Identifying Interventions to Reduce Breast Cancer Screening Barriers using Community Centered Prioritization Exercises.

Abstract

PICK charts are Lean Six Sigma tools used to prioritize improvements based on effort required and potential impact. Our purpose was to conduct PICK chart prioritization exercises with a low income, diverse community advisory group to identify and prioritize patient and community centered interventions to reduce mammography screening disparities. Community advisory focus group was composed of 22 adults from low-income neighborhoods in Madison, Wisconsin. Included participants were from the Wisconsin Network for Research Support Community Advisory on Research Design and Strategies, recruited from community centers and food banks that serve individuals from diverse racial, socioeconomic, and educational backgrounds. Structured, divergent thinking brainstorming sessions were conducted to identify interventions to improve the mammography screening process. The idea generation process revealed 52 unique ideas across 7 process map domains. Among participants, the most highly cited ideas that were classified as high impact, low effort ideas included: reminders, sharing positive stories about mammography experiences, offering reassurance during mammograms, and reducing co-pays. Community centered prioritization exercises identify patient-centered, contextually relevant interventions to improve cancer screening percentages in medically underserved patient populations, including high-quality, patient centered communication about the mammography screening process and reduced costs.