Community Health Workers and Breast Health Navigation: An Innovative Strategy to Increase Breast Cancer Screenings in Chicago

Background: There is a large Black: White disparity in breast cancer mortality in Chicago (RR=1.62, 2005-07). The Sinai Health System has implemented a “community navigation” program to improve breast health outcomes for the health of all women enrolled.

Methods: Navigation steps include: completing an intake form, attending a PCP appointment (to receive a referral), completing a mammography screening, attending the follow-up appointment, receiving results, and completing diagnostic services. Navigators also provide social support, financial assistance and assistance with transportation when needed.

Results: In the Fall of 2010 (September through December) 383 women requested a service and 87 received a mammogram. Average time to completion of the mammogram was 3 months. In 2010, 4 CHW's participated in over 400 community outreach activities and recruited 1,167 women. 2/3 were Black and 1/3 Hispanic; 45% had a recent mammogram and about half were uninsured. CHWs navigated over 300 women to mammography services and 32% of women who should have completed a repeat (n=69) have done so.

Implications: HHL is the first community navigation program of its kind. It demonstrates how to link women from the community to screening and resolution of abnormal mammograms through to treatment. HHL demonstrates how health care delivery systems can take preventive care measures to the community and promotes improved health among those most vulnerable populations who are often least likely to receive and benefit from advances/basic health care. It is a model for institutions serving the most vulnerable populations in engaging communities.