Reaching At-Risk Women to Promote Breast Cancer Screening on the Westside of Chicago

BACKGROUND: Poor access to breast cancer screening may be one cause of widening Black-White disparities in breast cancer mortality (RR=1.62, 2005-07). Building on the successses of patient navigation programs, community navigation aims to reach women who are most at-risk where they live. METHODS: Between 2008-2010, we developed 10 unique targeted channels of communicating with women in two vulnerable communities on the Westside of Chicago. These efforts included but were not limited to 3 broadly defined categories: Outreach, including one-on-one canvassing, visting households door-to-door, and setting up information tables and kiosks at local venues; Events, including hosting events and attending existing health fairs; and Workshops, small-group educational sessions. We evaluated the impact of each activity by assessing, which yielded the greatest participation and produced the most requests. RESULTS: On average, we encounted 3,000 women a month, recruited 100 of them and assisted 30 in their getting a mammogram. 61% were Black, 11% Puerto-Rican and 20% Mexican and 85% were either un- or under-insured. The greatest yield in participation came from events and outreach in the predominantly Black community and from events and workshops in the Hispanic communities. Across all activities, 80% of women contacted requested a service. This observation held true in Black and Hispanic communities. IMPLICATIONS: Community navigation has proven to be an effective means of reaching those who are underserved and navigating them through the health care system. It is a model for linking at-risk and uninsured women to preventive services, particularly in light of natioanl health care reform.