University of Hawai’i
The University of Hawai’i will strengthen telehealth infrastructure, provide cancer education and case management through Project ECHO, and train community health workers to improve delivery of cancer services and outcomes for Native Hawaiians and the US Affiliated Pacific Island communities of Guam, American Samoa, and the US Commonwealth of the Northern Marina Islands.
In the State of Hawai’i there are an estimated 15,000 migrants from USAPI countries. The Pacific migrant population suffers from disproportionate rates of homelessness, incarceration, and low-wage jobs. There are insufficient resources for cancer screening, diagnosis, and treatment for USAPI flag jurisdictions and infrastructure challenges to access health care services includes lack of transportation, absence of health providers, and marginal bandwidth. Many patients are diagnosed at advanced stages with poor prognosis and are sent off-island for care. In the most rural and geographically isolated communities, treatable cancers may not be diagnosed and patients suffer without any clinical support or palliative care.
The University of Hawai’i John A. Burns School of Medicine and Pacific Cancer Programs have developed a robust network of US and USAPI flag jurisdictions to address cancer health disparities in the US Pacific over the last twenty years. Three key strategies will provide health systems strengthening to four Pacific Islander communities of Guam, American Samoa, the Commonwealth of Marina Islands, and a remote community in Oceanview in the State of Hawai’i: 1) infrastructure strengthening through telehealth policy, health system organization and coordination, and health system/community collaboration; 2) health provider training via telehealth education and case management delivered via Project ECHO framework; and 3) training community health workers to provide cancer-related outreach and services.