Abstract B05: An evaluation of a community-based breast education and navigation program: Highlights and lessons learned from the Pitt County Breast Wellness Initiative

Essie Torres, A. Richman
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Abstract

Background: Pitt County is located in a rural disadvantaged part of Eastern North Carolina (ENC) and maintains persistent breast cancer disparities among minority women as compared to their white counterparts. Pitt County has the highest breast cancer mortality rate among minority women in ENC, with breast cancer mortality rates for minority women being twice as high compared to their white counterparts (42.4 vs. 21.9, respectively). Furthermore, minority women are diagnosed at later stages of the disease, with the rate of diagnosis at stage 4 being almost three times higher than white women in Pitt County. The Pitt County Breast Wellness Initiative provides culturally tailored breast cancer education and navigation to age-appropriate screening services for uninsured/underinsured Black and Latina women ages 25 and older. Methods: We conducted a qualitative evaluation to assess the effectiveness of our education and navigation components. We contacted program participants via telephone and administered a structured interview guide. Out of the 85 participants that were both educated by our program and received a free mammogram and clinical breast exam, we reached 60% (n=51) of these women. Results: This funded program has created a network of 20 community-based lay breast health educators, which includes faith leaders, breast cancer survivors, community advocates, and ECU BS in Public Health students. In a span of 2 years, we have educated over 600 women in eastern North Carolina (ENC) on breast health and breast cancer screening guidelines, and navigation services have been provided to 275 women, of whom 230 were given breast health assessments and 85 received a mammogram. We have identified five lessons learned to share in the successful implementation of a community-based cancer screening intervention: (1) community partnerships are critical for successful community-based cancer screening interventions; (2) assuring access to screening and appropriate follow-up should precede interventions to promote increased use of cancer screening; (3) the reduction of access barriers is effective in increasing cancer screening; (4) culturally tailored interventions can overcome barriers to screening for diverse racial/ethnic and socioeconomic groups; and (5) multicomponent interventions that include multiple community-health strategies are effective in increasing screening. Up-to-date results from program participants will be reported during the presentation. Conclusion: Although PCBWI can improve, we have been successful at increasing knowledge and screening for our population. Future community-based interventions must go beyond the overall assessment of effectiveness and expand current understanding of why given strategies are effective and analyze the cost-effectiveness of these strategies, to ensure replicability and sustainability. Citation Format: Essie Torres, Alice Richman. An evaluation of a community-based breast education and navigation program: Highlights and lessons learned from the Pitt County Breast Wellness Initiative [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B05.
摘要B05:基于社区的乳房教育和导航项目的评估:皮特县乳房健康倡议的亮点和经验教训
背景:皮特县位于北卡罗来纳州东部的农村弱势地区,与白人妇女相比,少数族裔妇女的乳腺癌发病率一直存在差异。皮特县少数族裔妇女的乳腺癌死亡率最高,少数族裔妇女的乳腺癌死亡率是白人妇女的两倍(分别为42.4比21.9)。此外,少数民族妇女在疾病晚期才被诊断出来,在皮特县,第4阶段的诊断率几乎是白人妇女的三倍。皮特县乳房健康倡议为25岁及以上的无保险/保险不足的黑人和拉丁裔妇女提供文化上量身定制的乳腺癌教育和适合年龄的筛查服务。方法:我们进行了定性评估,以评估我们的教育和导航组件的有效性。我们通过电话联系了项目参与者,并进行了结构化的面试指导。在85名接受了我们项目教育并接受了免费乳房x光检查和临床乳房检查的参与者中,我们达到了60% (n=51)。结果:这项资助的项目已经建立了一个由20名以社区为基础的非专业乳腺健康教育者组成的网络,其中包括信仰领袖、乳腺癌幸存者、社区倡导者和ECU公共卫生BS学生。在两年的时间里,我们在北卡罗莱纳东部对600多名妇女进行了关于乳房健康和乳腺癌筛查指南的教育,并向275名妇女提供了导航服务,其中230人接受了乳房健康评估,85人接受了乳房x光检查。我们确定了成功实施社区癌症筛查干预的五个经验教训:(1)社区伙伴关系对于成功的社区癌症筛查干预至关重要;(2)在干预措施之前,应确保筛查的可及性和适当的随访,以促进增加癌症筛查的使用;(3)减少获取障碍对增加癌症筛查是有效的;(4)有文化针对性的干预措施可以克服对不同种族/民族和社会经济群体进行筛查的障碍;(5)包括多种社区卫生策略在内的多组分干预措施在增加筛查方面是有效的。项目参与者的最新结果将在演示期间报告。结论:虽然PCBWI可以改善,但我们已经成功地增加了我们人群的知识和筛查。未来以社区为基础的干预措施必须超越对有效性的全面评估,扩大目前对某些战略为何有效的理解,并分析这些战略的成本效益,以确保可复制性和可持续性。引文格式:Essie Torres, Alice Richman。基于社区的乳房教育和导航项目的评估:皮特县乳房健康倡议的亮点和经验教训[摘要]。见:第十届AACR会议论文集:种族/少数民族和医疗服务不足人群的癌症健康差异科学;2017年9月25-28日;亚特兰大,乔治亚州。费城(PA): AACR;癌症流行病学杂志,2018;27(7增刊):摘要nr B05。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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