Pacific Center of Excellence in the Elimination of Disparities (Pacific CEED)
The Pacific Center of Excellence in the Elimination of Disparities (Pacific CEED) focuses on the peoples of the US Affiliated Pacific Islands (USAPI). Cancer mortality now ranks as the second most common cause of death in nearly all USAPI jurisdictions. Cervical cancer is among the top five leading causes of cancer mortality in the Marshall Islands, the Republic of Palau, the Federated States of Micronesia (FSM) and in the Commonwealth Northern Mariana Islands (CNMI). Both breast and cervical cancer rank among the top six most prevalent cancers in the region and are underreported and/or diagnosed in the late stages for multiple reasons including; no access to mammography in several jurisdictions, lack of culturally appropriate preventive services and severe challenges in the health infrastructure.
The mission of Pacific CEED is to develop, implement and evaluate a comprehensive regional program that promotes the elimination of breast and cervical cancer disparities by; 1) providing the infrastructure to implement, coordinate, refine and disseminate culturally relevant, evidence- and practice-based programs, 2) intervening at multiple levels of the social ecological model, 3) monitoring and evaluating promising practices and outcomes, 4) expanding partnerships at the local, regional and U.S. national levels and 5) serving as a national expert resource center. Pacific CEED aims to contribute to reducing cancer disparities that are unequally borne by racial and ethnic populations in the U.S. Affiliated Pacific Islands communities through community based approaches and policy & systems change across the cancer prevention-to-care continuum addressing risk factors common to non-communicable diseases.
Pacific CEED’s Operational Goals:
- Reduce disparities and influence B&CC risk factors & social determinants related policy, systems and infrastructural changes to sustain health and well-being
- Serve as a regional resource & expert center
- Carry out comprehensive evaluation
- Support the priorities of the Regional Comprehensive Cancer Control Program & Plan
Pacific CEED’s Community Action Plan (CAP) Objectives:
- Work with regional partners to assist each USAPI CCC to implement at least two priority systems and/or policy changes that address B&CC and intervening factors.
- Work with regional partners & CCCs to increase resource sharing via a web portal & other communication methods to establish & maintain a shared regional focus on cancer disparities (i.e. regional laboratory, regional HRH, regional QA, etc.)
- Support, document, & disseminate culturally relevant and resource appropriate promising practices, &/or evidence-based models & policies, including training approaches that contribute to the elimination of disparities in B&CC and/or address the multiple intervening factors and determinants.
- Contribute to Regional HRH & health workforce capacity development to increase knowledge and practices for eliminating racial/ethnic disparities for breast and cervical cancer and/or intervening factors.
- Establish an evaluation framework supported by an online database to monitor and report on progress & outcomes and increase evaluation leadership and capacity.
- Assist CCPI & regional partners (e.g. PHIOA) to coordinate, plan & establish minimum regional B&CC standards across the continuum of care (prevention, early detection, diagnosis, treatment & palliative care).
- Assist regional partners to identify funding sources and /or collaborative relationships to secure additional funds to sustain activities related to eliminating disparities within the USAPI populations with a focus on B&CC.
Pacific CEED supports the regional coordination and targeted technical assistance functions of the Comprehensive Cancer Control program partnership model. This partnership model includes the Regional Comprehensive Cancer Control Program, the Regional Cancer Registry Program, the Pacific Region Cancer Coalition, (Cancer Council of the Pacific Islands and the USAPI Comprehensive Cancer Coalitions) and Pacific CEED.
Pacific CEED Program Areas Include:
Capacity building – All REACH US Centers of Excellent offer a Legacy Projects competitive small grants program with technical and organizational support provided by Pacific CEED. Pacific CEED also funds Local Projects to respond to CCPI’s equity commitment. Selective training programs have been developed and piloted and a number of these training programs have resulted in the development of formal curriculum for continuing education and/or integration into ongoing community college programs.
Models – The program models that all CEEDs subscribe to are; 1) Community-based participatory approaches (CBPR) and 2) the Socio-ecological Model (SEM) that acknowledges the role of multiple social determinants of health on the status and well-being of populations. In the case of the Pacific, these include policy, the environment (built and natural), society, culture, and more.
