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State Programs

New Jersey: Strength of Coalitions
Several programs funded by CDC's National Breast and Cervical Cancer Early Detection Program (NBCCEDP) have benefited from becoming involved in local coalitions. In New Jersey, the Statewide Cancer Coalition, initiated in 1994, has been instrumental in advocating for increased funding. The Coalition has brought together organizations and individuals with an interest in cancer control issues. The Coalition includes varied cultural and ethnic representation and membership is comprised of grass roots, civic, minority, community-based, and faith-based organizations; cancer service providers; other health care providers; consumers; survivors; pharmaceutical corporations; insurance corporations; and national and local cancer organizations. Since 2000, with the help of coalition partners and the hard work of screening programs, state funding doubled, enabling screening for twice as many women.

South Dakota: Working Together for Greater Success
In South Dakota, two NBCCEDP-funded programs are working together to serve better the women in their area. Collaboration between the Cheyenne River Sioux Tribal Project and the state's All Women Count! program continues to grow, through recognition and appreciation of the distinct contributions from which both programs can benefit. This relationship took time to evolve, but as the staff from each program got to know each other they identified opportunities to assist, collaborate, and create economies of scale in screening women for breast and cervical cancer. The programs hold joint meetings, provide technical assistance between programs, participate on coalitions, communicate regularly about their programs, and are beginning to share resources for projects that benefit all of the women they serve. The state program serves as the portal for access to Medicaid through the Medicaid Treatment Act for women in both programs, while the tribal program helps resolve issues that affect the Native American women in the state program. They are also moving forward on efforts to develop health messages for American Indian women, with resulting materials to be used by both programs. Women throughout the state have benefited from this collaboration.

Colorado: Risk Reduction
Under the banner of "Citizens for a Healthier Colorado," voluntary health organizations, tobacco control advocacy organizations, and statewide chronic disease coalitions, including the Colorado Cancer Coalition, advocated for an increase in tobacco excise taxes. These taxes would allocate 16% of new revenues for the prevention, early detection, and treatment of cancer, heart disease, and pulmonary diseases and 16% for tobacco prevention. Armed with the Colorado Cancer Plan, a broadly supported strategic action plan based on sound data, the coalition member organizations successfully garnered public support for Amendment 35 and its cancer-related provisions.

Since 2005, nearly $45 million has been distributed to support statewide and local efforts to prevent, detect, and treat cancer, heart disease, pulmonary disease, and related risk factors through a competitive grants program. An additional $90 million was distributed to local health agencies and nonprofit organizations for tobacco use prevention and cessation, eliminating exposure to secondhand smoke, and reducing health disparities resulting from tobacco use.

Cancer programs, including colorectal cancer screening, skin cancer education, genetics counseling and screening, patient navigation programs, prostate cancer education, and development of a health disparities action team, have received funding.

Oklahoma Cherokee Nation: Addressing Health Disparities
Cherokee Nation was the first tribal nation to develop a Comprehensive Cancer Control (CCC) Plan for its population (published in 2006). The goal of this data-driven, systematic CCC Plan is to address cancer priorities and sites to reduce the cancer burden in Cherokee Nation. In October 2006, Cherokee Nation successfully convened the first Cherokee Nation Cancer Summit to promote the Cherokee Nation CCC Plan and its implementation, and increase awareness about cancer disparities among the community and its leaders, health professionals, and other entities interested in eliminating cancer disparities in Cherokee Nation. Participants were diverse representatives from the state and region, including key Cherokee Nation and state partners, cancer survivors, researchers, health care providers, legislators, and tribes.

The release of the Cherokee Nation CCC plan at the summit greatly increased credibility and awareness of the Cherokee Nation CCC Plan, its goals, and cancer disparities in Cherokee Nation. As a result of the summit,

• Partnership with the University of Oklahoma (OU) was greatly enhanced, with Cherokee Nation entering into a $1.5 million Memorandum of Understanding with OU-Tulsa for chronic disease care, including cancer care.



• Cherokee Nation is working with the Oklahoma Society of Clinical Oncologists on an initiative to facilitate access to clinical trials in Oklahoma and surrounding states. The Cherokee Nation Web site will serve as the central site for information on this initiative.

Overall, the summit helped meet Cherokee Nation Government Performance Results Act goals by raising awareness among providers about cancer screening, with a focus on colorectal cancer and disparities in Cherokee Nation.