Focused, Personal Approach for African American Women Aims to Increase Breast Imaging to Reduce Breast Cancer

An African American woman in Chicago is more than twice as likely to die of breast cancer compared with a White woman according to the Metropolitan Chicago Breast Cancer Task Force. A new program at Rush University Medical Center aims to bridge this large disparity by adding a breast health nurse navigator to the Rush team to help overcome barriers such as language, health literacy, logistics and fear that have been identified by the task force as reasons why African American women are less likely to get a mammogram than White women.

“The task force found that an estimated 70 percent of White women in Chicago over the age of 40 have received a mammogram in the last two years compared to 55 percent of African American women,” said Sharon Brown-Elms, manager, Rush Breast Imaging Center. “The recommendations of the Metropolitan Chicago Breast Cancer Task Force, a group whose leadership includes Rush’s Chief Medical Officer, Dr. David Ansell, have guided our approach.”

During the initial year, the nurse navigator will focus on decreasing no-show rates,

discouraging women from delaying or interrupting treatment, and increasing patients’ comfort level in the hospital environment.

“As a nurse, our navigator is equipped to explain complex concepts. As an individual intimately familiar with the target community, she is attuned to the needs and cultural assets of her audience,” said Brown-Elms.

When women arrive at the Rush Breast Imaging Center or Coleman Foundation Comprehensive Breast Cancer Center at Rush, the navigator will provide assistance as needed throughout the continuum of care. Her responsibilities will include ensuring timely communication of test results; coordinating appointments; mitigating fears by explaining screenings and procedures; arranging for transportation when necessary; and connecting women to support services and integrative medicine resources that can improve quality of life.

The navigator will conduct follow-up for all women who receive services at Rush’s Breast Imaging Center, contacting approximately 5,000 women during the course of the year via phone, mail, or in person. She will track the weekly no-show rate, calling those who don’t keep appointments and compassionately communicating the importance of screening.

Shama Shrestha, RN, is Rush’s first Breast Health Nurse Navigator. She sees herself as an advocate, teacher, resource and someone to talk to.

“As an advocate I help women come in for mammograms and return for biopsies by helping them overcome powerful, potentially life-threatening barriers to mammograms, whether it is fear, finances, lack of knowledge, time or transportation,” said Shrestha. “Sometimes women just need a simple reminder call with some assurance that it is important to come back and get checked out.”

The project, which is supported by a $75,000 grant from the Chicagoland Area Affiliate of Susan G. Komen for the Cure, is designed to improve access to high quality breast cancer screening, diagnosis, treatment and support services.

“Studies have shown that patient navigators who understand the strengths and needs of the target population can make a real impact on the timeliness of screenings and diagnoses as well as the coordination of treatment,” said Norma Melgoza, assistant vice president, Hospital Operations, Rush University Medical Center.

The navigator will make a special priority of building relationships in predominantly African-American neighborhoods on the South and West Sides of Chicago, offering educational presentations to church and community groups to emphasize the importance of quality in cancer screening and diagnosis.

While the nurse navigator services are available to all who need them, the program strives to reach those who are low income, uninsured and lack a regular medical provider. In 2008, Rush became the first of Chicago’s academic medical centers to serve as an Illinois Breast and Cervical Cancer Program site through a partnership with the Chicago Department of Public Health. On an annual basis, Rush provides screening and diagnostic services to approximately 700 wait-listed public health patients.

“At the Komen Chicagoland Area Affiliate, we conducted a needs assessment of our community and realized that we must address breast health disparities in underserved communities,” said Executive Director Michael Ziener. “We are confident that Rush’s Breast Health Patient Navigator Program will improve access to high-quality breast cancer screening, diagnosis and treatment services for African American women.”

Rush University Medical Center, Chicago, Illinois