Community-Based Navigation to Improve Breast Health Outcomes on the Westside of Chicago

BACKGROUND: Though hospital-based navigation is known to be effective in reducing delays in diagnosis and treatment of breast cancer, there are virtually no community-based navigation programs aimed at improving breast health outcomes. PROGRAM: With support from the Avon Foundation, we launched an outreach navigation project by taking traditional navigation from the hosptial to the community. A community health worker (CHW) model was adapted to increase breast cancer screening, reduce delays in diagnosis, and ensure access to timely treatment for women in two communities with some of the highest breast cancer mortality rates in Chicago. FINDINGS: Between Oct 2008-Jan 2010, CHWs reached over 20,000 people through health fairs and community events and made presentations to 1,933 women. About 40% had a mammogram in the last 2yrs and about 2/3 were Black and 1/3 Hispanic. In addition, we facilitated 1,392 services (such as scheduling primary care and mammogram appointments) for 1,353 women at several different facilities. CHWs follow up with clients multiple times over several weeks to ensure they get services. DISCUSSION: Community-based navigation is proving to be an effective way to improve breast health outcomes along the continuum of care. CHWs are successful in reaching the hardest to reach women, linking them to a medical home, and tracking whether women receive services and all follow-up care necessary. Evaluation strategies presented are important for breast cancer education and outeach programs aimed not only at increasing access to screening but also to improving overall breast health outcomes.