Assignment task:
Cambridge Health Alliance set out to increase mammography rates among women 50 to 69 years of age. Screening rates for all women were below 60% when the initiative began. The initiative focused on three areas: developing patient tracking systems and other information systems (such as improving communication within and between facilities), improving access by enhancing the capacity of the radiology department to reduce appointment wait times, and conducting outreach to difficult to reach and unscreened patients.
The outreach process included staff and patient education. Outreach staff work individually with the 15 clinics, reviewing their breast health screening rates and lists of patients due for mammograms and identifying factors that contribute to unscreened patients. This review assisted the clinic staff with understanding the clinic population. The clinic and outreach staff worked together and sent unscreened patients a personalized letter from their primary care provider. The content of the letter encouraged the patient to go to the clinic for a screening.
After the letter was sent, a follow-up personal phone call was made to the patient. The patient was called up to three times. During the call, the staff offered to schedule, and occasionally transport, women to the clinic for their screening. Letters and phone calls were provided to patients in their own languages.
Special Saturday events took place to assist working women with having the screening. The patients were often able to attend a session with friends. The Saturday sessions provided group education and individual screenings.
At the end of the initiative, screening rates were at 86% and rates for all language groups were above 80%; the screening rate for Spanish speakers was 92% and the screening rate for Portuguese speakers was 94% (Eliminating Disparities in Care, n.d.).
1. Why do you think these initiatives were successful?
2. Do you think these program changes would be helpful with other groups? Why or why not?
3. What health outreach program changes have you seen other programs make (e.g., on billboards, on television) to improve the health among specific groups?