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Christine B. Foundation Nutritional Assistance Program in Eastern Maine

Get to Know Matt Dexter, Founder and Executive Director of the Christine B. Foundation 

Matt Dexter is a Massachusetts native, happily building a home and life in Bangor, Maine. He was roped into the beauty of Maine when he attended the University of Maine, Orono receiving his Bachelors in social psychology. He then earned an MS in Nonprofit Management from Lasell College there after. In 2008 his life changed forever, and in 2014, him and his family decided to do something about it. Matt, founder and executive director of the Christine B. Foundation, shares with us all, “Why We Should Care More About Cancer In Eastern Maine”. 

First and foremost, why Eastern Maine?

The rich history, expansive geography, and restoring culture that embodies Eastern Maine communities make this region stand out and admired by many. Families from Sail Rock, the easternmost point of America, to Mt. Katahdin, the end of the Appalachian Trail, are connected by these proud attributes and have overcome barriers, locked in arms. The most significant of which invades the lives of thousands, with waves powerful enough to devastate one’s financial, emotional, professional, and physical security. Cancer is the leading cause of death in the State of Maine with Eastern Maine drowning in its wake.

Top cancer incidence and mortality rates continue to take the lives of those in Eastern Maine communities. This region is notorious for the two highest counties of cancer incidence (Washington and Penobscot) and the two highest counties of cancer mortality (Washington and Piscataquis). Though these significantly higher rates of cancer have been addressed by many, from medical communities to government agencies, all the way to grassroot efforts, more must be done. Cancer needs to be a public priority with a response that embraces transparent collective action, community voice, and continued investment. 

In 2017, the CDC published data that there were 3,391 deaths attributed to cancer that year in the state. These rates represent deaths that COULD be prevented through improved public health programs that support healthier behaviors and neighborhoods or better access to health care services. This is the driving force of why I’ve proudly committed my life to this work and what guides the Christine B. Foundation team and vision forward. Where you live should not depend on if you live.

Maine Annual Cancer Report

https://www.cdc.gov/nchs/pressroom/states/maine/maine.htm

https://www.cdc.gov/nchs/pressroom/sosmap/cancer_mortality/cancer.htm

https://cancerstatisticscenter.cancer.org/#!/state/Maine

https://www.cdc.gov/ruralhealth/cause-of-death.html

Tell me about the genesis of how you created CBF and how it has evolved over the years?

To illustrate the beginnings of The Christine B. Foundation, we must go back in time to 2007. A time where my life was filled with unconditional encouragement and opportunity. The majority of which stemmed from my mother, Christine. She was a social worker by trade, but happily took the promotion of motherhood when my sister and I were born. I often share that she was the type of person who worked tirelessly on relationships, just to make others comfortable, happy, and successful. She always had candies to hand tollbooth operators. Shined bright while substitute teaching by bringing in homemade goodies for students. While also firmly emitting strong morals and teaching her children the boundless value of friendship. 

October 2007, this all changed. My mother was diagnosed with stomach cancer. Crippling news that only grew in paralyzing fashion until her passing in April of 2008. I felt helpless, abandoned, and angry. No parent should have to tell their children this news. No one should lose their life at the age of 47. No 13-year-old son should witness the life vanish from his mother’s mind, body, and heart. Dozens of surgeries didn’t reverse the misdiagnosis made and led to a depressing, dark, and empty period in hospice.

It was not until 2014 when I was living in Orono that my family and I made the defining leap to start an organization that could help those affected by cancer. I was a growing advocate for the Eastern Maine community at the time, not knowing much for certain except for these two things. That these regions were in need of continued cancer support and that I knew I needed to do something. 

The Christine B. Foundation was born on the simple premise to build a community of support for those affected by cancer in Eastern Maine. The mission and values, held tightly to those of my mother’s, have remained relatively consistent as our vision and involvement has expanded. The organization began as a single fundraising event (Eastern Trek for Cancer, relay-run from Portland, Maine to New York, New York), to now investing in cancer patient navigation, community collaboration, nutrition access, and referral-system improvement. Initiatives that we now know can change the face of cancer in Eastern Maine. This was a result of a meticulous assessment, carefully considering the needs and capacity of communities, organizations, families, survivors, and patients. We can all play a part in making our communities healthier.

