A NURSE-DELIVERED INTERVENTION TO REDUCE BARRIERS TO BREAST AND CERVICAL-CANCER SCREENING IN CHICAGO INNER-CITY CLINICS

An 18-month intervention was implemented to increase breast and cervic al cancer screening among poor African-American women in Chicago. Brea st and cervical cancer screening programs were set up in two public cl inics, one community-based and the other hospital-based. Nurse clinici ans and public health workers were used in these programs to recruit w omen in the clinics and in targeted community institutions to receive free breast and cervical cancer screening. The following barriers were specifically addressed by the intervention: accessibility of screenin g, knowledge about breast and cervical cancers, access to followup scr eening examinations, and access to treatment. A computerized followup system was specifically designed to track patients. During the 18 mont hs of the intervention, 10,829 visits were made by 7,654 low-income wo men. A total of 84 cases of breast cancer and 9 cases of cervical canc er were detected. Awareness of the program, as measured by a survey af ter the completion of the intervention, increased in both clinics comp ared with baseline results. Knowledge about breast and cervical cancer s also increased, as measured by scores on tests given before and afte r a class on breast and cervical cancers. Followup rates were 86 perce nt for women attending the programs. More than 90 percent of the women referred for evaluation of breast abnormalities kept an appointment. In summary, the intervention was successful in reducing barriers to br east and cervical cancer detection and in attracting a high-risk group of women.