Resource Documentation & Sharing – The remote and disparate location of the individual island nations signal the imperative to document and disseminate promising practices and local models via the website, tailored local newsletters, email communications and other means. Likewise, efforts to research the evidence and adopt resource-appropriate models and methods that work in the Pacific, is a large commitment of Pacific CEED. For example, Pacific CEED Promising Practices and CRCH ‘spotlights’ highlighting Pacific CEED accomplishments are all posted on this website in order to share lessons learned and to disseminate resource-appropriate models that ‘work’ in the Pacific context.
Systems change – Pacific CEED has worked closely with several Ministries of Health and Comprehensive Cancer Control programs to research and establish resource-appropriate guidelines or standards for breast and cervical cancer across the prevention – to – care continuum. These standards have become national policy and contribute to the regional Quality Assurance/Quality Improvement initiative by addressing a ‘core’ set of objectives.
Behavior change – Through subcontracts and direct grants, the Local Projects funded by Pacific CEED address the knowledge gap on the islands by promoting healthy lifestyles, caring for providers, and aiming to increase uptake of B&CC screening and to decrease drop-out upon diagnosis.
Pacific CEED Promising Practices:
Each Pacific CEED Legacy Project and Local Project (or direct grant) is required to prepare a Promising Practices report to document its project model, share lessons learned and report on outputs and outcomes for dissemination to other partners and colleagues in the Pacific and elsewhere.
- Tasi le Ola (One Life): A 5-part Breast Cancer Prevention Radio Drama. Legacy Project - American Samoa. (2009) - (pdf 129 KB)
- Understanding the Role of Cultural Hierarchy and Religion in the Chuukese Community of Guam. Legacy Project - Guam. (2009) - (pdf 95 KB)
- Mobilization of Micronesian Communities in Hawaii for Health Equity. Local Project - Hawaii. (2009) - (pdf 156 KB)
- NCD Workshop to Evaluate 1st 5 Years Strategic Plan and Draft the Next 5 Years NDC Strategic Implementation Plan. Local Project - Palau. (2009) - (pdf 106 KB)
- Training on Cancer Affecting Women & Practical Solutions for Early Detection & Information Dissemination Project. Legacy Project - Pohnpei, FSM. (2009) - (pdf 315 KB)
- Healthy Lifestyles. Local Project - Republic of the Marshall Islands, Majuro. (2009) - (pdf 300 KB)
- "NO WOMAN LEFT BEHIND" - Enhancing Breast & Cervical Cancer Screening Skills Training. Legacy Project - Yap, FSM. (2009) - (pdf 477 KB)
- COM FSM Chuuk Youth Risk Behavior Survey Training Workshop and Pilot Surveys. Local Project - Chuuk, FSM. (2010) - (pdf 76 KB)
- Micronesian Health Advisory Coalition Interpreter/Translator Training Project. Legacy Project - Hawaii. (2009 - 2010) - (pdf 232 KB)
- Pohnpei GO LOCAL Community Awareness on Diet and Lifestyle to Help Prevent Cancer. Local Project - Pohnpei, FSM. (2010) - (pdf 254 KB)
- Pilot Program Geared to Develop Culturally Competent Practices Against Breast and Cervical Cancer in Kwajalein Atoll. Legacy Project - Ebeye, Kwajalein Atoll, Republic of the Marshall Islands. (2010) - (pdf 431 KB)
- Creation of Cancer Screening Standards for the Republic of the Marshall Islands. Local Project - Republic of the Marshall Islands. (2009 - 2010) - (pdf 105 KB)
- Exploring Yapese Beliefs on Death and Dying. Local Project - Yap, FSM. (2010) - (pdf 89 KB)
Pacific CEED & Cancer Information Services, Cancer Research Center of Hawaii ‘Spotlights’:
The Cancer Information Service (CIS), a former program supported by the National Cancer Institute (NCI) was Pacific CEED’s technical partner in Years 1, 2 & 3, Oct 2007 – January 2010. CIS produced news articles called ‘spotlights’ for all program activity carried out in collaboration with Pacific CEED during this time period. The same staff are still employed by CRCH in the Pacific Cancer Research Group and continue to partner with Pacific CEED as active members of the Technical Assistance Team
- Pacific CEED Spotlight FSM B&CC National Standards (Nov 2008) - (pdf 740 KB)
- Pacific CEED Caring Pacific Way (July 2009) - (pdf 460 KB)
- Pacific CEED Spotlight P-WAC Training (July 2009) - (pdf 1.2 MB)
- Pacific CEED Spotlight Palau Palliative Care Training (July 2009) - (pdf 1 MB)