title: Using community outreach to explore health-related beliefs and improve surgeon-patient engagement.
abstract: Fostering surgeon engagement in community outreach was recently identified as a major priority toward reducing health care disparities in surgery. We aimed to increase surgeon engagement in the local community, understand prevalent beliefs, and identify educational opportunities in the local community regarding cancer screening and treatment using community outreach.
  
  
  
  In collaboration with the university's cancer center, the medical student surgical interest group, surgical faculty, and residents developed a community outreach program. The program consisted of networking time, a formal presentation, panel discussion, and question and answer time. A survey was distributed to all participants before the educational session, and a program assessment was distributed at the program's conclusion.
  
  
  
  A total of 256 community members and 22 surgical volunteers attended at least one of the two events. Attendees were insured (175; 92.7%), female (151; 80%), and African-American (176; 93.1%), with a mean age of 61 y (standard deviation 14.0). About 56 participants (29.6%) were unwilling to undergo screening colonoscopy. Forty-eight respondents (25.4%) endorsed mistrust in doctors and 25% believed surgery causes cancer to spread; a significantly higher proportion of them aged <60 y old. About 113 (59.8%) and 87 (46.1%) misunderstood the definitions of malignant and metastatic, respectively. Males were more unsure than females (61% versus 55%, P = 0.5 and 70% versus 55%; P = 0.01).
  
  
  
  Risk perceptions related to fatalism, mistrust, or lack of knowledge were prevalent. The ability of surgeons to reach at-risk populations in the prehospital setting is an important opportunity waiting to be capitalized upon.
authors.affiliation: Department of General Surgery, Hospital of the University of Pennsylvania, Center for Surgery and Health Economics, Philadelphia, Pennsylvania. Electronic address: Rebecca.hoffman@uphs.upenn.edu.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Hoffman
authors.affiliation: Office of Diversity, Abramson Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Brenda
authors.initials: B
authors.lastname: Bryant
authors.affiliation: Division of Trauma and Critical Care, Penn State Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Steve R
authors.initials: SR
authors.lastname: Allen
authors.affiliation: Division of Endocrine and Oncologic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Major K
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Division of Colorectal Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Cary B
authors.initials: CB
authors.lastname: Aarons
authors.affiliation: Division of Endocrine and Oncologic Surgery, Hospital of the University of Pennsylvania, Center for Surgery and Health Economics, Philadelphia, Pennsylvania.
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Kelz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002648:Child; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000601:surgery; D003159:Community-Institutional Relations; D005260:Female; D006266:Health Education / Q000379:methods* / Q000458:organization & administration; D054625:Healthcare Disparities; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D015143:Philadelphia; D010817:Physician-Patient Relations; D013337:Students, Medical; D066231:Surgeons; D035502:Trust; D055815:Young Adult
keywords: Colon cancer; Community outreach; Health belief model; Medical student; Surgeon engagement