Online Program

321119
Navigating Under-served Women to Better Breast Health: A national model for health disparity policy development


Tuesday, November 3, 2015

Edward Rafalski, PhD, MPH, FACHE, Strategic Planning and Marketing, Methodist Le Bonheur Healthcare, Memphis, TN
Background: Memphis, TN is the city with the largest disparity in breast cancer mortality rates between non-Hispanic Black and non-Hispanic White women.  Memphis, which is predominantly black, has a 20% poverty level and a dismal uninsured rate despite efforts to expand coverage under the Affordable Care Act and recent failure to adopt “Insure Tennessee,” a proposal to extend coverage to 200,000 uninsured Tennesseans who earn less than 138 percent of the federal poverty level (FPL) advanced by Governor Haslam in a special session of the Tennessee Legislature.

Methods: Through a cooperative partnership between the Methodist Le Bonheur Healthcare System and West Cancer Center, we utilized the Congregational Health Network (CHN) and a Community Outcome and Relations Coordinator (CORC) to seamlessly transition participants from the community to the clinic. The CHN is comprised of 8 patient navigators and over 600 trained liaisons.

Results: From September 2014 to January 2015, 559 eligible women were initially contacted.  325 women have been screened—222 screening and 103 diagnostic mammograms. Our estimated adherence rate (patients who showed interest who obtained a screening exam) was 82%.  This resulted in a 5.8% call back biopsy rate (19/325), 15 of which have been completed.  Two malignant lesions have been detected. 152 patients were still pending call back for screening.  67% of women were black, 29% Hispanic and 1% white.  77% of women were between the ages of 40-60 years.

Conclusion: We have described and successfully replicated a community-based outreach model for breast cancer navigation.

Learning Areas:

Administer health education strategies, interventions and programs
Administration, management, leadership
Advocacy for health and health education
Diversity and culture
Provision of health care to the public
Public health or related research

Learning Objectives:
Demonstrate a successful implementation of a community-based outreach model for reducing breast cancer mortality disparity. Explain the benefits of using a peer-reviewed template and evaluation of community-based outreach. Compare results of the model which was used among the under-served in Chicago, IL and replicated in Memphis, TN where breast cancer mortality disparity is the highest in the nation.

Keyword(s): Cancer and Women’s Health, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator for grants awarded for breast cancer disparity reduction. My academic interests include health services research, healthcare decision support, quantitative methods and health disparity reduction. I have academic appointments at the University of Memphis School of Public Health, University of Illinois School of Public Health and the University of Tennessee Health Sciences Medical School, Department of Preventive Medicine.
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.