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breast assessment


									Breast Cancer Screening
  and Latina Women:
            Findings on Barriers and
               Supporting Factors

  Presenters: Barbara Clifton Zarate, Meghan Clouse,
       Tamra Groode, and Mariana Zuzunaga

  Community Adjunct Facility: Kim Cox, MPH, Maria
    Barsa, BS, and Andrea DuBrow, MSW, MPH

Women’s Health Partnership website
Women’s Health Partnership
 • WHP is a project of the Community Wellness and
   Prevention Program (CWPP) of Contra Costa
   Health Services (CCHS)

 • WHP was developed to increase health care
   access, decrease mortality rates from reproductive
   cancers, and address other health disparities that
   affect underserved women in Contra Costa County
         Background Statistics
• One in every 12 Latina               • The Latino population
  women will develop breast                  represents 17.7% of
  cancer sometime during her             the total Contra Costa
  lifetime (WHP, 2003)
                                            County population
                                            (U.S. Census, 2002)

• The incidence of breast
  cancer for all women in
  Contra Costa County is the        • The highest concentration
  second highest in the State of      of Latina women over the
  California; the highest rate in     age of 40 in Contra Costa
  California is among Latina                 is in Central County
                                                    (CCBCP, 1995)
  (CCBCP, 1995)
       Project Description
• Look at factors that could lead to increase
  early detection of breast cancer among Latina
  women over age forty living in Central Contra
  Costa County

• Determine what the supportive factors and
  barriers are that enable Latina women to
  access breast cancer screening services
  Methodology                               Community
          1 Focus Group
          October 2003

  Monument Corridor                    3 Community Forums
Concord/Central County                     August 2003

Spanish Speaking Latina              San Pablo/West County
  women over 40 who                  Concord/Central County
received a mammogram                  Pittsburg/East County

                  All women living in CCC accessing cancer
                  screening services for reproductive cancers
       Outreach/ Recruitment
Focus Group
• Distributed 700 fliers

• Networked with community
  advocates and organizations

• Provided $25 stipend, dinner,
  and child-care to participants

Community Forums
• CCHS mailed 1000
            Coding: Focus Group
                         1 Focus Group
                  Years of          Years in       Health
                 Education          the U.S.      Insurance
   58 (2)            6 (2)
                                 >10 years (2)     Yes (1)
    44                12
                                 < 10 years (2)    No (3)
     41               16

• Qualitative Data

• Transcribed/ translated
  2 hours of audio tape
   Coding: Community Forums
                                     2   1
• Coded summaries             7
  provided by CCHS
• Included variables     11
  that were present in                   n=4
  all 3 community
                                  Community Member
                                  CBO Staff
                                  CCHS Staff
• Common and
  consistent themes               Medical Provider
      Supportive Factors
Focus Group            Community Forums

Personal             Personal and clinic staff
knowledge/           knowledge/awareness
                     Family Support
Family Support
                     Access to community
Having concern for   clinics
own health
Spanish language
television as main   Linguistic and cultural
information source
                     competency of providers
         Findings: Barriers
Focus Group                    Community Forums
Language                    Language
Fear                        Fear
Health insurance or         Health insurance or money to
money to cover services     cover services

Lack of information         Education or knowledge
regarding services          about reproductive cancers

No local family support     Lack of cultural competency
                            of community clinics
Providers rushed services
without care to women’s     Transportation
health concerns
        Focus Group                 Community Forums

• Loss of key community         • Community forums did not
  liaison due to change of        just focus on breast cancer
• Outsiders to the community    • All community forums were
• Lack of response to focus       held in the month of August
  groups                          due to funding
• Small sample size             • Low attendance
• Time due to school schedule
• 1 woman was unclear about
  definition of a

• Feedback from providers, advocates, and patients
• Range of perspectives
• After focus group, provided education about breast
• All focus group participants came from fliers/ networking
• Incentives both addressed/anticipated barriers
  (knowledge, food, child-care, stipend, transportation)
• Students and host organization are
  culturally/linguistically competent
• Collaboration with students and host organization
Provide culturally/linguistically competent and sensitive

Promote free and/or low-cost breast cancer screening
services for Latina women, including uninsured and

Provide mentor/peer support groups for Latina women

Provide information on breast health/breast cancer
screening at younger age

Maintain patient, provider, and community (schools)
collaboration as a priority

Primary focus on Spanish language television for

Working with family unit
        • Women that
          participated in the focus
        • Participants of the
          community forums
        • Kim Cox, MPH, Maria
          Barsa, BS, Jennifer
          Balogh, MSW, MPH, and
          Andrea DuBrow, MSW,
        • Roma Guy, MSW
        • Mia Luluquisen, DrPH,
          MPH, RN

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