Date of Completion

5-14-2023

Document Type

Open Access Capstone

Degree Name

Doctor of Nursing Practice (DNP)

Faculty Advisor

Eileen Stuart-Shor

Site Advisor

Stephen Tringale

Second Reader

Heather Losee

Abstract

Background: Breast cancer is the most prevalent form of cancer in the U.S. Cancer screenings can result in prompt treatments and positive health outcomes. Disparities in screening rates are prevalent among vulnerable populations. At a Federally Qualified Health Center (FQHC), where the project occurred, the rate of breast cancer screening in 2021 (64%) was lower than the target set by the Healthy People 2030 (77%). This quality improvement project aimed to increase the rate of routine breast cancer screening among women aged 50-74 years old in the FQHC.

Methods: Previous studies have reported that decision aids on breast cancer screening can decrease decisional conflict, increase screening intention and screening rates. In collaboration with an on-site committee, a standardized patient outreach process using a decision aid on breast cancer screening was developed and assessed.

Intervention: A phone script incorporating a decision aid was used to provide information on mammograms to eligible patients. The patients were offered an appointment for a mammogram. Four months after this call, the participants’ medical charts were reviewed for the completion of the scheduled mammogram. A group of FQHC staff reviewed the outcomes and provided feedback. Follow up calls were made to patients who declined the decision aid, declined the mammogram after completing the decision aid, and missed their scheduled mammogram.

Results: Sixty-five percent of eligible patients (n = 103) were successfully contacted. Of this number, 30% completed the decision aid, in which 75% of these patients scheduled a mammogram and 47% completed the screening. Of the patients who did not complete the decision aid, 57% scheduled a mammogram, and 67% completed the screening. Ninety-five percent of participants who completed the decision aid thought they made an informed decision about having a mammogram.

Conclusion: Consistent with the improved screening rates for mammograms after implementation of a decision aid reported in the literature (47%), the outreach calls with the decision aid led to more scheduled mammograms (47%) at the project site. The decision aid appears to promote more awareness about breast cancer screening at the project site rather than increase screening rate.

Community Engaged/Serving

Part of the UMass Boston Community-Engaged Teaching, Research, and Service Series. //scholarworks.umb.edu/engage

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