4 strategies for increasing use of cancer screening

If your women’s health center isn’t swimming in clients, despite the excellence of your cancer screening services, you may need to find creative ways to link up with insured women through employers, as well as to find new sources of funding for uninsured women.

Here are four strategies used by some women’s centers for increasing use of cancer-screening services. Use these as a starting point for brainstorming unique ways for contacting the women in your area.

Strategy 1: Link up with local media to generate interest in your service.

At St. Louis Health Care Network, which consists of six hospitals, Susan Kendig, RNC, MSN, director of women’s health education, and her colleagues have a long-established relationship with the news producers at a local TV station. Kendig and her team think up ideas for health-related news stories. They outline the topic on paper, including the names of experts available to be interviewed, ask for a meeting with the producers, and present their story ideas to them.

For instance, for National Breast Cancer Awareness Month last October, Kendig and her staff presented 15 story ideas to the news producers. They chose 11 that they wanted.

"We had a clinical person with us when we pitched the story lines, which helped when they said, ‘It’s been done.’ Our clinical person was able to say, ‘Yes, but this is why it still needs to be done.’"

In the case of breast self-exams, the clinician explained that women need to be reminded repeatedly of how and why they should perform them because the majority still don’t do self-exams regularly.

The broadcasts included separate stories on who is at higher risk for breast cancer, on breast self-exams, on mammography, and on breast cancer surgery. Several of the stories dealt with social issues, such as family support for women with breast cancer and the role of women’s support groups.

The stories ran for most of a work week, with one story broadcast during the noon news show, another at 5 p.m., and a third at 10 p.m. For two hours after each broadcast, four women’s health center staffers answered calls to information hotlines. Each broadcast generated 200 to 300 calls from women who wanted more details about breast cancer, such as where to get a mammogram or whether they fall into a high-risk category. In many cases, the hotline personnel were able to refer the callers to physicians or services within the St. Louis Health Care Network.

These shows cost Kendig’s health center nothing, except for the staff time to come up with the story ideas, pitch them to the producers, be interviewed on air, and answer the hotline calls.

Strategy 2: Work with local employers to get women to take advantage of their health plan’s mammography coverage. (If it doesn’t exist, see Strategy 3, below.)

Mammograms must be made more accessible, says John Coronna, executive vice president of the Industry’s Coalition Against Cancer in Huntington, NY. This nonprofit alliance of manufacturers, small businesses, cancer centers, and health organizations is dedicated to early detection of cancer through education and screening in the workplace.

"If you leave it up to employees [to get mammograms], most will never get around to it," Coronna says. Employers need to be made aware that cancer screening is a win-win situation for the company and its employees, because the direct and indirect costs of late detection of breast cancer can be 10 times more than the cost of cancer caught in an early stage, he says. (See handout in Women’s Health Center Management, September 1996, supplement.)

Coronna recommends work-site screening on company time, whenever possible. When it’s not (because, for example, there is no mobile mammography unit available), Coronna suggests that women’s health centers ask employers to give employees paid leave for off-site mammograms, with transportation assistance if necessary.

Strategy 3: Make it more likely that your services will be used by major employers by meeting with benefits managers before they negotiate health care contracts.

Marilyn Stockman, RNC, director of women’s services for Health Midwest, a network of 14 hospitals and 28 physicians’ services in and around Kansas City, MO, makes a point of meeting annually with the benefits directors of major employers, with a view of influencing them to make prenatal care and mammography integral to their health care benefits package.

"It’s important to meet with the benefits people before they sign on the dotted line [with their health plan providers]," she said. "Employers really do call the shots. We give them the information they need to go and fight their battles [with their providers] for covering our services."

Strategy 4: Seek government funding for unemployed or indigent women who are not covered by a workplace health program.

Federal funds to screen lower-income women for breast and cervical cancer may be available in your state for women 50 and older.

"Women at 200% to 250% of the federal poverty guidelines are covered for mammograms and Pap smears," says Brenda Nickerson, RN, MSN, director of the division of cancer prevention and control of the South Carolina Department of Health and Environmental Control in Columbia. "For most states, that’s almost middle income."

For more information about this program, contact your local state health department and ask to speak with the program director for the Breast and Cervical Cancer Control Program. (See story on Avon’s funding for breast cancer outreach programs, below.)