MODULAR MAMMOGRAPHY PROGRAM (MMP) Taking Mammography Screening to Rural Arkansas Kimberly S. Enoch, BS Project Coordinator UAMS/ACRC Modular Mammography Program Arkansas Cancer Community Network LEARNING OBJECTIVES l Eliminate Disparities by Bridging Gaps l Utilize a MMP for Screening Services in Rural and Underserved Arkansas Initiate Successful Partnerships between an Academic Institution and Local/State Community Organizations to Implement Effective and Sustainable Models BREAST CANCER INCIDENCE l 1 out of 7 women l 1,830 cases estimated for 2007 Early Detection = Key To Survival & Best Treatment Options ACS Cancer Facts & Figures 2007 BREAST CANCER MORTALITY l 410 cases in 2007 Early Detection = Key To Survival & Best Treatment Options ACS Cancer Facts & Figures 2007 MAMMOGRAPHY SCREENING l X-ray of Supposedly Healthy Breasts l Women Age 40 and Older l Two Views (Breast Compressions) of Each Breast < 1/3 of Arkansas Women ANNUAL MAMMOGRAMS RECOMMENDED 40 & OLDER American Cancer Society Guidelines American Medical Association American College of Radiology American College of Ob& Gyn Earlier Stage 5 Year Survival Rate is 97% Average Cost of Breast Cancer: Early Stage $12,000 Late Stage $143,000 FDA-APPROVED MAMMOGRAPHY FACILITIES Recent trend: National decline by 6.0% { } # needing screening GAO Report: Mammography Current Nationwide Capacity: July 2006 ARKANSAS STATISTICS CDCs National Center for Chronic Disease Prevention & Health Promotion, 2003 ACCESS BARRIERS l Lack of FDA-approved mammography facilities l Lack of insurance l Lack of knowledge of navigating the system UNDERSERVED COUNTIES Benton Washington Boone Carroll Sebastian Yell Crawford Searcy Marion Newton Madison Scott Logan Pope Johnson Franklin Baxter Van Buren Conway Poinsett Jefferson Cleveland Little River Independence Sharp Fulton Stone White Grant Hot Springs Pike Sevier Jackson Lawrence Randolph Izard Cleomes Faulkner Dallas Clark Howard Perry GarlandMontgomery Polk Clay Greene Cross Lonoke Prairie Miller Columbia Union Ashley Chicot Drew Bradley Desha Calhoun Ouachita Lafayette Lincoln Saline Crittenden Mississippi Craighead Monroe Saint Francis Lee Phillips Woodruff Pulaski Arkansas Nevada Hempstead 23 Focused Counties No Mammograms No Mammograms/ Mobile Van Little Rock MOBILE COVERAGE NARMC Harrison SEMMC Ft. Smith SBRHS Jonesboro SJRHC Hot Springs MOBILE COVERAGE Counties remaining outside mobile coverage: CalhounClevelandDallas GrantLincolnLonoke MonroePerryPrairie ARKANSAS AFFILIATE KOMEN PROVIDES FUNDING Mammography Screening for 23 Arkansas Counties that Lack Mammography Facilities. GOALS OF MMP Provide Onsite Breast Cancer Screening & Education in 23 Underserved Counties Provide Resources of Referrals for Abnormal Screenings Work With AR DHHS to Ensure No Woman Goes Unscreened SOPHIE TRANSPORT VAN Shown is a transport van equipped with a hydraulic lift system. SOPHIE TRANSPORT VAN The hydraulic lift allows the SOPHIE to be transported directly into a screening facility. Access to Wheelchair Ramp Minimal 36 Door Frame SOPHIE UNIT EQUIPMENT & SUPPLIES DARK TENT BATCH PROCESSING BATCH PROCESSING ACRC MAMMOGRAPHY OUTREACH NETWORK COMMUNITY-BASED PARTNERS Primary Care Clinics Community Health Centers Local Health Units Nursing and Rehabilitation Senior Centers The Witness Project TM INSTITUTIONAL COLLABORATION American Cancer Society Arkansas Department of Health and Human Services (AR DHHS) Arkansas Cancer Coalition NCI Cancer Information Service NCI Centers to Reduce Cancer Health Disparities METHODS PCP within the Intervention Counties Screening Mammos Only Resource Manual Distributed Screening Guidelines Focused MMP Counties Access & Space Requirements Payment Mechanisms for Coverage Referral Directory NORTHWEST COUNTIES Franklin = 27 PPs = 2 Marion = 0Newton = 145 PPs = 3 Scott = 30 PPs = 3 Searcy = 54 PPs = 2 Total = 256 patients screened 10 PPs PP = Participating Provider SOUTHWEST REGION Calhoun = 83 PPs = 1 Dallas = 166 PPs = 3 Lafayette = 197 PPs = 2 Miller = 16 PPs = 1 Montgomery = 0Nevada = 0 Pike = 30 PP = 2 Total = 492 patients screened 9 PPs CENTRAL REGION Grant = 76 PPs = 5 Lonoke = 204 PPs = 2 Perry = 36 PP = 1 TOTAL: 316 women screened 8 PPs NORTHEAST REGION Fulton = 45 PP = 1 Poinsett = 150 PP = 1 Woodruff = 135 PPs = 2 TOTAL: 330 women screened 4 PPs SOUTHEAST REGION Cleveland = 54 PP = 1 Lee = 113 PPs = 3 Lincoln = 5 PP = 1 Monroe = 62 PP = 2 Prairie = 247 PP = 5 TOTAL: 481 women screened 12 PPs MEAN AGE: 57 Years ~ 14 / visit RACE African American 33% Caucasian 65% Hispanic