Regina Otero-Sabogal, PhD¹, Desi Owens, MS, LCSW¹, Jesse A. Canchola, MS¹, Farzaneh Tabnak, MS, PhD², and Patrick J. Fox, PhD¹. (1) Institute for Health and Aging, University of California, San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, 415-476-3311, reginas@itsa.ucsf.edu, (2) Cancer Detection Section, California Department of Health Services, 1616 Capital Avenue, Suite 74.421, MS-7203, P.O. Box 997413, Sacramento, CA 95899-7413

Background: Given the multiple barriers on the clinic, provider, and patient levels, mammography re-screening rates are low among uninsured women. This study re-designed clinic screening practices through a multi-faceted intervention that included: 1) clinic assessments and feedback; 2) tracking systems; 3) reminder calls; 4) tailored patient education; and 5) physician prompts. The primary aim of the study was to increase patients’ mammography re-screening rates within three community clinics participating in a free state-wide mammography program, and to identify multi-level predictors of re-screening. Methods: We used a quasi-experimental design with a random selection of 447 patients at baseline. A comparable cross-sectional random sample was drawn at post-intervention. Chart reviews were conducted to establish re-screening rates. Results: Exact binomial proportion difference tests indicated significant improvements at Clinic 1 and Clinic 2 [baseline: 29.6% v. post-intervention: 46.1% (p=.003), and baseline: 38.9% v. post-intervention: 69.0% (p=.02) respectively]. At Clinic 3, where the baseline rate was the highest, there was a slight improvement in the re-screening rate following the intervention. However, this result was not statistically significant [baseline: 44.4% v. post-intervention: 48.0% (p=.60)]. Similar results were found for CBE re-screening. A stepwise multivariable logistic regression will be performed to identify substantive predictors of re-screening, and results will be reported. Conclusions: The most effective way to improve utilization of breast health services among the underserved is to implement tailored patient interventions, and system redesign.

Learning Objectives:

• Describe the process of how to assess and re-design clinic system practices that affect the delivery of mammography screening services in underserved women.
• Describe specific interventions that positively influence mammography re-screening within underserved populations.
• Identify multi-level predictors of mammography re-screening.

Keywords: Breast Cancer Screening,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.