple state and regional cancer partners (ACS, Komen Foundation, etc.). o Involvement of a member of Advisory Board (See http://www.etsu.edu/kellogg/Cancer/AdviseBoard.doc for list of advisory board members/note: travel expenses for Advisory Board will be covered by a separate budget) All successful applicants are required to submit invoices for payment to ETSU that clearly document project related expenses incurred. REPORTING REQUIRMENTS OF SUCCESSFUL APPLICANTS Successful applicants that receive funding support are expected to participate in overall program evaluation activities and complete a final report. This will include: 1. Participate in a pre- and post- program written survey 2. Submit a list of invitees and participants at roundtable(s) 3. Submit list of CCCC membership including members from Appalachian region 4. Distribute and collect evaluation questionnaire at each roundtable meeting 5. Submit copies of all media coverage (news articles) about roundtables 6. Write final report that discusses the process and the products of the roundtable project FURTHER INFORMATION  Potential applicants are encouraged to visit the ETSU Office of Rural and Community Health and Community Partnerships website (http://www.etsu.edu/kellogg/cancer.RFP.htm) for informational updates, including Frequently Asked Questions.  The information gathered in this project will be used by state CCCCs, the CDC, the ARC, and ETSU to enhance communication between CCCC and Appalachian counties and promote additional cancer control activities in Appalachian counties.  Participants should be aware that the grantor will provide a few simple measures to be completed before, during, and after the Roundtable. Appendix 42: Original Request for Proposals (Roundtable)
  44. 44.  Also, the grantor intends to send a representative to observe event, and he/she will be available to speak about the partnership at your event. Contact the Grant Coordinator for more details. Participants are expected to commit to sharing their results with state, regional and national cancer control organizations. Participants are encouraged to present and publish their findings in appropriate situations. Contact Information If you have questions about this RFP, the process, or submission, please contact: Office of Rural and Community Health and Community Partnerships http://www.etsu.edu/kellogg Appendix 43: Original Request for Proposals (Roundtable)
  45. 45. Request for Proposal Comprehensive Cancer Control Plans Implementation In Appalachian Communities Program Replicating the Appalachian Cancer Control Forum GENERAL STATEMENT OF PURPOSE In 2007 the Centers for Disease Control and Prevention (CDC) and the Appalachian Regional Commission (ARC) entered into an Interagency Agreement to support the Comprehensive Cancer Control Plans Implementation in Appalachian Communities Program. The program is managed by East Tennessee State University (ETSU). An Appalachian multi-state Advisory Board was developed to guide the project, and the Community Cancer Control in Appalachia Forum was held in October 2007. This Forum provides a blueprint to successfully engage Comprehensive Cancer Control Coalitions (CCCCs) and rural Appalachian communities. The Forum resulted in exchange of information and identification of potential opportunities for cooperation between the state and local levels. This Request for Proposal (RFP) will provide resources for state CCCCs to conduct forums in the Appalachian regions of their states. Agendas for state-specific forums are expected to replicate successful elements of the regional Forum while addressing the unique needs of its state (agenda elements listed below). The intent of this RFP is to provide funding support that will: - Encourage statewide coalitions to identify local communities and organizations with interest and experience in local implementation of cancer control activities; - Conduct a forum in the state’s Appalachian region replicating successful elements from the October 2007 regional Forum that promoted information sharing and collaboration with local Appalachian local communities about cancer issues; and - Promote visibility for and engender commitment to state cancer plans in the Appalachian regions of states. Potential applicants and Eligibility Criteria - State CCCCs as recognized by the CDC Regional coalitions of State CCCCs as recognized by the CDC are eligible with support from the statewide CCCC Appendix 44: Original Request for Proposals (Forum)
  46. 46. - Statewide or Appalachian cancer partner organizations that submit application on behalf of state CCCC for the project Key Dates Forums must take place before June 30, 2009. This RFP will be distributed beginning May 22, 2008 and inquiries will be entertained until all funds have been distributed. PROPOSALS MUST BE ELECTRONICALLY RECEIVED. Paper copies of proposals, including original signature pages must be received via US Postal Service to the address listed on the submission page before proposals will be considered (see Submission Instructions). We are now accepting proposals on a Firstcome, First-served Basis, until we have allocated all funds. Funding Information      Up to $5,000 will be awarded to each of ten successful applicants. This is a cost reimbursement contract. Documentation of paid expenses will be required with an invoice upon completion of project. Funds must be expended by June 30, 2009. Reimbursement will occur with one or two invoices. Funds may be used for meeting expenses, including space, meals, and lodging; preparation of a report that describes cancer incidence and mortality data for the Appalachian region of a state including state and national comparisons; travel for speakers; and cost of producing a written report on the process and findings of forum. Funds may not be used for honoraria or staff salaries. Matching funds are not required. FORMAT OF SUBMISSION All proposals must use the following headings and order, and must be 12 point Arial font, single spaced, with one-inch margins on 8½ x 11” pages. A. Cover Sheet (up to 2 pages)  Title of Proposal  Primary Applicant (CCCC or partnering organization that will be primarily responsible for this proposal)  Contact Information  Identify Project Director, Administrative Contact, Financial Contact, and Authorized Official for contracting purposes. *Applicants must submit the substitute W-9 form in the Appendix (found at http://www.etsu.edu/kellogg/Cancer/RFPs/Substitute W9 Form.doc).  Identify key partners and list contact information. B. Plan for Forum (up to 5 pages)  Description of applicant and partners o Identify the CDC supported state cancer control programs (Cancer Registry, CCCC and Breast and Cervical Cancer Programs) and how they will be involved in the proposed Forum Appendix 45: Original Request for Proposals (Forum)