What are the most common barriers people in Eastern Maine face when it comes to accessing cancer treatment/resources?

Lifestyle adjustments are inevitable for those who receive an abnormal screening and begin their cancer treatment. Dealing with one’s own mortality can be very stressful and increase levels of anxiety for both the patient and their family. Similarly, managing treatment and work schedules, as well as family priorities, leave many faced with a lack of energy and time for rest and recovery. 

Nearly all of the 250,000 people living in Eastern Maine have been or are currently affected by cancer. These families and individuals are ‘proud Mainer’s’ who don’t concede easily. However, when faced with cancer many encounter what feels like an endless stream of barriers to appropriate care into survivorship. 

Learning to accept help as well as one’s own limitations during/after treatment leave patients facing a new reality. A reality that their employment, age, health insurance, living arrangements, and income status can hinder greatly. Only 55% of Eastern Maine is in the civilian labor force, a rate that is in strong relation with the 15.4% living in poverty with a median household income of $44,612. These labor force and income rates are lower than the State of Maine average and are significant social determinants of health to consider when overcoming barriers to cancer. 12.6% live without health insurance and 23.6% are 65 years of age or older. The barriers to living healthy lives are only enhanced when cancer enters their lives. 

By embracing the “Vacation Land” montra, where 90% of the State of Maine is forested and communities reinvest in preserving this landscape, we also are faced with the rural challenges that these surroundings possess. Traveling distances of 100+ miles, one way, for cancer treatment are not uncommon in rural parts of Maine, including Washington and Piscataquis County. This distance far surpasses the average commute time many have to their jobs. Facing financial toxicity, limited nutrition access, family/pet care, unemployment challenges, and changes to one’s emotional health are a few complications that add to the complexity of cancer care. 

In a time where cutting-edge treatment is becoming more available, coordination of care is of the utmost importance. On a national level, 9 out of 10 adults may lack the skills needed to manage their health and prevent disease. Eastern Maine’s high school graduation rates (90.9%) and those holding bachelor’s degrees (24.3%) are lower than the state’s rate and are strongly associated with an at-risk population of low health literacy.

How could the most rural state in the country become a leader in innovative communication efforts to increase access to cancer care and resources? Could we as a community eliminate barriers to basic needs such as proper nutrition during treatment and access to personalized support? The Christine B. Foundation continually seeks creative and community-led solutions to these questions and invites those across diverse sectors to play a role in its mission. 

Maine Cancer Foundation Transportation Needs Assessment, 2017

CDC Census, 2019

Can you give an example of a situation where barriers to cancer care were overcome in Eastern Maine?

CBF often hears about and plays a role in, the increasing need for coordination of care. One case in particular highlights the many complex layers that can be associated with a single day of treatment for those living in Eastern Maine. For a moment, please imagine you are a 60-year-old, male, resident in Calais, Maine. When you aren’t working full-time managing a local farm, you’re the sole caregiver for your 85-year-old mother. You manage to make ends meet, however, put your mother’s health before your own. Transportation is unreliable as your truck reaches 250,000 miles and endures heavy ware and tare while at work. You’ve lived your entire life in Calais and took over the farm when your father passed. You graduated from high school but have no college experience, no health insurance, and little savings in the bank. You’re an active smoker, with little exercise outside of the labor put in on the farm. You can’t recall your primary-care doctor’s name because annual check-ups and visits have become a thing of the past. Until one day the pain becomes so unbearable, you visit the Emergency Room, where you soon find out, you have lung cancer. 

Though this is not a real story, it illustrates the challenges that many living in Eastern Maine’s rural communities face. For this individual, barriers that need to be navigated far exceed clinical treatment. It also includes navigating financial barriers, the 100+ mile journey to radiation treatment each day, managing their mother’s health needs, considering tobacco cessation, understanding their role in shared decision-making, accepting help to manage the family farm, and much more. This case requires ongoing, person-centered planning, something that continues to be done each day through patient navigation programs throughout the state and those the Christine B. Foundation are involved with. 

