Cervical cancer screening in Canada: 2021/2022

Strategies to improve screening for First Nations, Inuit and Métis

Screening programs in eight provinces report work with First Nations, Inuit and/or Métis to increase participation and improve the screening experience. This work includes engaging First Nations, Inuit and Métis in decision-making and informing approaches to culturally appropriate screening and program resources, such as social media campaigns, and engaging with and educating healthcare providers working directly with First Nations, Inuit, and Métis communities.

Strategies to improve screening for First Nations, Inuit, and Métis

P/T Intended audiences Strategies used Strategy co-developed with community? Description of activities to improve screening for First Nations, Inuit and Métis
AB · First Nations
· Inuit
· Métis
· Education (one on one and group)
· Client invitation and reminders
· Media (small and mass)
· Provider assessment and feedback
· Healthcare provider cultural competency training
· Development of culturally safe materials and resources
· Direct community engagement to co-design programs
All: ✓ · Partner with Indigenous representatives to conduct screening disparities evaluations and use findings to inform strategies to improve screening in Indigenous populations.
· Share evidence and learnings with service providers to provide culturally safe care.
· Work with Indigenous partners to develop and provide culturally appropriate information.
SK · First Nations
· Métis
· Education
· Client reminders
· Media
· Provider reminders
· Knowledge translation
· Patient representative on provincial planning task force for guideline revision; as part of the Accelerating Innovations to Build Resilience in Cancer Screening during COVID-19 project, knowledge translation strategies at the population, community and individual client levels are being readied and will be implemented in the next year.
MB · First Nations
· Métis
· Education – public and provider
· Extensive invitation campaigns
· Provider reminders and client fail safe letters
· Cross screening program awareness
· Extensive web site with Pap clinic maps
· Healthcare provider competency training
All: ✓ · CervixCheck partners with Community Engagement Liaisons in each regional health authority in the province to provide resources for group educations
CervixCheck provides Competency Training for all cervical screening providers in the province, including working with 1 RHA that targets training for First Nations.
· Partnered with several communities to promote Pap clinics through targeted invitation letters, and social media posts.
· BreastCheck mobile clinic supports cross promotion with eligible persons.
ON · First Nations
· Inuit
· Métis
· Group education and mass media
· Client reminders
· Development of culturally safe materials and resources
· Provider reminders and recall systems
· Mobile screening
· Partnerships
· Direct community engagement to co-design programs
All: ✓ · Through Indigenous Cancer Care Unit (ICCU), Regional Indigenous Cancer Leads and regional teams, communities are engaged to inform programs/initiatives to improve education and awareness of cancer screening.
· The ICCU is currently engaged in a study to investigate current correspondence and identify methods to enhance patient reminders. Reminders are sent to all eligible Ontarians through Ontario Health (Cancer Care Ontario)’s cancer screening correspondence letters for both invitations and recalls.
· Continued ICCU support for the Cancer Screening Fact Sheets, Toolkit, and awareness postcards/posters which were designed and tailored with and for each First Nation, Inuit and Métis population.
· Cancer 101 Video: Ontario Health (Cancer Care Ontario) made this video for First Nations people. The video gives basic cancer information and answers many common questions about cancer. Other groups that helped make the video are CAREX Canada, the Occupational Cancer Research Centre and the Canadian Cancer Society.
· The Screening Activity Report (SAR) is an online report, which provides screening data to help family doctors improve their cancer screening rates and appropriate follow-up. The report allows family doctors to quickly find specific cancer screening information for each patient, including those who are overdue or have never been screened. In June 2018, the SAR was expanded to the Sioux Lookout Zone, which consists of several First Nations communities, providing non-patient enrollment model physicians and nurses access to their community data. This SAR was developed specifically for the Sioux Lookout municipality and the 27 First Nation communities that reside in the Sioux Lookout Zone.
· The ICCU and Northwestern Regional Cancer Program in partnership with communities jointly plan community events to provide access to screening through a mobile screening coach in the North West region.
· Through the relationships developed and fostered by the ICCU, regional teams have been able to continue working with communities as guided through the Indigenous Cancer Strategy.
· There are on-going efforts by the ICCU to support the integration of equity considerations in program operations and guidelines (i.e., advocating for self-sampling and inclusion of participants with invalid OHIP).
· A grant received by Dr. Jill Tinmouth and Dr. Amanda Shephard (“Catching Cancer Early how well do Ontario screening programs perform for First Nations and Métis persons?”) will provide Ontario Health (Cancer Care Ontario) with strategies to improve participation for First Nations and Métis people and may inform cancer screening recommendations in these populations.
NB · First Nations
· Métis
· Group education
· Leverage learnings from under screened population project
1. ✓^
· The program offers group presentations upon request from First Nations Communities based on education needs for targeted audience.
· Plan to leverage the recommendations from the ongoing project ‘Developing Strategies for Underscreened Populations through Community Engagement’.
NS · First Nations · Education · Health fairs
PE · First Nations · Join community events · Asked/ invited to come to events organized by community health centre · Attended community events – joined cancer screening booth with focus on participant’s health, joined activities with other health department
NL · First Nations
· Inuit
· Métis
· Participation and engagement with CPAC funded project for First Nations, Inuit, and Metis within Cancer Care Program
· Targeted presentations to health care professionals who provide direct health services to Indigenous populations

QC: *Since there is no organized screening program available there are no concerted strategies in place
NB: ^Yes, based on invitation to participate