title: A Community-Based Partnership to Successfully Implement and Maintain a Breast Health Navigation Program.
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.
authors.affiliation: 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.|Alvin J. Siteman Cancer Center, St. Louis, MO, USA. drakeb@wustl.edu.|Institute of Public Health, Washington University, St. Louis, MO, USA. drakeb@wustl.edu.
authors.forename: Bettina F
authors.initials: BF
authors.lastname: Drake
authors.affiliation: Betty Jean Kerr People's Health Centers, St. Louis, MO, USA.
authors.forename: Shivon
authors.initials: S
authors.lastname: Tannan
authors.affiliation: Institute of Public Health, Washington University, St. Louis, MO, USA.
authors.forename: Victoria V
authors.initials: VV
authors.lastname: Anwuri
authors.affiliation: Betty Jean Kerr People's Health Centers, St. Louis, MO, USA.
authors.forename: Sherrill
authors.initials: S
authors.lastname: Jackson
authors.affiliation: Betty Jean Kerr People's Health Centers, St. Louis, MO, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Sanford
authors.affiliation: 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.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tappenden
authors.affiliation: 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.|Alvin J. Siteman Cancer Center, St. Louis, MO, USA.
authors.forename: Melody S
authors.initials: MS
authors.lastname: Goodman
authors.affiliation: 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.|Alvin J. Siteman Cancer Center, St. Louis, MO, USA.|Institute of Public Health, Washington University, St. Louis, MO, USA.
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D003159:Community-Institutional Relations; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D008913:Minority Groups; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D062526:Patient Navigation / Q000458:organization & administration* / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
keywords: Breast cancer; Disparities; Mammography; Patient navigation; Screening