The `Ohana Day Project: A Community Approach to Increasing Cancer Screening

BACKGROUND: Native Hawaiians have higher cancer mortality rates and lower cancer screening rates compared with non-Hawaiians in Hawaii. People living in rural areas have particularly limited options for cancer services, especially for services that are culturally attractive and convenient. CONTEXT: `Ohana Day, offered in a small, rural, and predominantly Hawaiian community, was designed to attract underserved Hawaiians to cancer screening. METHODS: The year-long project involved a 1-day ho`olaule`a (community celebration) for families that featured 30-minute visits with a same-sex Hawaiian physician (for adults), culturally relevant cancer education and brochures, Hawaiian music, and games for children. Recruitment and follow-up for screening and treatment were offered. Principles of community-based participatory research, Hawaiian values, and Kreuter's strategies guided the design of the event. CONSEQUENCES: Of the 73 participants, 10 had abnormal screening results, and all received follow-up screening, treatment, or both within 3 months. Six months after the event, the number of men current with prostate cancer and colorectal cancer screening and the number of women current with clinical breast examination and colorectal cancer screening increased significantly. In addition, the number of participants affiliated with the community's Native Hawaiian health care system and the number with health insurance increased significantly. Participant evaluations showed high overall satisfaction with the `Ohana Day program. INTERPRETATION: Previous studies have noted the barriers to increasing cancer screening among underserved minorities. Culture- and community-based strategies appear to be successful at overcoming these barriers.