McMaster University

McMaster University

Faculty of
Health Sciences

Major grant for cancer screening promotion among low-income communities

By Amanda Boundris
Published: July 4, 2012
Angela Frisina and Olive Wahoush
Hamilton public health nurse Angela Frisina, left, and Olive Wahoush, assistant professor with the School of Nursing

A researcher from the McMaster University School of Nursing (SON) and a team of Hamilton public health nurses have received almost $1 million from the Public Health Agency of Canada to promote screening for three types of cancer to people living in low-income housing communities.

The project will be led by assistant professor Olive Wahoush and Hamilton Public Health Services, in partnership with the public health units from Halton, Niagara, Haldimand-Norfolk and Brant County, along with Brock University. Hamilton is the pilot site, with expansion planned for the fall into Halton, Niagara, Haldimand-Norfolk, Brant County and Aboriginal communities in the area.

The Creating Access to Screening and Training in the Living Environment (CASTLE) project will promote breast, cervical and colorectal cancer screening to residents of low-income housing communities through a multi-sectoral network that encourages community engagement.

Wahoush said her team will target low-income residents who are more likely to have never been screened, which may include Aboriginal people; the disabled; newcomers to Canada; seniors; and the lesbian, gay, bisexual, and transgender (LGBT) community.

"The common factor among these groups is that they tend to be low-income. It’s working with these communities to develop messages around cancer screening and how best to reach them," said Wahoush, a co-principal investigator. "We want to see what works best to promote cancer screening, in communities like these across Canada. It’s not just that they become aware, but that they actually take action and get screened."

Angela Frisina is a co-principal investigator on the project and a Hamilton public health nurse for the Chronic Disease Prevention Program. She said since low-income populations tend to be under screened, cancer is often diagnosed too late.

"Cancer screening is probably not the first thing on their mind when it comes to their health," said Frisina, who is also a clinical lecturer with the SON. "It’s how do I get food on the table? Do I need to take time off work? Who will take care of my family?"

The project is just getting underway and will be completed by March of 2014.

The model involves the development of a CASTLE network; hiring a social marketing consultant to help develop messages and promotional items like a website and videos; and working with community organizations and community health brokers (CHB) to develop appropriate messages. One CHB recruited from each region will be trained to deliver cancer screening messages in low-income housing communities with the help of cancer screening ambassadors, who are volunteer residents.

Wahoush said it is significant that the project’s focus is on low-income populations, as they include diverse groups who are often never or under screened for cancer.

"We’re really taking the notion of being at risk or vulnerable and applying it in a more inclusive manner. It’s a step toward more equitable health care," she said.

For further information on CASTLE, please email

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