Abstract B17: Providing access and reducing barriers to mammography use in an underserved area

Purpose: A federally-qualified health care center (FQHC) and a university in St. Louis, MO have partnered to increase access and reduce barriers to mammography in an underserved area. The purpose of this study is 1. to assess the barriers to mammography use in this underserved population; 2. the proportion of women in this population who are uninsured and do not quality for governmental assistance; 3. the previous lack of compliance to mammography among the women currently being navigated. Background: Even though black women have higher rates of utilizing mammography services than that of white women in Missouri, black women9s mortality rate is much higher in comparison to other groups and it is steadily increasing. This data reflects the importance of continuing to encourage routine mammography use among minority and underserved women in accordance with screening recommendations. The female patient population of the target clinic is 87.0% black and has a disproportionate number of women who were due or overdue for a mammogram (87.7%). Methods: The FQHC, Betty Jean Kerr People9s Health Centers, has instituted a mammography screening program in one of its clinics that previously did not provide mammography services. The university, through the Program for the Elimination of Cancer Disparities, provides training in patient navigation as well as financial assistance for uninsured participants who do not qualify for governmental co-payment assistance. The patient navigator assists women, age 40 and over in determining their eligibility for financial assistance, scheduling appointments, as well as any follow-up services. If the participant is uninsured and does not qualify for co-payment assistance, a study voucher is provided. All navigated women are surveyed on barriers to mammography use as well as the date of their last mammogram. Results: To date, 309 women have been navigated through the clinic. 65% report cost as a barrier. 72% of the navigated women are uninsured. Among those uninsured, 13% also do not qualify for state co-pay assistance. Of the women currently navigated, 60% were non-compliant for a mammogram, having a mammogram over 1 year previously. Among these women, 53%, 21%, and 25% of women were non-compliant for 1, 2 and 3 or more years respectively. Conclusions: There is a need for increased access to mammography in underserved areas. Even when access is achieved, financial barriers remain. FQHCs can subsidize these services, however even co-payments can be financial barriers for some uninsured women and there is a proportion of uninsured women who do not qualify for governmental assistance for co-payment. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B17.