220722 Community-Based Navigation to Improve Breast Health Outcomes on the Westside of Chicago

Monday, November 8, 2010

Ami Shah, MPH , UCLA Center for Health Policy Research, Los Angeles, CA
Kristi L. Allgood, MPH , Sinai Urban Health Institute, Sinai Health System, Chicago, IL
Teena Francois, MPH , Sinai Urban Health Institute, Chicago, IL
DeShuna Dickens, MPH, AE-C , Urban Health Institute, Sinai Health System, Chicago, IL
Giselle Vásquez-Jones, MPH , Sinai Urban Health Institute, Chicago, IL
Gloria Seals , Sinai Children's Hospital, Sinai Health System, Chicago, IL
Pauline McCaskill , Sina Urban Health Institute, Chicago, IL
Ana-Rosa Garcia , Sina Urban Health Institute, Chicago, IL
Wanda Rodriguez , Sina Urban Health Institute, Chicago, IL
Celevia Taylor , Sina Urban Health Institute, Chicago, IL
Regina Flowers , Sina Urban Health Institute, Chicago, IL
Steven Whitman, PhD , Sinai Urban Health Institute, Sinai Health System, Chicago, IL
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.

Learning Areas:
Advocacy for health and health education
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research

Learning Objectives:
- Describe how community-based navigation of breast health care works in hard-to-reach and uninsured populations. - Evaluate a model community-based navigation program and demonstrate how to track client services along the continuum of breast health care. - Share lessons learned in expanding outreach efforts and coordinating breast health services between institutions for improved breast health care.

Keywords: Breast Cancer Programs, Breast Cancer Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee this community-based navigation program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.