Health Literacy is part of patient-centred care. We want to improve people’s ability to access, understand and use health information and services, so that they can make the best health decisions. This means taking in to account the barriers to accessing and using services.
Jullums has been part of two North Coast Primary Health Network projects (funded through the Cancer Institute NSW) to improve the participation rates of breast, cervical and bowel screening in under-screened populations. The projects looked at barriers to screening for Aboriginal people, one of the highest under-screened populations. They also included health literacy training and action planning.
Barriers to screening identified by local engagement work included:
- A lack of understanding of what cancer screening involves or why it is important.
- Fear of cancer screening.
- Discomfort and shame around cancer screening.
- Transport cost and logistics.
- Lack of discussion about screening with health professionals.
One of the first steps for Jullums was getting help from the Primary Health Network’s Quality Improvement team to help clean their practice data and recall system. This made it easier to identify the under-screened groups. Then, Jullums came up with some fun ways to address the barriers to screening.
Pamper Days!
Jullums staff know from previous experience that block bookings are successful. So, they have been treating their breast and cervical screening target populations with Pamper Days! These are informal and relaxed. “We all know each other, the women feel comfortable”, said Kris Roberts, Aboriginal Health Worker.
The last Breast Screen ‘block booking’ Pamper Day was at the Breast Screen NSW clinic in Lismore. The group of women had their own private space where they could get massages, have fun doing artwork on bras, enjoying a yarn with friends, sharing stories and learning more about other women’s health topics and Breast Screening through the BreastScreen nurse.
The similar cervical cancer screening days are at Jullums AMS and are called ‘ATSI Women’s Business’. The women can combine their health check/assessment and their cervical screenings on the day.
Some women excitedly ask “when’s the next one”!
Access issues were overcome with Jullums offering transport. Additional transport was provided by Population Health at the Local Health District.
Phoning women individually and visiting their home (having face to face conversations) to encourage them to attend the pamper days really helped to get the women involved.
Kris says “Women are starting to realise that this is a must and it’s important. I think indigenous women are becoming more aware and understand cancer and cancer screening. More women want to be involved in the screening now. Its word of mouth and the women that participated go back and tell family. Then family is keen to get involved.”
Red Apple Day
To increase awareness around bowel cancer screening, Jullums held “Red Apple Day” for the month of December.
They filled the waiting room with bright red posters along with large bowls of red apples highlighting the event. Each consult room put up posters on the walls and very strategically placed bowls of apples near where the patient sat, along with a sign saying, “take an apple and discuss with your GP about having a bowel screen”.
Over the 3-week period an additional 41 conversations (on the importance of bowel cancer screening) were had and13 tests were ordered.
Despite the high cost of applies in December and a busy lead up to Christmas, Jullums plan to run Red Apple Day regularly. the Practice Manager at Jullums AMS said, “Even with the barriers we encountered, the overall result was fantastic! Every single person and every single conversation matters.”
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Northern NSW Health Literacy Project acknowledges the traditional custodians of the lands across our region and pays respect to the Elders past, present and emerging. We recognise these lands were never ceded and acknowledge the continuation of culture and connection to land, sky and sea. We acknowledge Aboriginal and Torres Strait Islander peoples as Australia’s First Peoples and honour the rich diversity of the world’s oldest living cultures.