title: Recruitment of underserved women for breast cancer detection programs.
abstract: OBJECTIVE
  The purpose of this correlational, nonexperimental study was to survey a sample of uninsured/underinsured women entering a no-cost, state-funded breast cancer screening program to identify factors that might enhance existing recruitment strategies and adherence to breast cancer screening.
  
  
  BACKGROUND
  Inadequate access to breast cancer screening contributes to the high morbidity and mortality that have been documented in low-income American women with breast cancer. Two hundred and four participants in a no-cost cancer screening program at the Johns Hopkins Oncology Center's East Baltimore Community Health Program in Maryland were surveyed by telephone to identify methods to enhance recruitment strategies. The survey solicited information in areas such as demographics, healthcare practices, and recruitment sources. Knowledge about breast cancer and its treatment, perceived control over health matters, and the practice of preventive measures were low in this group. Based on the data obtained, recruitment strategies better tailored to this population were developed and implemented.
  
  
  CONCLUSIONS
  Recruiters and clinicians must understand that for impoverished women, day-to-day survival takes precedence over most other issues. The possibility of a condition that may cause illness or death 10 to 20 years from now is of less importance than obtaining food, clothing, and shelter today. This program demonstrates that services such as transportation and child care are important elements of care for this population. Culturally sensitive recruitment strategies, personalized care, and vigilant follow-up are important requisites to breast cancer screening programs. A multidisciplinary team effort is critical in bringing together the elements required for a successful screening program.
authors.affiliation: Johns Hopkins Oncology Center, Baltimore, Maryland, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Zabora
authors.forename: C
authors.initials: C
authors.lastname: Morrison
authors.forename: S J
authors.initials: SJ
authors.lastname: Olsen
authors.forename: B
authors.initials: B
authors.lastname: Ashley
mesh_terms: D000328:Adult; D000368:Aged; D015142:Baltimore; D001943:Breast Neoplasms / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening / Q000458:organization & administration*; D017057:Medically Uninsured; D008875:Middle Aged; D010349:Patient Compliance; D018579:Patient Selection; D011795:Surveys and Questionnaires; D014932:Women's Health Services / Q000458:organization & administration*