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J Community Health. 2015 Dec;40(6):1216-23. doi: 10.1007/s10900-015-0051-z.

A Community-Based Partnership to Successfully Implement and Maintain a Breast Health Navigation Program.

Author information

1
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., Campus Box 8100, St. Louis, MO, 63110, USA. drakeb@wustl.edu.
2
Alvin J. Siteman Cancer Center, St. Louis, MO, USA. drakeb@wustl.edu.
3
Institute of Public Health, Washington University, St. Louis, MO, USA. drakeb@wustl.edu.
4
Betty Jean Kerr People's Health Centers, St. Louis, MO, USA.
5
Institute of Public Health, Washington University, St. Louis, MO, USA.
6
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., Campus Box 8100, St. Louis, MO, 63110, USA.
7
Alvin J. Siteman Cancer Center, St. Louis, MO, USA.

Abstract

Breast cancer screening combined with follow-up and treatment reduces breast cancer mortality. However, in the study clinic, only 12 % of eligible women ≥40 years received a mammogram in the previous year. The objective of this project was to implement patient navigation, in our partner health clinic to (1) identify women overdue for a mammogram; and (2) increase mammography utilization in this population over a 2-year period. Women overdue for a mammogram were identified. One patient navigator made navigation attempts over a 2-year period (2009-2011). Navigation included working around systems- and individual-level barriers to receive a mammogram as well as the appropriate follow-up post screening. Women were contacted up to three times to initiate navigation. The proportion of women navigated and who received a mammogram during the study period were compared to women who did not receive a mammogram using Chi square tests for categorical variables and t tests for continuous variables with an α = 0.05. Barriers to previous mammography were also assessed. With 94.8 % of eligible women navigated and 94 % of these women completing mammography, the implementation project reached 89 % of the target population. This project was a successful implementation of an evidence-based patient navigation program that continues to provide significant impact in a high-need area. Cost was the most commonly cite barrier to mammography. Increasing awareness of resources in the community for mammography and follow-up care remains a necessary adjunct to removing structural and financial barriers to accessing preventive services.

KEYWORDS:

Breast cancer; Disparities; Mammography; Patient navigation; Screening

PMID:
26077018
PMCID:
PMC4626535
DOI:
10.1007/s10900-015-0051-z
[Indexed for MEDLINE]
Free PMC Article

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