Unidas por la Salud: A Comprehensive Breast Cancer Program ... · lack access to healthcare •...
Transcript of Unidas por la Salud: A Comprehensive Breast Cancer Program ... · lack access to healthcare •...
Julie Zenger Hain, Ph.D., FACMG
Department of Clinical Cytogenetics
Oakwood Hospital & Medical Center
Unidas por la Salud: A Comprehensive Breast Cancer Program for Women in
Southwest Detroit
These slides are the property of the presenter, do not duplicate without express written consent.
Unidas por la Salud United for Health
These slides are the property of the presenter, do not duplicate without express written consent.
Unidas por la Salud United for Health
Goal 1: Increase awareness of breast cancer risk among women in Southwest Detroit. Goal 2: Increase proportion of breast cancer diagnosed at earlier stages among women in Southwest Detroit Goal 3: Reduce financial barriers for timely and complete breast cancer screening follow-up and treatment among women of Southwest Detroit Goal 4: Increase awareness of breast cancer risk factors among women and promote education for women at increased risk in Southwest Detroit to seek appropriate services through their healthcare professional
These slides are the property of the presenter, do not duplicate without express written consent.
Genomics Objectives G1: Increase the proportion of women with a family history of breast and/or ovarian cancer who received genetic counseling
Health People 2020
These slides are the property of the presenter, do not duplicate without express written consent.
These slides are the property of the presenter, do not duplicate without express written consent.
These slides are the property of the presenter, do not duplicate without express written consent.
Primary Focus
• Hispanic Women in Southwest Detroit
• Women under age 40 and over age 64
These slides are the property of the presenter, do not duplicate without express written consent.
Why Women in Southwest Detroit?
• 57.2% of the population is Hispanic origin • Medically underserved, high rates of unemployment and poverty &
lack access to healthcare • Breast cancer is the most commonly diagnosed cancer among
Hispanic women & the leading cause of cancer death • Breast cancer is diagnosed less often among women of Hispanic
origin but more frequently at a later stage • Hispanic women are about 20% more likely to die of breast cancer
than non-Hispanic women at a similar age and stage – Lower utilization of screening tests – Disparities in access to care and treatment 2010 US Census and Data Driven Detroit ACS CA Facts & Figures for Hispanics/Latinos
These slides are the property of the presenter, do not duplicate without express written consent.
Why Women in Southwest Detroit?
• 57.2% of the population is Hispanic origin • Medically underserved, high rates of unemployment and poverty
& lack access to healthcare • Breast cancer is the most commonly diagnosed cancer among
Hispanic women & the leading cause of cancer death • Breast cancer is diagnosed less often among women of Hispanic
origin but more frequently at a later stage • Hispanic women are about 20% more likely to die of breast cancer
than non-Hispanic women at a similar age and stage – Lower utilization of screening tests – Disparities in access to care and treatment 2010 US Census and Data Driven Detroit ACS CA Facts & Figures for Hispanics/Latinos
These slides are the property of the presenter, do not duplicate without express written consent.
Why Women in Southwest Detroit?
• 57.2% of the population is Hispanic origin • Medically underserved, high rates of unemployment and poverty &
lack access to healthcare • Breast cancer is the most commonly diagnosed cancer among
Hispanic women & the leading cause of cancer death • Breast cancer is diagnosed less often among women of Hispanic
origin but more frequently at a later stage • Hispanic women are about 20% more likely to die of breast cancer
than non-Hispanic women at a similar age and stage – Lower utilization of screening tests – Disparities in access to care and treatment 2010 US Census and Data Driven Detroit ACS CA Facts & Figures for Hispanics/Latinos
These slides are the property of the presenter, do not duplicate without express written consent.
Why Women in Southwest Detroit?
• 57.2% of the population is Hispanic origin • Medically underserved, high rates of unemployment and poverty &
lack access to healthcare • Breast cancer is the most commonly diagnosed cancer among
Hispanic women & the leading cause of cancer death • Breast cancer is diagnosed less often among women of Hispanic
origin but more frequently at a later stage • Hispanic women are about 20% more likely to die of breast cancer
than non-Hispanic women at a similar age and stage – Lower utilization of screening tests – Disparities in access to care and treatment 2010 US Census and Data Driven Detroit ACS CA Facts & Figures for Hispanics/Latinos
These slides are the property of the presenter, do not duplicate without express written consent.
Why Women in Southwest Detroit?
• 57.2% of the population is Hispanic origin • Medically underserved, high rates of unemployment and poverty &
lack access to healthcare • Breast cancer is the most commonly diagnosed cancer among
Hispanic women & the leading cause of cancer death • Breast cancer is diagnosed less often among women of Hispanic
origin but more frequently at a later stage • Hispanic women are about 20% more likely to die of breast cancer
than non-Hispanic women at a similar age and stage – Lower utilization of screening tests – Disparities in access to care and treatment 2010 US Census and Data Driven Detroit ACS CA Facts & Figures for Hispanics/Latinos
These slides are the property of the presenter, do not duplicate without express written consent.
Why Under Age 40 & Over Age 64?
• Breast & Cervical Cancer Control Program (BCCCP)
– Services women 40-64 years of age
These slides are the property of the presenter, do not duplicate without express written consent.
