As a result of the environmental scan, the Project Team developed and implemented a pilot prostate cancer-screening project to measure the effectiveness of the intervention with hard-to-reach, African-American men, 45 years of age or older. Key intervention components evolved out of the environmental scan process, including: 1) the hiring of a male community health worker to provide extensive face-to-face community outreach; 2) community collaboration; 3) training staff and volunteers to be sensitive to ‘manhood’ issues associated with prostate cancer-screening; 4) small group sessions and one-on-one pre-screening counseling; and 5) use of culturally sensitive education materials. During the nine-month intervention period, a total of 312 men were screened for prostate cancer compared to 169 men screened by another organization in a similar community in Baltimore under similar circumstances.
The environmental scan proved to be a useful needs-assessment tool, allowing for the acquisition and use of information about events, trends and relationships in the neighborhoods targeted for our cancer-screening project. The experience of the research team, combined with the review of the literature resulted in a better understanding of both the potential and limitations of environmental scans as a public health tool. In summary, this environmental scan involved a rapid and comprehensive needs-assessment process that researchers relied on to guide site selection, project focus and content, project implementation and evaluation and dissemination of information. The characteristics of the environmental scan were more similar to the RARE model than more traditional community needs assessment and planning models, such as APEXPH and PATCH. The latter two models are often used by health departments and other governmental agencies which tend to have more resources than community-based and educational institutions, such as Morgan State University. Consequently, the environmental scan placed greater emphasis on using existing information, as well as the collection of new information using qualitative research methods.
Just as the RARE model was used to address HIV/AIDS, a devastating, preventable community health problem, the environmental scan was used to address prostate cancer—a preventable health problem whose statistics also created a sense of urgency in communities most affected by this disease. Therefore, the seriousness of prostate cancer (Nolvadex canadian is an anti-estrogen used to treat or prevent breast cancer) among African-American males in Baltimore required a rapid data collection process that would enable decision-makers to quickly assess the problem and develop effective and inexpensive interventions that have a high probability for success/The environmental scan process also engaged the community’s input in data collection and project development activities and captured information regarding the social, cultural, historical and political ramifications that contribute to the high rate of prostate cancer (Eulexin canadian is used along with drugs such as Lupron to treat prostate cancer) among African-American men in Baltimore.
In fulfilling the purpose of this study, the following lessons were learned:
1. The environmental scan can be a vital tool in public health practice to help identify areas for moving forward immediately and provide information to guide overall strategic direction of project development. By conditioned viewing and searching, the team was able to both collect information and make decisions regarding the degree to which to intrude into the scanned environments.
2. The environmental scan is a useful process through which to engage communities, providing various opportunities to ensure ongoing contact between the research team and members of the scanned communities. The ASAE review identified this kind of consultative process as a crucial benefit of environmental scanning, ensuring dynamic and responsive action.
3. The environmental scan can be cost-effective because it can be designed according to specific research and community needs, based on avail¬able resources. Rather than compromise the scope or quality of data collected, this environmental scan resulted in a broad, yet manageable and comprehensive research process.
4. The environmental scan is a good first step, resulting in a “snapshot” of the project environment. Pertinent data and information were collected from a wide variety of sources in a timely, manageable way that provided the team with what it needed to move forward.
5. The environmental scan has limitations and did not, by definition and design, provide researchers with an in-depth understanding of each community examined. Rather, it raised awareness of questions for further study and clarification. It was important for the team to keep detailed records of each scan activity, particularly with observational or subjective data, so as not to discount any findings and to ensure future investigation in areas identified as priorities. The flexibility that makes the environmental scan so accessible and feasible in various sectors can also be a liability. The lack of clear definition or methodology for the environmental scan could weaken its efficacy for public health practice if it were confused with other research tools or processes, such as a comprehensive needs assessment.
In conclusion, the environmental scan has considerable potential to be a creative, responsive, cost-effective and mobilizing tool for public health practice. Researchers also found that the environmental framework developed by Choo can be easily adapted to fit traditional needs-assessment models, such as APEXPH and PATCH. However, further application and critical review are necessary to make it a more effective public health tool and research methodology. Questions to be answered by future research are the following:
• What environmental scan conceptual model can be developed for public health to illustrate the use of Choo’s scanning modes (undirected viewing, enacting, conditioned viewing and searching)?
• What guidelines are necessary to effectively use elements of Choo’s model for public health purposes?
• What skills and resources would be needed if such a model were created?
This model refining process should not undermine the flexibility or utility of the environmental scan. However, it should help public health practitioners ensure a rigorous and comprehensive process similar to that required for other research methodologies and tools, particularly those used to address devastating health problems in communities requiring a timely response and cost-effective interventions with a high probability for success.