IMPLEMENTING HOME-BASED CANCER PREVENTION AND SCREENING: AN OPPORTUNITY FOR EQUITY.

Abstract

Cancer remains a leading cause of mortality in the United States, with significant inequities across racial and ethnic groups. Evidence-based cancer screening and prevention offers one pathway to reducing cancer mortality but can be challenging to implement with high fidelity and equity. In this paper, we describe the development of equitable, evidence-based cancer screening programs in Central Texas as a potential model for other regions and for other conditions for which evidence-based clinical preventive services exist but are not well-implemented or have not been implemented equitably. Key features include basing the program in Federally Qualified Health Centers (FQHCs); developing proactive outreach along with opportunistic in-reach; bilingual, bicultural social work-trained patient navigators for follow-up of abnormal screening; virtual multi-disciplinary conferences for challenging diagnostic and management decisions; and advocacy work to improve the entire screening process, including treatment.