A Socio-Ecological Framework for Cancer Control in the Pacific: A Community Case Study of the US Affiliated Pacific Island Jurisdictions 1997–2017

Frontiers in Public Health

John Ray Taitano¹  Neal A. Palafox²  Mavis Nitta²  Lee E. Buenconsejo-Lum²  Sheldon Riklon³  Livinson Taulung⁴  Helentina Garstang⁵  Martina Reichhardt⁶ 

[1] Cancer Council of the Pacific Islands, Tamuning, GU, United States;Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, United States;Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, United States;Kosrae State Department of Health Services, Kosrae, Micronesia;Republic of the Marshall Islands Ministry of Health, Majuro, Marshall Islands;Yap State Department of Health Services, Yap, Micronesia;

关键词: pacific;    cancer;    disparities;    coalition;    social ecology;    management;   

DOI  :  10.3389/fpubh.2018.00313

来源: DOAJ

【 摘 要 】

The United States Affiliated Pacific Island Jurisdictions (USAPIJ) are politically associated to the United States (US) as US Territories (Guam, American Samoa), a US Commonwealth (Commonwealth of the Northern Mariana Islands), and as sovereign nations linked to the US through Compacts of Free Association [Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), Republic of Palau (ROP)]. Cervical cancer incidence in the RMI is the highest in the world, mammography services are not available in the FSM and only Guam has on-island oncology services. Cancer risk factors such as obesity, tobacco, and Hepatitis B are prevalent. Twelve years of nuclear testing in the RMI adds to the cancer burden. A community-based, multi-national coalition with multi-system external partners the Pacific Regional Cancer Control Partnership (PRCP) was developed to address cancer prevention and control in the USAPIJ. Through the PRCP, local cancer coalitions, a regional cancer registry, 12 years of regional cancer control plans, and cancer prevention programs and research has been implemented.Methods: The PRCP is the subject of this community case study. The PRCP is analyzed through a socio-ecological theoretical framework to contextualize its typology, building blocks, and management. The respective roles and work of each partner and organization will be described and aligned with the levels of the socio-ecological framework.Results: The USAPIJs evolved a community-focused internal and external regional cancer prevention and control network over 20 years. The function and structure of the PRCP fits within a socio-ecological framework for cancer control. An adaptive management strategy has been used within the PRCP to manage its multi-national, multi-level, and multi-system partners.Conclusion: The PRCP has been able to advance cancer prevention and control programs with a community-centric model that functions in a multi-national, multi-cultural, low-resource, geographically dispersed environment over the last 20 years. The PRCP operates with a structure and management style that is consistent with a socio-ecological framework for cancer control. This case study provides a blueprint for the PRCP organizational structure and a mechanism for its function. The PRCP concept, a community-centric model for cancer control in multi-national resource-limited environments, may be scaled to other global environments.

【 授权许可】

Unknown