Associations between levels of education, socioeconomic factors and cancer are well documented. Stockholm is no exception – the data show important disparities across the city in the rates of new cancers, rates of survival and attendance levels at screening.
At Stockholm’s Regional Cancer Centre, we are trying to find the best way to help communities most at risk to take action to protect themselves. We’ve started by focusing on a community with the lowest mean income and educational level in the region – the south Stockholm suburb of Botkyrka, which has a large migrant population, with residents originating from more than 100 countries and speaking 160 different languages.
One part of the project is to recruit and educate volunteers from the community to serve as ‘Peer Advisors’. Their role is to inform their peers about health and how to reduce their risk of developing cancer. We now have 42 peer advisors, women and men, the youngest being only 16 and the oldest 63. They originate from 30 different countries, and each speak at least four languages. Six of our peer advisors have been diagnosed with cancer and the others have family members or friends with cancer.
We will compare participation rates in cancer screening programmes before and after the project, and gather supplementary evidence using surveys and qualitative interview data. The results from the evaluation will guide our future work on addressing multicultural inequalities in cancer care in the region.
One of the peer advisors is a well-known rapper and song-writer, Dogge Doggelito. He lost his young wife to cancer some years ago, has always lived in Botkyrka, and is a role model for young people in the community. His involvement in the project has been very important and has generated extra attention from media.
Before the start of the project, the peer advisors were trained for their new role, learning about the European Code Against Cancer, cancer screening, cancer biology and care, patients’ rights, motivational interviewing, and more.
A key part of this project is to organise public information activities in the community to raise awareness about cancer and cancer prevention. Much of this is done in collaboration with cultural organisations active in the community.
Our experience so far is that this work is bringing us closer to people we usually do not reach with other health campaigns in Swedish. The main challenges we’ve encountered include issues related to language barriers, health literacy, and different cultural and/or religious attitudes about cancer.
In addition to the excellent collaboration between people working at local and regional levels, the involvement of people who are not healthcare professionals as well as patient representative at all levels has been very important for the success of the project. The peer advisors are in a unique position to reach populations who may be unfamiliar with the national healthcare system, and may have a low level of health literacy. The fact that the project manager is a cancer survivor seems to have been an important factor in establishing the legitimacy of the project in the eyes of the local community.
The project has attracted good media coverage such as in the local newspaper Södra Sidan , and features on the local council website and Facebook page. Further information can be found on the website of the Stockholm-Gotland Regional Cancer Centre
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