Pathways to breast health: An evaluation of an intervention to increase breast cancer screenings among women in a community mental health setting

Background: Published research suggests that women with psychiatric disorders are less likely to receive mammograms and participate in traditional mammography screening programs.  However, there is a lack of evidence for best practices to increase breast cancer screenings in this population.

Objective: To evaluate whether a pathways-style client navigation intervention is more effective than the usual case management services provided at a community mental health center.

Methods: The study was a mixed-methods, quasi-experimental, pre/post design. The intervention consisted of a personalized “pathways style” client navigation approach provided by certified community health workers. Intervention activities included risk reduction education and guided referrals to breast cancer screenings and needed follow up services. The comparison group received the usual and customary case management approach.

Results:  A total of 1,418 women over the age of 40 years were identified as potential participants. The vast majority of clients (98%) were insured; most being covered by Medicaid. Over one third (38%) of potential participants were racial/ethnic minorities.  A total of 100 women were recruited for each arm of the study.  The following outcome variables will be assessed in both groups: behavioral intentions, attitudes, readiness to change, perceived barriers, self-efficacy, and actual screenings. Personal interviews will also be used to evaluate the efficacy of and satisfaction with the services. Data analysis will be completed June 2014.

Conclusion: This will be the first study to assess a pathways-style system to increase breast cancer screening among women with mental health diagnoses.