ASPO Abstracts
Challenges to Implementing Cancer Prevention & Screening Programs in Low Income Rural Settings: Outcomes from Texas A&M's Cancer Screening & Prevention Program
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: The purpose of the Texas A&M cancer screening, training, education, and prevention, (C-STEP) program is to provide evidence-based cancer screening and diagnostic services, prevention education, patient care and navigation, through a unique interdisciplinary clinical training program carried out, in part, by the AGGIE Nurses CARE & Houston Methodist Neal Cancer Center. Methods; Through generous funding from the Cancer Prevention & Research Institute of Texas, (CPRIT), Temple Foundation, and the Pink Alliance, unique interdisciplinary teams of Nurse Practitioners, NP-students, MPH students and CHW's developed and implemented evidence-based cancer screening and diagnostic services, prevention education, and patient care and navigation, through an evidence-based, interdisciplinary training program. Safety-net individuals, (<250% of federal poverty level) in 17 central Texas counties (12 rural counties, 15 whole-county MUAs), received colonoscopy, pap, and/or mammogram services. Results: Between 01/1/2014 and 12/31/2021, a total of 3,615 unique women received the following grant-funded screening and diagnostic (where necessary due to positive findings) services: 2016 mammograms; 981 pap tests; 701 clinical breast exams; 223 breast ultrasounds; 64 breast biopsies; 281colposcopies; and 59 loop electrosurgical excision procedures. Precursors to cancer were detected in 23% of pap test results. We detected 37 cases of breast cancer, and two cases of cervical cancer were diagnosed. Bilingual community health workers provided direct (face-to-face) prevention education, navigation assistance, and outreach services to > 25,000 people. Conclusions Improved access to cancer screening procedures for low-income uninsured, and underinsured persons, through provision of free screenings and use of community health workers for outreach and education, can contribute to improved cancer detection in rural, underserved areas decreasing cultural and behavioral barriers to screening. Significance & Impact: This interdisciplinary screening and prevention program serves as a state and national model for addressing the significant need for greater numbers of providers, nurses, public health professionals, and community health workers who are trained in cancer navigation.
Keywords: Rural, Underserved, Cancer Screening, Cancer Prevention, CHW's