The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56928

Regina Otero-Sabogal, PhD¹, Desi Owens, MS, LCSW², Jesse A. Canchola, MS², Farzaneh Tabnak, MS, PhD³, and Patrick J. Fox, PhD². (1) Institute for Health and Aging, UCSF, 3333 California Street Suite 340, San Francisco, CA 94118, (415) 476-3311, reginas@itsa.ucsf.edu, (2) Institute for Health and Aging, University Of California, San Francisco, 3333 California Street Suite 340, San Francisco, CA 94118, (3) California Department of Health Services, Cancer Detection Section, 601 North 7th Street, MS-428, P.O. Box 942732, Sacramento, CA 94234-7320

Background: Given the limited resources within community clinics, and limited breast health education and access, mammography rates continue to be low within uninsured, ethnic communities. This study re-designed clinic screening services through a multi-faceted intervention that included: 1) clinic operational assessments and feedback; 2) tracking systems; 3) patient reminder calls; 4) patient education; and 5) physician prompts. Objective: The study sought to increase patients’ clinical breast exam (CBE) and mammography re-screening rates within three clinics. Methods: We used a quasi-experimental design with a random selection of 447 ethnically diverse patients at baseline. A comparable cross sectional random sample was drawn 18 months following the intervention. Chart reviews were conducted to establish re-screening rates. The post-intervention follow-up re-screening rates will be compared to baseline rates. Multivariable modeling will be conducted to identify variables that predict re-screening. Results: The clinics’ baseline mammography re-screening rates were 29.6%, 32.4% and 44.4%. It is anticipated that there will be at least a 15% increase in re-screening rates. Conclusions: To improve the quality of breast health services, it is critical that interventions address the patient, clinician, and system needs.

Learning Objectives:

At the conclusion of the presentation, participants will be able to:
• Discuss the process of how to assess and improve clinic system practices that affect the delivery of CBE/mammography screening services.
• Describe both system and patient barriers to CBE/mammography re-screening.
• Describe specific interventions that positively influence CBE/mammography re-screening within underserved populations.

Keywords: Mammography Screening, Low-Income

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.