Breast and Cervical Cancer Early Detection BEST PRACTICES AND MODELS PRESENTED BY: LATHANHARRIS, INC.
PRESENTATION OBJECTIVES Describe disparity issues for African American women Describe barriers African American women face in obtaining b/c screening, diagnosis and treatment Describe best b/c early detection practices and strategies
TYPES OF BREAST EXAMS Self examination When you check your own breast for lumps and changes in size or shape of the breast or underarm Clinical breast examination When is when a doctor or nurse examines the breast with his or her hands to feel for lumps or other changes Mammogram Mammograms can detect cancers that are much smaller than those that can be found by clinical breast exams or by breast self-exams. recommended for 40 and older American Cancer Society: Cancer Facts and Figures 2015. Atlanta, Ga: American Cancer Society, 2015.
WHEN SHOULD SCREENINGS BEGIN It is recommended that an exam of your breast be conducted by your doctor : Age 20 s & 30 s clinical breast exam every three years Age 40+ - Clinical breast exam every year Mammography generally should begin at age 40, but may begin earlier in women with a family history of early breast cancer.
DISPARITIES Breast cancer is the second leading cause of cancer deaths among women African American (AA) women have the highest breast cancer death rates of all racial and ethnic groups AA women are less likely to get prompt follow up care when their test show something abnormal AA women often have fewer social and economic resources than their counterparts www.ncbi.nlm.nih.gov
BARRIERS TO CARE Medical mistrust of health care systems, access to quality health care coverage Cultural/Spiritual-role of faith and understanding health status and intervention Economic-single income households, financial burdens of co-pays or co-insurance Transportation to/from care
BARRIERS TO CARE Fear of Cancer fear of the unknowns and familiar experiences of loved ones Lack of a medical home Cost of services Lack of social/emotional support
OVERCOMING BARRIERS In culturally trusted settings provide education about patient rights, services and resources Use and continue to build on established collaborations and partnerships Use traditional referral networks Telephone calls/text reminders Partner with non traditional groups civic, social, family, neighborhood
BEST PRACTICES Patient-Provider Communication Build trust Dispel myths around treatment and outcomes Communication with patients, family and friends Understanding family history Explaining diagnosis and treatment Psycho-social support Involve spiritual leaders Access relevant resources Provide culturally competent support groups in trusted settings
MODEL RECRUITMENT STRATEGIES Educate women about the importance of screenings Remove barriers to screenings Follow-up and maintenance Use available resources
MODEL RECRUITMENT PROGRAMS Tell a Friend Program Various strategies that encourages women to tell friends about the need for early detections The Witness Project The project trains volunteers to conduct presentations in churches and churches and community centers to increase the detection behaviors in the African American Community (Bloom, Grazier, Hodges, Hayes, 1991) Project Safe o A system of patient navigation services designed to help low-income, ethnic-minority women overcome barriers to timely breast cancer care and treatment after receiving an abnormal mammogram
ELIMINATING DISPARITIES May require a focus on overcoming social, structural, and economic barriers with access and trust of health care Studies show that multiple strategies were generally more effective than single behaviors Strategies include: Community education, system directed intervention and individual directed interventions in health care settings, over coming social, structural, and economic barriers, as well as trust and the health care systems American Cancer Society: Cancer Facts and Figures 2015. Atlanta, Ga: American Cancer Society, 2015.
CONCLUSION Social and emotional support from early detection to treatment is essential Trust and communication in patient-provider and patient-support system relationships Ongoing community level breast and cerivcal cancer education Continuous recruitment of new partnerships and collaborative relationships
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