Evaluation of ENCOREplus. A community-based breast and cervical cancer screening program.
BACKGROUND
Minority women and women with low income levels are significantly less likely to practice appropriate mammography and Pap test screening. ENCOREplus is a health promotion program that provides outreach, education, referral, and other service that facilitate breast and cervical cancer screening for medically underserved women. The program is delivered through a network of community-based nonprofit organizations (YWCA of the U.S.A). The purpose of this study was to assess the effectiveness of ENCOREplus in promoting mammography and Pap test screening among women who were nonadherent to screening guidelines.


METHODS
Baseline data were collected from women participating in the program. Follow-up occurred within six months of baseline to assess whether or not enrollees received recommended screenings. Screening-completion rates were compared to rates from other published intervention studies.


RESULTS
Data from the program's second implementation year show that 27,494 women participated in the ENCOREplus program. Over half the women were racial/ethnic minorities, over 75% reported annual incomes under $15,000, and 49% reported no insurance. Among women 40 and over, 69.7% were nonadherent to ACS mammography screening guidelines at baseline. Among participants 18 and older, 68.9% were nonadherent to Pap test screening guidelines. Of nonadherent participants, 57.8% received mammograms and 36.5% received Pap tests. Both mammography and Pap test screening-completion rates compared favorably with other programs.


CONCLUSIONS
This study demonstrates that programs implemented through community-based organizations can be successful in increasing mammography and Pap test screening among low-income and minority women.
Fernandez
M E
ME
University of Texas-Houston School of Public Health, Center for Health Promotion Research and Development 77030-9960, USA.
DeBor
M
M
Candreia
M J
MJ
Wagner
A K
AK
Stewart
K R
KR
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control*; D003153:Community Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D010349:Patient Compliance; D015397:Program Evaluation; D012959:Socioeconomic Factors; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data*