Date of Completion

Summer 8-2-2024

Document Type

Open Access Capstone

Degree Name

Doctor of Nursing Practice (DNP)

Faculty Advisor

Joanne Roman-Jones, JD, PhD, RN

Site Advisor

Gertha Dabady, DNP, MSN, FNP-BC

Second Reader

Dana Mars, DNP, MSN, FNP-C

Abstract

Background and Problem Description: Breast cancer continues to be the most common and second most lethal form of cancer among women in the U.S. Although there have been improvements in breast cancer screening in the US, major disparities persist. The national breast cancer screening rate for the year 2021 was 75.6%; the rate for the underserved and minority population was 54%. This QI project took place at a Federally Qualified Health Center that provides medical care to medically underserved and vulnerable populations.

Purpose and Aim: This project aimed to increase breast cancer screening at the proposed site to optimize early detection and improve clinical outcomes for underserved women ages 40 to 74. The overarching aim of this project was to develop, implement, and evaluate an outreach strategy intervention to increase breast cancer screening rates among women who were not up to date or have missed appointments. The goal was to increase BCS by 4% above baseline.

Method: The health belief model guided the development of the outreach strategy. The model used for the evaluation of this project was the Plan-Do-Check-Act cycle. Support from stakeholders was obtained and an outreach list was generated. Phone calls were placed, and participants were successfully contacted. Education was provided as needed, barriers assessed, and appointments were scheduled. A provider satisfaction survey was used to assess the feasibility and value of the outreach intervention.

Intervention: The intervention consisted of a telephone call to women who have missed screening appointments, an assessment of barriers to completing their screenings, scheduling an appointment, and offering expert education. This intervention used a navigator approach to guide women through the screening process.

Results: Sixty one percent of the patients called (n=14) were successfully contacted. Of this number, 92.85% accepted screening and scheduled an appointment for a mammogram exam and 38.46% completed the exam. One hundred percent of the providers completed the post-intervention survey and found the intervention feasible and valuable for patient care outcomes.

Conclusion: The results demonstrated that patients are aware of the need for BCS and are willing to have the exam completed. The phone call intervention provided further incentive regarding the need for timely screening. This was demonstrated by 92.85% of patients who received the phone call scheduling an appointment. Further work should consider a larger sample size.

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