Unidas por la Salud United for Health
Goal 1: Increase awareness of breast cancer risk among women in Southwest Detroit. Goal 2: Increase proportion of breast cancer diagnosed at earlier stages among women in Southwest Detroit Goal 3: Reduce financial barriers for timely and complete breast cancer screening follow-up and treatment among women of Southwest Detroit Goal 4: Increase awareness of breast cancer risk factors among women and promote education for women at increased risk in Southwest Detroit to seek appropriate services through their healthcare professional
These slides are the property of the presenter, do not duplicate without express written consent.
Unidas por la Salud
Patient Care Expense • Clinical Breast Exams • Mammography • Office visits • Genetic risk assessments • Follow-up patient care
– Ultrasounds – Biopsies – Follow-up mammograms – MRI
• Transportation • Interpreters
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American Cancer Society’s Promotoras de Salud Program
These slides are the property of the presenter, do not duplicate without express written consent.
Oakwood’s Faith-based Outreach Program
These slides are the property of the presenter, do not duplicate without express written consent.
These slides are the property of the presenter, do not duplicate without express written consent.
These slides are the property of the presenter, do not duplicate without express written consent.
These slides are the property of the presenter, do not duplicate without express written consent.
These slides are the property of the presenter, do not duplicate without express written consent.
• Personal history of: Breast cancer Ovarian cancer If Yes, age at diagnosis: _________ • Current age • Age at first menstrual period • Age at first live birth • Have you ever had a breast biopsy? If Yes, was atypical hyperplasia found under the microscopy? • Race/Ethnicity • Do any of these family members have a history of breast cancer: Mother – Age of onset: Sister(s) – Age of onset: Daughter(s) – Age of onset: • Do you have any of the following family history? Female breast cancer diagnosed under age 50 Male breast cancer diagnosed at any age Ovarian cancer diagnosed at any age Pancreatic cancer diagnosed at any age Colon cancer diagnosed under the age of 50
These slides are the property of the presenter, do not duplicate without express written consent.
These slides are the property of the presenter, do not duplicate without express written consent.
Process Flow
Grassroots Promotoras
Covenant
Clinical Breast Exams
Midwest
Mammograms
Breast Care Center-
Dearborn
Diagnostics
These slides are the property of the presenter, do not duplicate without express written consent.
Process Flow
Grassroots Promotoras
Covenant
Clinical Breast Exams
Midwest
Mammograms
Breast Care Center-
Dearborn
Diagnostics
These slides are the property of the presenter, do not duplicate without express written consent.
Unidas por la Salud United for Health
Goal 1: Increase awareness of breast cancer risk among women in Southwest Detroit. Goal 2: Increase proportion of breast cancer diagnosed at earlier stages among women in Southwest Detroit Goal 3: Reduce financial barriers for timely and complete breast cancer screening follow-up and treatment among women of Southwest Detroit Goal 4: Increase awareness of breast cancer risk factors among women and promote education for women at increased risk in Southwest Detroit to seek appropriate services through their healthcare professional
These slides are the property of the presenter, do not duplicate without express written consent.
Unidas por la Salud United for Health
Goal 1: Increase awareness of breast cancer risk among women in Southwest Detroit.
• Strong partnership established/providers trained • Unidas por la Salud programs promoted (English and Spanish) • 15 Promotoras culturally trained to educate women on breast health • Exceeded project program goal of 700 women impacted
• 1,109 women participated
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Unidas por la Salud United for Health
Goal 2: Increase proportion of breast cancer diagnosed at earlier stages among women in Southwest Detroit
• Provided 40 clinical breast exams and referred 149 to BCCCP • Provided 14 digital mammograms and 2 biopsies (benign lesions)
These slides are the property of the presenter, do not duplicate without express written consent.
Unidas por la Salud United for Health
Goal 3: Reduce financial barriers for timely and complete breast cancer screening follow-up and treatment among women of Southwest Detroit
• 14 mammograms • 15 ultrasounds • 1 MRI • Referred 149 women to BCCCP for mammograms • 2 biopsies
These slides are the property of the presenter, do not duplicate without express written consent.
Unidas por la Salud United for Health
Goal 4: Increase awareness of breast cancer risk factors among women and promote education for women at increased risk in Southwest Detroit to seek appropriate services through their healthcare professional
• Promotoras and provider education • 30+ identified women/family at higher risk • 7 individuals seen for Genetic Counseling • 1 Mammogram and 1 MRI for woman <40 years of age • 0 referrals for chemoprevention of breast cancer
These slides are the property of the presenter, do not duplicate without express written consent.
Unidas por la Salud United for Health
Lessons Learned
• Promotoras de Salud a successful program • Provider education/implementation impacted by available
follow-up care • Underutilization of available Federal/State funded programs • Follow-up care involved care at facility requiring legal ID • Risk Assessment – follow-up appointments poorly attended • Limited importance on breast health when dealing with acute
medical issues, poverty, and unemployment
These slides are the property of the presenter, do not duplicate without express written consent.
Julie Zenger Hain, Ph.D., FACMG
Department of Clinical Cytogenetics
Oakwood Hospital & Medical Center
Dearborn, MI
313.593.8483
These slides are the property of the presenter, do not duplicate without express written consent.