The Collaborative Effort

Submission Date: February 2020

State/Territory Submitted on the Behalf of: Mississippi

States/Territories Involved: Mississippi

Funding Source: CDC, NACDD

CDC Funding:

Yes

Domain Addressed:

Community-Clinical Linkages, Health Systems Strategies

Public Health Issue:

Breast cancer is one of the most commonly diagnosed cancers among women in the United States. Although advances in treatment have helped many women live longer healthier lives after a diagnosis, detecting breast cancer at early stages is imperative for long-term survival.

Project Objectives:

Breast cancer is one of the most commonly diagnosed cancers among women in the United States. Although advances in treatment have helped many women live longer healthier lives after a diagnosis, detecting breast cancer at early stages is imperative for long-term survival. The Mississippi State Department of Health Breast and Cervical Cancer Program (MS-BCCP) is a screening program that supports and promotes breast and cervical cancer screening for medically underserved women considered high risk in Mississippi. The goal of the project is to screen underserved women for breast and cervical cancer to reduce morbidity and mortality. These groups include underinsured, uninsured, medically underserved, minority, and elderly women and women of military families. MS-BCCP and community organizations came together to collaborate as partners to promote and facilitate screening for breast and cervical cancer.

Research has shown screening rates for breast and cervical cancer have been increasing, possibly due to the efforts of the initiatives by the Centers for Disease Control and Prevention/NBCCEDP that targets cancer prevention and control. The opportunity to participate in the ASTHO Reducing Breast Cancer Disparities 2019 Learning Community Collaborative Project aided the state’s efforts to provide life-saving services. Research studies have shown that older women who are uninsured or underinsured have a lower socioeconomic status, they are from racial or ethnic minority groups, or lack a traditional source of health care and are least likely to be appropriately screened for breast and cervical cancer. Additionally, structural, interpersonal, financial, and cultural factors that affect adherence to breast and cervical cancer screening have been identified.

Other barriers may include lack of transportation, lack of knowledge about cancer and cancer screening, distorted perceptions of risk and susceptibility to cancer, cultural beliefs and low literacy, mistrust of doctors and the health care system.

The focus for this project was to recruit women that met the eligibility guidelines including women that we might not often see from military families. The general public is unaware of the struggles of modern-day military families. Several articles have been written to address this issue such as “When Active-Duty Service Members Struggle to Feed Their Families” in 2017, a multi-collaboration of several private news reports and NPR (National Public Radio). The U.S. Department of Veteran Affairs published “Veteran Poverty Trends” in 2015. With the struggle to feed their families, many women overlook breast and cervical cancer screenings for themselves since there is a potential to create another expense. The Mississippi Breast and Cervical Cancer program can help many of these women who have no insurance or whose insurance has lapsed due to the families’ military member’s return from deployment.

Strategies:

1. Collaborated and partnered with the University of Mississippi Medical Center Pathology Association on See Test and Treat (STT) efforts during the June event as one of the BCCP events for women interested in participating in the event.

2. MSBCCP nurses emphasized to women during the enrollment, screenings, and information sessions, if follow-up diagnostics are needed appointments were provided within 5 to 7 days following the event.

3. Worked closely with other community partners (i.e. North Sunflower Hospital Radiology Group, Susan G. Komen Memphis Mid-South Affiliate, Southeast Mississippi Rural Health Initiative) to provide activities to the rural communities in Mississippi to encourage women to be screened and educated on the importance of being screened.

4. Collaborated with Mississippi’s BHMC (Building Healthy Military Communities) to get the word out to needy military families who could utilize BCCP services.

5. Utilized educational resources, technical support, and logistical planning with getting women in and out of the clinics.

Program Action:

See Test and Treat is a one-day event that provides cancer screenings for pre-approved women. The goal is to screen approximately 100 women during the same-day event. Healthcare providers met over a six-to-eight month period to form a collaborative effort for the one-day screening event for women that were uninsured and underinsured, seeking breast and cervical cancer screenings. These women received their test results on the same day. Some challenges encountered were transportation barriers and locating additional sites to perform the processing of the pap tests. The hospital that sponsored the event provided their lab and staff for the same-day test results and utilized the organizations’ transport system for transporting the labs to and from the site.

• There were physicians, nurses, pathologists, radiologists, dietitians and other healthcare professionals onsite to assist with the educational needs of the participants in this one-day event.
• The See Test & Treat (STT) Coordinator screened women to determine eligibility and scheduled for the Saturday event.
• Mississippi Breast and Cervical Cancer Program staff was available onsite for enrollment into the BCCP and provide assistance and additional information as needed.

Data/Other Information Collected:

Breast Cancer Outcome Data from 2017 thru 2019. Sources include: Mississippi Breast and Cervical Cancer Program, U.S. Census ACS (2015), CDC Breast Cancer Statistics and Mississippi Vital Statistics. (Figures 1-6)

Impact/Accomplishments:

There were 103 women screened for See Test and Treat. As a result of this one-day effort:

• The women that participated in the one-day event received results the same day.
• Referrals made to a medical home for follow-up services and women with abnormal results were referred for diagnostic follow-up.
• Educational resources, technical support, and logistical planning aided with getting women in and out of the clinics.
• Utilization of social media, flyers, word-of-mouth and faith-based organizations covered a larger geographical region.
• Of the 103 participants screened during the event:
  • Fifty-eight women received mammograms,
  • Forty-four received paps, and
  • Twenty-one had abnormal mammogram results.

Of this total, 17 enrolled in the Breast and Cervical Cancer Program, 13 completed diagnostic testing, and 16 required diagnostic testing. There were no breast or cervical cancers detected.

Challenges/Lessons Learned:

The BCCP staff processed subcontracts with three contracted providers to increase screenings in rural communities. Other stakeholders that were aware of the one-day event had similar events in their area where the popluation was identified as hard-to-reach. The statistics for completed diagnostics for this event was more than 75 percent. Upon careful review, this data actually meet the goal of CDC’s cancer screening abnormal core indicator 25d for the Breast and Cervical Cancer Program. The collaboration of committed healthcare partners will help serve more women. The picture on the story represents the population served.

Next Steps:

The Program will collaborate and partner with the UMMC/Pathology Association and some of the Federal Qualified Healthcare Facilities again next year to provide services to the women of Mississippi. The plan is to try to increase the number of women screened and encourage other healthcare organizations to provide similar events in their rural communities in the state.

Program Areas:

Cancer, Health Equity and Cultural Competency

State Contact Information:

MS
Deborah A. Lake, LCSW
Mississippi State Department of Health
601-576-7016
deborah.lake@msdh.ms.gov

Program Activities Date Range:

September 2021

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