One success story of a case such as this is a collective effort by 4+ organizations. If you recall, this individual does not have reliable transportation. The closest cancer institute is in Brewer, Maine, many miles from home. A patient-navigator serving Washington County was referred to this person after their emergency room visit, to help eliminate barriers to care. Quickly, the navigator knew that the initial surgery and subsequent six-weeks of radiation treatment, five days a week, would never happen if no transportation assistance was secured. The navigator was able to secure transportation assistance, free of charge, and coordination of care from organizations such as CBF, the Beth C. Wright Cancer Resource Center, the American Cancer Society, Northern Light Eastern Maine Medical Center, and Downeast Community Partners. Once at the hospital for his surgery, a CBF staff member met with him, stayed for the duration of the surgery, and was there to sign him out and return him to the volunteer vehicle for the return trip home. This scenario required a collective effort of flexible organizations, playing a small but important role. 

What are your plans for the future and how do you wish to expand the programming in place?

The Christine B. Foundation’s guiding light is to build a community of support for those affected by cancer in Eastern Maine. I am inspired by what the future has in store to reduce cancer mortality across Eastern Maine, and empowered by what is happening right now also.

Treating cancer, both clinically as well as emotionally, physically, and financially, is growing in complexity. More treatment options are becoming available. Survivorship planning is becoming more and more important as the number of patients reaching remission grows. There are a number of needs present that could, and should, be addressed to help reduce the burden of cancer. Preventative campaigns, medical research, mental health interventions, transportation aid, discretionary financial assistance, are just to name a few. However, CBF carefully, openly, and strategically deemed these three priorities as both vital and achievable in the short and long term. These priorities are community-based cancer patient navigation, nutrition assistance, and collaborative coordination of resources. 

Far too often, the messages which organizations share about their services and resources are either not received or discovered too late. New patients, those in active treatment, their families, and survivors continue to voice their frustration that education and awareness is lacking across the region. This is similarly echoed by leaders of many organizations who are prioritizing a growing checklist of needs bouncing between funding and programming. Outreach often is left behind. 

The personalized nature of cancer navigation services in addition to increasing access to nutrition through treatment has been shown to eliminate barriers to care. In addition, these services are needed in Eastern Maine, compliment the effects of clinical treatments, and reduce patient readmittance in the short-term. Long-term, CBF is inspired by what continued collaborative coordination of care could mean for future partnerships and the measurement of program impact. No single organization can fulfill all the needs a cancer diagnosis brings. By developing a “frictionless transition” from provider to provider for individuals, I firmly believe that cancer patients and their families will have better access to trusted care they seek and higher survival rates from this stronger coordination. 

As your neighbor, public servant, and previous cancer caregiver, I challenge you to think beyond “being right” with a single solution and see the opportunity as “getting it right” with a collective effort, led by the voices of Eastern Maine. 

How can others get involved in helping cancer patients in Eastern Maine?

There is a place for you in the fight against cancer. The Christine B. Foundation is actively looking for committed community members who are ready to stand up as leaders across Eastern Maine. Here are a few volunteer opportunities that we’d appreciate you considering:

-Join the Program Committee

Your voice matters! CBF runs on collaboration, creativity, and a commitment to your community. You can shape CBF’s current and future programming through this committee and help those affected by cancer first hand. 

-Join the Board of Directors

CBF is seeking members of the Eastern Maine community to help steer CBF’s mission with lived experience, diversity, and professional talent. If you are passionate about supporting those affected by cancer with your time and knowledge, consider inquiring about the Board of Directors. Seeking background in PR/marketing, fundraising/development, finance, and program development.

-Become a Service Provider

CBF is seeking passionate members of Eastern Maine, to use their talent in counseling, healing touch, nutrition, massage therapy, fitness/wellness, behavioral health, &/or activism to join the CBF team and help others who have been impacted by cancer. 

-Fundraise for CBF

CBF offers their programs free of charge to the community. We depend on the continued support of many to work towards our mission of building a community of support for those affected by cancer in Eastern Maine. It is easy, fun, and rewarding to get active and raise funds for CBF.

Here are some opportunities for you. We are happy to talk and help you through every step of the way. Contact matt@chrisbfund.org

Post Author: Sarah DeGeorge

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