Cancer Survivorship Curriculum

In 2013, Partnerships for Native Health conducted a needs assessment with community healthcare workers from partner tribes throughout Washington State. Approximately 80% of those interviewed expressed a need for survivorship support and facilitator training for cancer survivors. To address this need, P4NH staff partnered with Dr. Rachel Ceballos from the Fred Hutchinson Cancer Research Center. Dr. Ceballos and her team had previously developed and evaluated a Spanish-language support group for Latino cancer survivors living in the lower Yakima Valley of Central Washington. Building upon Dr. Ceballos’s successful work, P4NH staff established a new survivorship curriculum called Staying in the Circle of Life (SITCOL).

 

SITCOL is a cancer survivorship curriculum for American Indian and Alaska Native (AI/AN) cancer survivors and their families. SITCOL is designed for delivery in a 6-week series of support groups, guided by a trained facilitator. The curriculum is ideal for AI/AN survivors in the post-treatment phase. SITCOL is organized into 6 distinct modules, each focusing on a different aspect of post- treatment life. Each of the sessions takes approximately 90 minutes to complete and includes topics such as social support, physical and emotional health, and family health history.

 

Please fill out our survey on how you will utilize our curriculum.

 

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Session 1: Group Introductions and Social Support

 

This module introduces the concept of social support for cancer survivors and their families. Participants will establish common ground rules and agreements that guide each session, and work on building connections within the group.

Facilitation Tools Evaluation Tools Handouts and Activities
Session 1 Video Knowledge Assessment Pre-Survey Spider Web Activity
Facilitation Guide Knowledge Assessment Post-Survey
Introductions and Social Support PowerPoint Baseline Survey
Participant Guide

 

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Session 2: Stress and Stress Management

 

This module presents helpful information on stress. Four distinct categories of stress will be discussed; Physical, Mental, Emotional, and Spiritual along with the different symptoms of each. Participants will brainstorm healthy ways of managing stress and participate in exercises for navigating stress management.

Facilitation Tools Evaluation Tools Handouts and Activities
Session 2 Video Knowledge Assessment Pre-Survey Ten Actions Survivors Can Take
Facilitation Guide Knowledge Assessment Post-Survey
Stress and Stress Management PowerPoint
Participant Guide

 

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Session 3: Medical Advocacy and Advance Directives

 

This module gives useful information to help participant’s better advocate for their own health through practical tips and role-playing exercises. Participants look at examples of advanced directives and discuss end of life care.

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Facilitation Tools Evaluation Tools Handouts and Activities
Session 3 Video Knowledge Assessment Pre-Survey Role Play Doctor Visit
Facilitation Guide Knowledge Assessment Post-Survey OncoLife Survey
Medical Advocacy and Advance Directives PowerPoint OncoLife Treatment Pathways
Participant Guide Advance Directive
5 Wishes Activity

 

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Session 4: Medical Nutrition and Fitness

 

This module presents practical information on staying physically healthy. The curriculum provides tips on how to include traditional foods into your diet, and offers strategies for increasing fitness levels.

Facilitation Tools Evaluation Tools Handouts and Activities
Session 4 Video Knowledge Assessment Pre-survey Traditional Food Principles
Facilitation Guide Knowledge Assessment Post-survey My Native Plate
Nutrition and Fitness PowerPoint Daily Protein
Participant Guide What’s on your plate?
Better Bites
Using Nutrition Facts
Chair-robics
Recipe Exchange Activity

 

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Session 5: Body Image and Intimacy

 

This module explores the impact of cancer and cancer treatment on the body. Participants are provided tools to explore their individual body image and intimacy issues.

Facilitation Tools Evaluation Tools Handouts and Activities
Session 5 Video Knowledge Assessment Pre-Survey Art Activity
Facilitation Guide Knowledge Assessment Post-Survey Writing Exercise
Body Image and Intimacy PowerPoint Sexual Health for Cancer Survivors
Participant Guide

 

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Session 6: Family History and Genetics

 

This module provides helpful information about genetics and family health history. Participants explore the role of family health history in both their individual health and the health of their children and relatives.

Facilitation Tools Evaluation Tools Handouts and Activities
Session 6 Video Knowledge Assessment Pre-Survey A Guide to Family Health History
Facilitation Guide Knowledge Assessment Post-Survey Understanding Genetics and Health
Family History and Genetics PowerPoint Follow-up Survey Continuing Leadership for Social Support
Participant Guide

 

Key Collaborator – Dr. Rachel Ceballos

SITCOL Collaborator

Dr. Ceballos is an Assistant Member in the Public Health Sciences Division at the Fred Hutchinson Cancer Research Center (FHCRC) and an Assistant Professor in the School of Public Health at the University of Washington. Dr. Ceballos’s research interests involve the development of culturally-appropriate interventions, the inclusion of community collaboration in research, and use of biobehavioral methods to assess program efficacy. She has interdisciplinary training in laboratory, clinical, and community settings with a focus on the role of psychosocial factors, such as stress, on biological outcomes. Dr. Ceballos is the recipient of a career development award funded by the National Cancer Institute and is the primary investigator for studies which build programs to support cancer survivors in the Latino and African-American communities.
 
The original cancer survivorship support group program was originally developed as a Spanish-language support group for Latinos living in the lower Yakima Valley of Central Washington. A rural and primarily agricultural community, resources to support Latino cancer survivors in a culturally-appropriate manner are scarce. The need for cancer survivor support specific to the Latino community was identified through community based participatory research methods (CBPR), a research strategy that involves community members at all levels of the research process. As part of a project led by Dr. Beti Thompson, a senior investigator at the Fred Hutch (PI: Thompson, U54CA153502), involved a 22 member community advisory board who first noticed the lack of resources for Latino cancer survivors. Qualitative research methods were first used to confirm the need for cancer survivor support in the Lower Yakima Valley and helped to identify the specific areas in which survivors needed support (Livaudais, et al, 2010). Following the qualitative assessment, Dr. Rachel Ceballos, Assistant Member at the Fred Hutch, developed a formalized Spanish-lanuguage cancer survivor support program that could be facilitated by community lay health workers (promotores). As a preliminary trial, Dr. Ceballos and her team were able to successfully develop a 10-week support program that integrated cultural aspects of community and health beliefs (Ceballos, et al, 2015). Additional projects building on this initial study include a career development award from the National Cancer Institute investigating the effect of the 10-week program on Latina survivors of breast and gynecological cancers (PI: Ceballos, K01CA154938) and two smaller projects to bring the same programs to Latinos living in the more urban Puget Sound region of Washington State. One of the goals of these projects is to provide a platform that could be easily adapted and disseminated to a diverse set of communities.