  47. 47. o  List programs/organizations from Appalachian region committed to co-sponsor or attend the Forum including affiliates of national cancer partners (Cancer Information Service, American Cancer Society, Komen and Lance Armstrong foundations, etc.). Project Plan o Describe the process used to identify and involve “best practices” in cancer control operating in the state’s Appalachian region (NOTE: “best practices” refers to programs and activities that use previous evidence and research as part of planning, provide generalizable recommendations on how to design cancer health programs, or use standards derived from expert recommendations including community experts). o Profile the history of involvement of state CCCC in the state’s Appalachian region  Describe past and current CCCC activities conducted in the state’s Appalachian region. Indicate if no activities have occurred.  Identify if special places or populations are included in state cancer plans; identify if Appalachia is defined as a special place or population in the state cancer plan.  Identify how the CCCC communicates with local communities to learn about the state coalition and cancer plan and to engage in coalition activities  Provide list of current CCCC membership including those from the Appalachian region of the state o Forum Agenda, including the following key elements:  Regional speaker to identify why cancer may be different in the Appalachian region  Presentation of Appalachian regional cancer incidence and mortality data for all cancers and multiple types of cancer  Presentation of background on CCCC and state cancer plans  Panel of Appalachian regional best practices  Identify regional cancer resource challenges and opportunities and how collaboration of CCCC and local communities could to address regional cancer challenges  Complete Give-Get Grid as planning tool to identify potential advantages to collaboration (see C. below)  Additional elements may be included that address the specific needs of a state or region.  Statement describing how the Forum and its outcomes will become part of CCCC and state cancer plan  Budget (including details and justification) and Timeline Appendix 46: Original Request for Proposals (Forum)
  48. 48. *Identify any additional funding in the budget details C. Anticipated Outcomes: Fill in the Give-Get Grid (1 page) Table of contributions and benefits to conducting the Forum CCCC and state Appalachian cancer programs communities and organizations Give’s = Committed What the CCCC will be What the communities contributions “giving” to make this will be “giving” to make proposal work this proposal work Get’s = Expected What the CCCC will be What the communities benefits “getting” from this will be “getting” from this partnership partnership Use the Give-Get Grid to document proposal planning by identifying expected contributions and benefits of engaging in the forum. D. Appendix  Letters of commitment and/or signature pages from each applicant and other partners (including state programs, national cancer partners [American Cancer Society, Komen Foundation, etc.], regional cancer centers, and local cancer control programs)  Signature Page from Primary Applicant (see website to download form)  Other information considered important to the application SUBMISSION INSTRUCTIONS All submissions must be made electronically through the ETSU Office of Rural and Community Health and Community Partnerships website (http://www.etsu.edu/kellogg/Cancer/dropbox.htm). Paper copies of proposal and original signature pages must be sent to address listed on the website. Call or email Jill Bumpus with questions concerning submission at bumpus@etsu.edu, or 423-439-4093. Since email/the internet can be unreliable, it is the responsibility of the applicant to confirm that the proposal was received. REVIEW PROCESS     Proposals will be reviewed by a committee. Proposals that do not follow the application guidelines will not be reviewed. Successful applicants will be notified by e-mail and mail as they are selected. Applications will be reviewed using the following criteria: o Quality and completeness of the plan for the Forum o Participation of state CCCC in Forum Preference will be given to applications that propose a planned relationship that includes: o State and regional affiliates of national cancer partners Appendix 47: Original Request for Proposals (Forum)
  49. 49. o o o  Local and state elected officials A CDC representative A member of the Advisory Board (see http://www.etsu.edu/kellogg/Cancer/AdviseBoard.doc) for list of Advisory Board members. Note that travel expenses for any Advisory Board participation will be allocated from a separate budget. All successful applicants are required to submit invoices for payment to ETSU that clearly document project related expenses incurred. REPORTING REQUIRMENTS FOR SUCCESSFUL APPLICANTS Successful applicants that receive funding support are expected to participate in overall program evaluation activities and complete a final report. This will include: 7. Participate in a pre- and post- program written survey 8. Submit a list of invitees and participants at forum 9. Distribute and collect evaluation questionnaire at forum 10. Submit copies of all media coverage (news articles) about forum 11. Write final report that discusses the process and the products of the forum project 12. List of CCCC membership including members from Appalachian region FURTHER INFORMATION     Potential applicants are encouraged to visit the Office of Rural and Community Health and Community Partnerships website (http://www.etsu.edu/kellogg/Cancer/RFP.htm) for information updates regarding this and other RFPs. Information, including Frequently Asked Questions, will be added to the website throughout the process. The information gathered in this project is intended to be used by state CCCCs, the CDC, the ARC, and ETSU to improve partnerships and communication. Participants should be aware that the grantor will provide a few simple measures to be completed before, during, and after the Forum. Contact the Grant Coordinator for more details. Participants are expected to present findings to their state CCCCs, and may be requested to present findings at additional meetings. Participants are encouraged to present and report their findings in appropriate situations. Contact Information If you have questions about this RFP, the process, or submission, please contact: Office of Rural and Community Health and Community Partnerships http://www.etsu.edu/kellogg Appendix 48: Original Request for Proposals (Forum)

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